WRHA first to gather patient, employee feedback

What if patients could rate their experience with Manitoba’s health-care system the same way shoppers rate their online experience or customer service support?

The Winnipeg Regional Health Authority has started pilot projects to gather feedback from patients and employees to improve health services, which is believed to be the first time in Canada a health body has adopted the practice that’s widely used in the private sector.

In the U.S., automated technology is used by the federal veterans affairs department to gauge veterans’ interactions with the publicly funded health-care system they have access to.

It started surveying them and their families when the department was plagued by long wait times, public scrutiny over coverup allegations, and a suicide crisis.

Lee Becker, who was chief of staff for veterans’ experience at the U.S. department from 2016 to 2020, spoke to public relations professionals in Winnipeg last week.

He talked about how he used customer-feedback technology to improve patients’ experiences and rebuild trust in the system. Becker spoke to the Free Press about how the same techniques can apply to Manitoba’s health-care system.

“It all starts with the data. You have to have the data that is really connected to understanding the people that you serve. That is the key piece,” said Becker, who is senior vice-president for Medallia. The company uses proprietary artificial-intelligence technology for its customer-experience management platforms that are used by Apple, Marriott hotels, and recently in Canada, Via Rail.

To date, no health agency in Canada is using Medallia’s technology, but health and government agencies in the U.S. have followed in veterans affairs’ footsteps.

Becker said the department was in crisis around 2014.

“Essentially, it was a crucible moment for the VA where change had to happen.”

The Veterans Health Administration is the largest integrated health care system in the U.S., which provides care at 1,321 facilities, including 172 medical centres and 1,138 outpatient sites, for nine million veterans each year.

Becker said its patients weren’t getting access to care and his team was tasked with finding out why and figuring out how to fix it.

“My remit was to help change the culture, help put in place a customer-experience strategy to improve the veterans’ experience,” said Becker, who is a U.S. Navy veteran who had worked as a trauma nurse.

His team’s first public trust survey showed only 55 per cent of respondents had any trust in the veterans affairs department.

When he left the job, it had reached 90 per cent.

He credits the improvement to making sure the department had the ability to listen to patients every step of the way through their interaction with the health-care system. Immediate, short surveys were sent by text or scheduled callbacks with patient relations staff.

It meant the department was checking in to make sure patients could schedule the appointment they needed, or make sure they had received the right medication.

“Any moment that a patient is interacting with the health-care system, there should be a way that we should be able to get their feedback — and it’s not a thousand-page survey. It’s just a quick pulse to say, ‘Did you get what you needed?’”

In one case, Becker said they learned via patients’ comments that a regional centre was cancelling surgeries due to a lack of supplies. There was a problem with sterilization of equipment that hadn’t come to the attention of officials in the central office, but once they knew about the problem, they could fix it.

In another case, the technology saved a life, Becker said. A veteran who was leaving a hospital pharmacy responded to a feedback request saying they were considering self-harm. “They shared that they were not doing well and they wanted to hurt themselves. They felt they were in crisis. So the system automatically picked it up, and we were able to use that information to help that veteran.”

The person was still on hospital premises and they were admitted for further treatment.

The artificial-intelligence technology was adapted to detect when someone is in crisis and put them through to a crisis phone line.

“There’s been over 20,000 veterans’ lives saved just by that process alone, which is super-powerful,” Becker said.

If focusing on patient experiences’ worked for the U.S. veterans health system, it can work for Manitoba’s health system, he said.

“I see a vision of where health care in Manitoba is the most trusted health care in Canada, something like that. I can see that headline as they apply these principles and these ideas,” Becker said. “It’s an exciting time.”

It requires a “culture change” from a paternalistic view of health care, he said.

“Traditionally, it’s, ‘Well, I know what’s best for you.’ Yeah, but you’re not really listening to me… What’s great is, we’re seeing this whole movement around, it’s more than (that), it’s the human experience.”

The Winnipeg health authority launched a patient-experience pilot project in October 2023 and just started a similar pilot to gather feedback from home-care employees.

The patient experience project “mirrors the methodology and philosophy that Mr. Becker implemented during his time at veterans affairs,” said WRHA spokesman Scott Sime.

He said the authority’s board has issued a mandate to transform the culture and timeliness of services.

“A key part of this depends on us being able to move from reacting to issues and gaps to being able to effectively anticipate the needs and expectations of our patients, clients, residents and staff. This cannot happen without really listening to them, making sense of a lot of real-time feedback, and taking action on what we find all across our region,” he stated.

“We are encouraged by what we’re seeing, hearing, and learning. We are looking forward to building on these pilot (projects) to help make sustainable changes to benefit everyone.”

katie.may@freepress.mb.ca