FOCUS AREA CLUSTERSPATIENT AND EXPERT TAKEAWAYSTRANSCRIBED DATA

Patient 01 Patient 02

SME 01 SME 02

Focus Area 3

Focus Area 2

Focus Area 1

Opportunity 3

Opportunity 2

Opportunity 1

OPPORTUNITY RECOGNITIONRAW DATA OUTCOMES

Interview Notes

Workgroup Minutes

Observations

Opportunities

Ideas

Patient Journey

Patient Journey

QDM/HCAHPS/Grievances

Patient & SME Interviews

1 2 3

4 5 6

7 8 9

The cystectomy journey seems simple when viewed as a series of touch points at which patients interact directly with UCLA.

REFER

RAL T

O UCLA

DECISI

ON FOR SU

RGERY

PREO

PERA

TIVE C

LEARA

NCE

DAY OF S

URGERY

HOSPITA

L STAY

DISCHARGE

POST

OPERA

TIVE V

ISIT

SYM

PTOM

S

TURB

T

CANC

ER D

IAGN

OSIS

INFO

RMAT

ION

SEEK

ING

DISC

USSI

ON O

F SU

RGER

Y

PREA

UTHO

RIZA

TION

SCHE

DULE

SUR

GERY

NEOA

DJUV

ANT

CHEM

OTHE

RAPY

PREO

PERA

TIVE

CLE

ARAN

CE

URIN

ARY

DIVE

RSIO

N TE

ACHI

NG

PERS

ONAL

AFF

AIRS

BOW

EL P

REP

/ NPO

STA

TUS

PREO

PERA

TIVE

HOL

DING

FAM

ILY IN

WAI

TING

ROO

M

ROBO

TIC

OR O

PEN

CYST

ECTO

MY

PACU

HOL

D

PAIN

MAN

AGEM

ENT

AMBU

LATI

ON

HOSP

ITAL

RECO

VERY

STOM

A / C

ATHE

TER

TEAC

HING

TOLE

RANC

E OF

DIE

T

DISC

HARG

E HO

ME

CANC

ER C

URED

FATI

GUE

/ WEI

GHT

LOSS

/ FT

T

URIN

ARY

CONT

ROL

DEPE

NDEN

CE O

N OT

HERS

ER V

ISIT

/ RE

ADM

ISSI

OM

BOW

EL R

ECOV

ERY

REGA

IN F

UNCT

IONA

LITY

RETU

RN T

O NO

RMAL

ACT

IVIT

IES

But the actual journey includes many more steps for patients…

REFER

RAL T

O UCLA

INITIAL V

ISIT W

/SURGEO

N

TREA

TMEN

T OPT

IONS & PL

AN

DAY OF S

URGERY

HOSPITA

L STAY

AT HOME R

ECOVER

Y

DISCHARGE

SYM

PTOM

S / T

URBT

CANC

ER D

IAGN

OSIS

INFO

RMAT

ION

SEEK

ING

DISC

USSI

ON O

F SU

RGER

Y

PREA

UTHO

RIZA

TION

SCHE

DULE

SUR

GERY

NEOA

DJUV

ANT

CHEM

OTHE

RAPY

PREO

PERA

TIVE

CLE

ARAN

CE

URIN

ARY

DIVE

RSIO

N TE

ACHI

NG

PERS

ONAL

AFF

AIRS

BOW

EL P

REP

/ NPO

STA

TUS

PREO

PERA

TIVE

HOL

DING

FAM

ILY IN

WAI

TING

ROO

M

ROBO

TIC

OR O

PEN

CYST

ECTO

MY

PACU

HOL

D

PAIN

MAN

AGEM

ENT

AMBU

LATI

ON

HOSP

ITAL

RECO

VERY

STOM

A / C

ATHE

TER

TEAC

HING

TOLE

RANC

E OF

DIE

T

DISC

HARG

E HO

ME

CANC

ER C

URED

FATI

GUE

/ WEI

GHT

LOSS

/ FT

T

URIN

ARY

CONT

ROL

DEPE

NDEN

CE O

N OT

HERS

ER V

ISIT

/ RE

ADM

ISSI

OM

BOW

EL R

ECOV

ERY

REGA

IN F

UNCT

IONA

LITY

RETU

RN T

O NO

RMAL

ACT

IVIT

IES

That positively and negatively impact the overall experience

Cancer Toll

SUPPORT (PATIENT-FACING)

