Hamad Medical Corporation’s Planetree journey lays out a pathway for person-centered care implementation across an expansive healthcare system. The pathway starts with a powerful vision fully embraced by leadership. That vision is brought to life through infrastructures that enable patients, families and staff to work toward shared goals. A set of defined standards ensures consistency while supporting versatility to meet diverse and evolving needs.
On December 18th, the entire country of Qatar celebrates Qatar National Day with immense pride in the country’s history and future. A hallmark event is the Qatar National Day Parade, a cavalcade of national dignitaries, military figures and others. In 2020, attendance at the parade was limited due to COVID-19, but the national pride was unmistakable. Perhaps that’s because leading the parade were hundreds of the country’s frontline healthcare workers. On a day that traditionally honors the country’s greatest heroes, healthcare workers were fittingly front and center. Mr. Nasser Al Naimi, Deputy Chief of Quality of the Center for Patient Experience and Staff Engagement and Director of the Hamad Healthcare Quality Institute for Hamad Medical Corporation (HMC), the main provider of secondary and tertiary care for all of Qatar, led this effort. The parade recognized the extraordinary courage and selflessness exhibited by all healthcare workers during the pandemic. Their efforts have resulted in Qatar having among the lowest COVID-19 death rates worldwide.
Poised to Respond
The Qatari health sector’s ability to respond so effectively to the crisis is credited to strategic investments made over time to build capacity, increase access to the best quality care, and elevate the patient and staff experience. These measures ensured the system was well-equipped to respond to the pandemic. They have also positioned Hamad Medical Corporation among the world’s premier healthcare providers.
A History of Service
HMC’s history is one of service to the population of Qatar. It was established by Emiri decree in 1979 to meet the specific cultural and healthcare needs of the country’s residents. Qatar has grown and become more diverse in the ensuing years and the populations’ needs have evolved. HMC has done the same, guided by a national quality strategy set forth by the Ministry of Public Health, led by Qatar’s Minister of Public Health, Her Excellency Dr. Hanan Mohamed Al Kuwari, who also serves as HMC’s Managing Director. With a goal of improving the healthcare infrastructure within the country, HMC opened new hospitals, introduced new service lines, invested in state-of-the-art technology and focused on integrating services across the entirety of the health sector.
Striving for a Superior Patient Experience
But HMC leaders recognized there is more to providing best in class healthcare care than offering the best facilities and the latest technology. This led to a sweeping commitment to set a new standard for healthcare in the country – one where patients have access to the care they need when they need it, but also in a way that meets their needs for information, responsiveness, involvement in decision-making and compassion in all interactions. The goal? To not only improve quality of care, but to deliver a superior patient experience.
The Power of Listening
To spread this vision across the growing network, HMC established the Center for Patient Experience and Staff Engagement (CPESE). With more than 250 patient experience staff working across all HMC facilities, CPESE is a driving force for engaging with patients and staff to improve the care experience.
Fundamental to this work is listening to the needs of patients, families and staff to understand what matters most, what is working and what is not meeting expectations. To hear these vital voices, HMC established the Nesma’ak customer service program. The program includes call centers and information desks located across the system, as well as a “walk-around” initiative to ensure leaders connect with patients and staff first-hand. Nesma’ak translates into “We are listening,” a way of reinforcing HMC’s culture of service to the population.
Nesma’ak translates into “We are listening.”
The Challenges of Transforming Culture Across A Complex System
The creation of the Center for Patient Experience and Staff Engagement (CPESE) and the Nesma’ak program provided the leadership and structure essential for reaching patients and staff across all of HMC. They are the anchors for HMC’s person-centered care strategy.
The introduction of the Planetree model in 2018 equipped HMC with a missing piece to the transformation effort — a set of defined and measurable standards for achieving excellence in person-centered care.
The Planetree Certification Program was the guide for turning the change vision into action and outcomes. The criteria offered consistency and versatility for how each site within HMC would meet the goals. They also provided the CPESE team and each site’s leadership with clear targets and priorities for advancing the effort.
A Layered Approach – Engaging at the System, Site and Individual Level
Initially, five HMC sites were selected to implement the Planetree model, supported by CPESE. To test the model in diverse settings, HMC piloted Planetree in a range of settings, including acute care, ambulatory care, long-term care, and home care. A standardized approach was used to first prepare CPESE staff to support the implementation effort. From there, Planetree engaged with leaders and staff at each location to personalize the roll-out to their specific needs and patient populations.
Staff Education
The effort emphasized providing HMC staff with the education, training, knowledge, and metrics necessary to successfully improve person-centered care. A universal priority was staff training across all the locations to ensure compassion as a standard of care. Planetree facilitators trained 96 HMC staff to deliver experiential compassion training. This train-the-trainer model enabled HMC to quickly reach a critical mass of staff. Within months, 1,000 staff members had gone through the training.
Multi-Disciplinary Teams
Planetree supported each site in launching multi-disciplinary Person-Centered Care Steering Teams. Empowering the site-based teams was instrumental for building ownership and engagement within each location. These teams identify site-specific priorities, execute improvement plans and track progress against the Person-Centered Care Certification Program performance benchmarks. Quarterly, staff and PCC champions from each facility come together as a system-level group that coordinates collaboration across all the sites.
“We are working to ensure patients feel confident in their treatment journey, feel connected to their care teams and engaged in their own care. Our ultimate goal is to deliver the best patient experience possible .”
– Mr. Nasser Al Naimi
Patient and Family Partnerships
In addition, each location recruited patients and families to join a Patient and Family Advisory Council (PFAC). Today, PFACs at each of the sites meet monthly to ensure the patient/family experience is designed around their expressed needs and priorities.
Developing and Sharing Best Practices
This work has resulted in the development of a number of exemplary person-centered care practices that have been spread across HMC. To further amplify this good work, HMC launched the Patient Experience Forum. The inaugural event was held in November 2019. It drew over 2,000 attendees and included speakers from across the globe. The forum highlighted the importance of involving patients, their families and caregivers in every decision that affects their care.
The Impact
Today, HMC’s journey to excellence in person-centered care has generated tremendous momentum. The cultural transformation is unmistakable. In focus groups, patients and staff alike have consistently expressed that they not only feel cared for, but cared about. Partnership is expressed through shared decision-making, meetings with the care team, patients having access to their medical records and being kept informed of their status and treatment, every step of the way.
The success of the initial pilot sites to pursue Certification has propelled the system to expand Planetree implementation to other locations. To further understand the depth of the impact on the culture, HMC has deployed a Caring Culture Survey, a validated tool designed to measure the amount of caring and empathy in an organizational culture. Teams across locations consistently scored highest on measures related to showing empathy and caring to patients and co-workers, feeling pride in the work they do and being able to tune in and really focus on patients.
Marching On
This piece started with a parade. Parades don’t just happen. They can’t be willed into existence. They take careful planning and coordination, a pre-determined route and appropriate pacing. Finally, it takes leadership out front, leading the way to keep everyone moving forward in the same direction.
Such has been the story of person-centered care implementation at Hamad Medical Corporation.
