DOMAIN NAME: Hospitality and Healing Services

DOMAIN OVERVIEW: Understanding the scope, structure and influence of critical hospitality and healing touch-points that can influence and impact overall experience.

DOMAIN LEARNING OBJECTIVES (3-5):

  1. Define ‘hospitality’ within healthcare, identifying the scope and core services that contribute to its function.
  2. Define “healing”, identifying the optimum environment for its occurrence, including the various “healing services”.
  3. Designate the key behaviors, assumptions, attitudes, values and skills, necessary to foster a culture of patient and family centeredness.
  4. Explain evidence-based practices for introducing healing touchpoints that positively impact the patient experience.
  5. Understand how to measure, sustain programs and build ongoing communication to promote these services to engage staff, align leadership, and garner support from the community.

DOMAIN OUTLINE

Section 1Hospitality

Objective:Define ‘hospitality’ within healthcare, identifying the scope and core services that contribute to its function.

Outline of Concepts

  1. Defining ‘hospitality’
  2. Commonalities to other industries
  3. Differentiations specific to hospitals
  4. Challenges specific to healthcare
  5. Disease states
  6. Orientation/mentation issues
  7. Physical limitations
  8. Altered state of health
  1. Target audience
  2. Patient
  3. Family
  4. Community
  5. Employees/Physicians: engagement/satisfaction
  1. Non clinical hospitality elements
  2. Hospitality design
  3. Removal of architectural barriers
  4. Solitude
  5. Family involvement
  6. Overnight accommodations for family
  7. Wayfinding solutions
  8. Signage
  9. Pre-admitting tours
  10. Print materials to include driving directions, parking accommodations, hotel availability
  1. Valet Services
  2. Concierge Services
  3. Patient- alleviation of stress, concentrate on healing
  4. Employee- work life balance, improved attitudes toward employer, retention
  1. Amenities
  2. Luxury Services
  3. Sustainability design
  4. Experiential design
  5. Technology
  6. Efficiency
  7. Timeliness
  8. Accuracy- to include right patient, right meds, allergy recognition
  1. Aromatherapy,
  2. decrease anxiety, relieve fears
  3. augment pain management modalities
  1. Incorporating the arts
  2. storytelling
  3. movies
  4. entertainment
  5. music, poetry
  6. crafts
  1. Designing Touch points
  2. First impressions
  3. Last impressions
  4. Scripting key words and phrases

Section II Healing

Objective:Define “healing”, identifying the optimum environment for its occurrence, including the various “healing services”.

Outline of Concepts

  1. Definitions
  2. Holism – Process of becoming whole (integration of mind/body/spirit/emotions)
  3. Spirituality (differentiate from religion: Some individuals may be religious and not spiritual, while others are spiritual and not religious, and others are both)
  4. Curing (“doing to”) vs. Healing (“being with”)
  5. Curing: “What’s wrong with you?” or “How can I fix this?”
  6. Healing: “How can we help you live your life fully?” or “What matters most to you?”
  1. Optimal healing environments (OHE)
  1. Optimal Healing Environments (OHE): 7 components as defined by the Samueli Institute
  1. Internal Component
  2. Creating Healing Organizations
  3. Organizational and leadership support for OHE structure & processes (mission, culture, teamwork, technology, evaluation service)
  4. Interpersonal Components
  5. Developing Healing Intention
  6. Hope, belief & expectation related to recovery/healing process
  7. Cultivating Healing Relationships
  8. Core concepts – Presence, intention, mindfulness, compassion, empathy, effective listening
  9. Access to social support
  10. Friends/family
  11. Spiritual/pastoral care
  12. Spiritual Practices
  13. Behavioral Components
  14. Applying Collaborative Healthcare
  15. Offering options and choice for individualized care
  16. Integrative Healing Modalities (4 domains):

MIND-BODY
Animal-Assisted Therapy
Music Therapy
Biofeedback
Meditation
Prayer
Yoga / ENERGY & BIOFIELD
Therapeutic Touch
Healing Touch
Acupressure
Acupuncture
Reflexology
Reiki
MANIPULATIVE/
BODY-BASED
Relaxation / Imagery
Massage
Tai Chi / BIOLOGICALLY-
BASED
Essential Oils

Reference: Snyder M & Lindquist R. (2009). Complementary/Alternative Therapies in Nursing. New York: Springer.