reluctance, guilt, fear, essential, family, friends

NEOBLADDERleakage, tubes,

maintenance, satisfaction

STOMAbody image,

odor, leakage, lifestyle change,

support, education

(timing/duration/quality),

appliance, suppliesCAREGIVER

ROLEScoach, advocate,

nurse, coordinator, cheerleader,

teacher, head of houseCAREGIVER

BURDENhousing, full time, cost, worry, fear, eased by others, assumed roles

RECOVERYhome support,

function, independence,

hobbies, weight, nutrition, sexual function, energy, family, job, mood

DISCHARGEtiming,

information, point of contact

HOME NURSEvariability,

stoma, invested,

immediate

MEDICAL CARE

variation, evidence-based, expert, thorough, consistent, cancer

control, appropriate,

CHEMOTHERAPY

benefit vs. toxicity,

delivery, stigma

COMPLICATIONS

bowel, anemia, infection,

informed, dx / tx, setback, ER, readmission

MOBILITYdelayed, PT, resources,

orders

PAINcontrol, NG, epidural vs.

IV, side effects, non-

narcotic CARE

ENVIRONMENT

chaotic, disruptive, alarms, sleep

trouble, PACU hold, limited resources,

computer time, work arounds

NURSINGefficiency, empathy,

competence, stoma comfort,

turnover, handoffs, morale

STAFFtimeliness

, variability in CICARE,

PHYSICIANScoach, advocate,

nurse, coordinator, cheerleader,

teacher, head of house

CARE COORDINATION

point of contact, connectedness, MD

access, myUCLAhealth, confidence in UCLA,

thorough, convenience, timeliness,

fragmentation, duplication

UCLA BRANDresearch,

trust, academic,

personalized

KNOWLEDGE GAPS

nutrition, “prehab”, recovery,

neobladder, stoma, risks, lifestyle

impact

INFORMATIONaccuracy, timeline, goals, expectations,

completeness, decision-making, regret, stickiness, honest, relatableEDUCATIO

Ntype, source, perspective, accessibility

empowering through

education

Cancer Toll

coordinating care across the journey

fostering a healing

environment

preparing patients for

lifestyle change

accelerating functional recovery

bolstering patient support

mechanisms

12

13frogThink © 2013 frog. Confidential & Proprietary.

Opportunity to Idea

Contests & Culture Building

I don’t eat all that other stuff…

I thought I was only supposed to eat lettuce and tomatoes…

Elderly LEP patient

‘intoxicado’ = $71 million

8 Bedside RNs

Subject Matter Experts

3 NPs

4 Cardiologist

4 Fellows

10 Residents

6 Medical Student, Clinical & industrial psychologist, Social Worker, Care Partners, Patient Expert

Cardiac Observation Unit (COU) General Internal Medicine & Health Services Research

Cardiac Care Unit (CCU) Bilingual Cultural Initiative Medical Psychology Assessment Center at Semel Institute for Neuroscience and Human Behavior

Cardiology UCLA Innovation in Health

Interpreter Services ValU/Quality

Nursing Department Leadership Performance Excellence

Pediatric Voice

I have to tell my parents that I’m not getting any better…

I don’t want to be reminded of my disease…

16 year old patient

Mother of a hospitalized infant, who is a nurse herself, stated that she “loves bedside rounds” but the nurse was present on rounds only about half of the time.

Mother of 6 year old child hospitalized for leukemia had concerns that her

child kept getting woken up in the night for trash being removed from the room.

Mother of 6 year old admitted multiple times with leukemia, who is unclear of the roles of the medical students/doctors on the team.

Innovation Shark Tank 2016

“The Patient Voice project changed how I view the care I deliver on a routine basis…

Our Department discovered a spectrum of actions we could take to enhance the value of care we deliver to our patients…

It all started with asking them about their care.”

  Christopher Saigal MD, MPH