  1. Experiencing Personal Wholeness (Mind-Body-Spirit-Energy)
  2. Practicing Healthy Lifestyles (Patients and staff)
  3. Diet
  4. Exercise
  5. Relaxation
  6. Balance
  1. External Component:
  2. Creating Healing Spaces
  3. Access to nature
  4. Positive distraction (use of color, light, aroma, music, artwork, architecture)
  5. Elimination of environmental stressors

Section IIIFostering a Culture of Patient & Family Centeredness

Objective: Designate the key behaviors, assumptions, attitudes, values and skills, necessary to foster a culture of patient and family centeredness.

Outline of Concepts

  1. Definitions
  2. Culture
  3. Behavior
  4. Values
  5. Skills
  6. Leadership’s Role
  1. Fostering a patient centered
  2. Mission and Vision
  3. Values
  1. Uniqueness-personalizing and humanizing the experience
  2. Cultural considerations, lifestyles, interests, preferences
  3. Identifying and addressing patient’s fears and concerns
  4. Promoting Open Communication and Information-Sharing
  1. Expectations
  2. Employee Engagement
  1. Behavioral hospitality elements
  2. Employee selection
  1. Hiring practices-engaging scientific methods of hiring
  2. On-boarding
  3. Hospitality training
  4. Empowering employees
  5. Patient/Family Rounding
  6. Service recovery
  7. Accountability
  1. Patient and Family Involvement
  1. Perceptions
  2. Involvement in their own care
  3. Open Chart Policy: patient access to medical records
  4. Self-medication programs
  5. Care Conferences
  6. Family care partner involvement
  7. Voice of the Patient

Section IVIntroducing Healing Touchpoints to Positively Impact the Patient Experience

Objective: Explain evidence-based practices for introducing healing touchpoints that positively impact the patient experience.

Outline of Concepts

  1. Definitions
  1. The Patient Experience – Beryl Institute
  2. Touchpoint
  3. In general
  4. Healing Touchpoints: interactions/moments in which the healing process is fostered and/or continued
  5. Emotional Touchpoints
  1. Examples of Touchpoints across the Healthcare continuum
  1. Internal OHE
  2. Need
  3. Diagnosis
  4. Education
  5. Evaluating Healthcare Providers
  6. Financial Paperwork
  7. Medical Paperwork
  8. Contact information
  9. Referring Physician
  10. Scheduling
  11. Choosing a Healthcare Provider
  12. Call Center
  13. Front Desk staff
  14. Contact information
  15. On-line assistance
  16. Family/Friends
  17. Visit
  18. Ease of and available Parking
  19. Orderliness and organization of services and processes
  20. Way-finding
  21. Check-in
  22. Waiting area
  23. Nursing care
  24. Physician care
  25. Support Services: room service, menu delivery, housekeeping, mail/email services, flower delivery, newspapers
  26. Response to special needs
  27. Treatment
  28. Assessments
  29. Diagnostics/exams
  30. Follow Up
  31. Instructions (verbal/written)
  32. Hand-offs
  33. Staff assistance
  34. Call backs for assistance
  35. Communication with referring
  36. Prevention plan
  37. Follow-up visits
  38. Patient portal
  39. Interpersonal OHE
  1. Need
  2. Diagnosis
  3. Education (verbal)
  4. Evaluating Healthcare Providers
  5. Patient’s family/friends and their word-of-mouth, perceptions, and similar
  6. Referring Physician
  1. Scheduling
  2. Choosing a Healthcare Provider
  3. Call Center
  4. Front Desk staff
  5. Family/Friends
  6. Visit
  7. Way-finding
  8. Employee appearance
  9. Employee greeting/friendliness/offers to assist
  10. Knowledge of staff: services, physical environs, etc.
  11. Check-in
  12. Waiting area
  13. Nursing care
  14. Physician care
  15. Treatment
  16. Assessments
  17. Diagnostics/exams
  18. Faculty/Medical staff
  19. Support staff
  20. Volunteers
  21. Follow Up
  22. Instructions (verbal)
  23. Hand-offs
  24. Staff assistance
  25. Call backs for assistance
  26. Communication with referring
  27. Prevention plan
  28. Follow-up visits
  1. Behavioral OHE
  2. Need
  3. Diagnosis
  4. Education
  5. Evaluating Healthcare Providers
  6. Referring Physician
  7. Scheduling
  8. Choosing a Healthcare Provider
  9. Call Center
  10. Front Desk staff
  11. Contact information
  12. On-line assistance
  13. Family/Friends
  14. Visit
  15. Orderliness and organization of services and processes
  16. Way-finding: is assistance offered or not
  17. Check-in
  18. Waiting area
  19. Nursing care
  20. Physician care
  21. Support Services: room service, menu delivery, housekeeping, mail/email services, flower delivery, newspapers
  22. Response to special needs
  23. Hand hygiene compliance
  24. Treatment
  25. Assessments
  26. Diagnostics/exams
  27. Follow Up
  28. Instructions (verbal/written)
  29. Hand-offs
  30. Staff assistance
  31. Call backs for assistance
  32. Communication with referring
  33. Prevention plan
  34. Follow-up visits
  35. Patient portal
  36. External OHE
  37. Need
  38. Education (written/video)
  39. Evaluating Healthcare Providers
  40. Financial Paperwork
  41. Medical Paperwork
  42. Contact information
  43. Scheduling
  1. Scheduling
  2. Choosing a Healthcare Provider
  3. Contact information
  4. On-line assistance
  5. Email
  1. Visit
  1. First sight
  2. Cleanliness of grounds and parking lot/garage
  3. Way-finding/Signage
  4. Cleanliness of facility
  5. Cleanliness of restrooms – public and personal
  6. Restroom supplies
  7. Check-in
  8. Waiting area
  9. Ease/intuitiveness of navigating
  10. Noise level
  11. Lighting
  12. Feeling safe (perception of safety both outside and within the facility)
  13. Parking Signage/Information
  14. Way-finding/Directional Signage
  15. Check-in
  1. Treatment
  1. Equipment: cleanliness, placement, availability, noise of, age, etc.
  2. Assessment information
  3. Diagnostics/exams
  4. EMR/Patient Portal
  5. Care team informational brochures
  6. White boards/similar
  7. Other communication to and with patient
  1. Follow Up
  1. Discharge/leaving campus
  2. Follow-up visits
  3. Instructions (written/recorded/online)
  4. EMR/Patient Portal
  5. Email
  6. Prevention plan (written)
  7. Online scheduling
  1. Key to Creating Healing Touchpoints
  1. Fidelity to brand promise; consistency
  2. Compelling and differentiating (positively memorable) feelings/emotions are relevant and resonant
  1. Evidence-Based Practices for Introducing Healing Touchpoints
  1. “Outside-in” focus – patient shadowing
  2. Strengths of this approach
  3. Limitations
  4. Emotional Touchpoint Patient Storytelling and Interviewing
  5. Strengths of this approach
  6. Limitations
  7. Experience/Journey Mapping
  8. Strengths of this approach
  9. Limitations
  10. Journey Mapping vs. Internal Touchpoint Mapping
  11. Differences
  12. Why Journey Mapping is best-practice over Internal Touchpoint mapping
  13. The Kano Model/Touchpoint Mapping: prioritizing Touchpoints
  14. Strengths of this approach
  15. Limitations

Section VMeasure, Sustain, and Promote

Objective: Understand how to measure, sustain programs and build ongoing communication to promote these services to engage staff, align leadership, and garner support from the community.

Outline of Concepts

  1. Definitions
  1. Measure – Determination of methodologies to benchmark and track effectiveness of programs
  2. Sustain—More than launching programs, make sure the quality and enthusiasm from the launch is maintained
  3. Communicate—Develop understanding of venues and outlets to communicate to patients, families, staff, leadership and the community at large
  1. Measure, sustain, Promote
  1. Internal Component
  2. Measure program effectiveness
  1. Align department leadership to understand the benchmarks and the goals of the programs. These may include HCAHPS, Press Ganey, Picker and others.
  2. Demonstrate effectiveness of initiative
  3. Promote inter-departmental communication and collaboration, i.e. EVS, nutrition, pastoral, patient life, etc.
  1. Interpersonal Components
  2. Sustain
  1. What to do after the “honeymoon period” is over
  2. Engage staff to continue excellence
  3. Survey: Know what patients and their families think about programs
  4. Evaluating staff response and engagement
  5. Creating metrics based on patient perceptions
  6. Developing a service culture to grow staff support for change
  7. Putting systems in place to solidify staff understanding of their impact on HCAHPS scores
  8. Identify key/core metrics for determining impact of hospitality and healing services efforts on the overall patient and family experience
  9. Clearly define and articulate the problem or situation
  10. Identify a strategy to address the situation
  11. Develop the team
  12. Establish benchmarks and goals
  13. HCAHPS domain or specialized research from selected vendor (or internal)
  14. Determine reasonable time period
  15. Refine approach and program elements
  16. Roll-out program
  17. Measure, reward, measure
  18. Celebrate success
  19. Publish
  20. Repeat!
  1. Behavioral Components
  1. Communicate and promote
  2. Staff awareness
  3. Recognition programs
  4. Demonstration of real metrics—build momentum
  5. Engage champion from senior leadership
  6. Sustain and communicate (with thanks to Tria Diebert, Meridian Health for source material)
  7. Training for the clinical team, guest relations, volunteers, etc. This included key scripting messages developed for use by the Guest Relations Representatives and other designated members of the team.
  8. Internal communications launched to engage staff across the hospitals including addressing the new program at team huddles, carrying the message out via a road show across all shifts, and integrating the message in leadership presentations and team member forums.
  9. Brand development by Hospital with the support of healing and hospitality initiative in creating key materials such as rack cards and a menu of services offered.
  10. Marketing the program to users. This took place through multiple media including web promotion, which was key for individuals researching their stay, unique signage in high traffic areas and then internal marketing efforts such as pillow wraps, elevator door signage and even notes included on all food trays that share the commitment to the guest experience signed by team members.

OUTSIDE RESOURCES/SUPPORTING MATERIALS TO CONSIDER:

For Section I:

  • Hospital hospitality: rules of engagement for a better patient-centered experience
  • Four Lessons Healthcare CEOs Can Learn From Hospitality
  • In age of high-tech medicine, don’t overlook patients’ nonclinical needs
  • What hospitals can learn from the Ritz
  • The Emerging Importance of Patient Amenities in Hospital Care
  • Concierge Services
  • Time to put a little bit of Disney into medicine
  • Low-cost concierge can be possible 02
  • The Rise of Amenities
  • Hospitals, clinics create concierge positions to improve the patient experience
  • How Good Wayfinding Solutions for Hospitals Enhance Patient Experience

For Section II:

  • Ananth S, Jonas W. Implementing OHEs. Explore. 2010; 6(1):52-53.
  • Findlay B, Smith K, Finch M, Loveless S. Survey on Healing Environments in Hospital: Nature and Prevalence. Alexandria, VA: Samueli Institute. Accessed August 27, 2012 at:
  • Gaudet, Tracy, M.D. Patient Centered Care. U.S. Department of VA Services website. Accessed on August 29, 2012 from
  • Schmidt S. Mindfulness and healing intention: Concepts, practice and research evaluation. J Alternative Complementary Medicine. 2004; 10(1):S7-S14.
  • Snyder M & Lindquist R. (2009). Complementary/Alternative Therapies in Nursing. New York: Springer.
  • Zborowsky T., & Kreitzer J. Creating optimal healing environments in a health care setting. Minnesota Medicine. 2008; 91(3):35-38.

For Section III:

  • Baptist Leadership Group, The HCAHPS Imperative for Creating A Patient Centered Experience
  • Simmons, Scott, Fraser, Christie article in Gallup Business Journal: Why Hospitals Don’t Deliver Great Service
  • Frampton Susan, Charmel Patrick, Gilpin Laura, 2003; Putting Patients First

For Section IV:

  • Beers, Collin, AIA and Jennifer O’Shea, ASIC. Hotel or Hospital-ity? Healthcare Design Magazine website. October 1, 2010. Accessed on Sunday, September 02, 2012 at:
  • Cole, Jared and Jamin Hegeman. Service Storming and Dragon Lines: From Acting to Action. Accessed on Saturday, September 08, 2012 at
  • “Creating Compelling Customer Experiences Through TouchPoints.” Corviturs, LLC. August 2009. Accessed on Tuesday, September 04, 2012 at
  • “Creating Patient Enchantment,” Gelb, Iowa Society of Healthcare Marketing and Public Relations, May 2012. Accessed on Monday, September 03, 2012 at
  • “Customer Journey Map” from Service Design Tools website. Accessed on Saturday, September 08, 2012 at
  • Design Business Case Study: Alexandra Hospital. August 2009. Design Singapore website. Accessed on Monday, September 03, 2012 at
  • Dewar B et al (2009): Use of emotional touchpoints as a method of tapping into the experience of receiving compassionate care in a hospital setting. J Research Nursing 15(1) 29-41.
  • Hostyn, Joyce. Mapping the Customer Experience with Customer Experience Journey Maps. Accessed on Wednesday, September 05, 2012 at
  • Howard, Jeff. On the Origin of Touchpoints. Design for Service website, November 7, 2007. Accessed on Wednesday, September 05, 2012 at
  • Liem André et al. A Culture and Touchpoint Approach to Improve Experiences in Service and Human-Computer Interaction Design. Accessed on Friday, August 31, 2012 at:

Manning, Harley. Customer Experience Defined. November 23, 2010. Forrester.com website. Accessed on Monday, September 03, 2012 at

  • Outside In: The Power of Putting Customers at the Center of Your Business. Harley Manning and Kerry Bodine. Las Vegas, NV: Forrester Research, Inc., 2012.
  • Sloan, Sue and Karen Barrie. Patient Stories: How does it feel for you? Accessed on Monday, September 03, 2012 at
  • Temkin, Bruce. CX Mistake #10: Mapping Internal Touchpoints. August 16, 2011. Customer Experience Matters website. Accessed on Wednesday, September 12, 2012 at:
  • Zorzi, Cara and John McKeever. Experience Mapping Builds Empathy and Revenue. M.D. Anderson Cancer Center and Gelb Consulting Group. Accessed on Tuesday, September 04, 2012 at

For Section V:

  • Innovation’s OrgDNA, Booz Allen Hamilton
  • Scope, Scale, and Sustainability: What It Takes to Create Lasting Community Change Tina R. Trent, M.A., NeighborWorks America, and David M. Chavis, Ph.D., Community Science
  • Sustaining Comprehensive Community Initiatives Key Elements for Success: the Finance Project
  • Prescription for Excellence: Leadership Lessons for Creating a World-Class Customer Experience, Joseph A. Michelli, Ph.D. McGraw Hill, 2011.
  • Peak. How Great Companies get their Mojo from Maslow, Chip Conley, Wiley, 2007

SUGGESTED ASSESSMENT QUESTIONS:

For Section I:

  1. Identify key differentiators between the concepts of hospitality in healthcare as opposed to other service industries.
  2. Discuss the role that experience design principles play in the patient’s perception of their overall care.
  3. Define specific utilizations of technology contributing to efficiencies and accuracy causing patients and family to recognize individualized care in their experience.

For Section II:

  1. What are key distinctions between the curative and healing models?
  2. Describe the six components of an optimal healing environment and how they are interwoven with one another.
  3. Discuss vital elements of each OHE component:
  • Creating a healing organization
  • Developing healing intention
  • Cultivating healing relationships
  • Applying collaborative healthcare
  • Experiencing personal wholeness
  • Practicing healthy lifestyles
  • Creating healing spaces
  1. As a patient experience leader, discuss
  • How you would assess your organization for the presence of OHE components
  • How you would advocate the need to strengthen any weak OHE component

For Section III:

  1. What is leadership’s role in patient and family centered care?
  2. Describe a scenario that you would consider a great patient experience encounter?
  3. Describe three ways to effectively communicate information to a patient?
  4. Describe best practices regarding hiring methods that support a culture of hospitality. Discuss the long-term implications of right and wrong hiring choices.
  5. Identify at least 5 essential behavioral standards that support a ‘culture of hospitality’ within a healthcare organization.
  6. Role play would be a great way to show great patient and family experiences.

For Section IV: