Welcome to Planetree
Planetree, Inc. is a mission based not-for-profit organization that partners with healthcare organizations around the world and across the care continuum to transform how care is delivered. Powered by over 50,000 focus groups with patients, families, and staff, and over 35 years of experience working with healthcare organizations, Planetree is uniquely positioned to represent the patient voice and advance how professional caregivers engage with patients and families. Guided by a foundation in 10 components of patient centered care, Planetree informs policy at a national level, aligns strategies at a system level, guides implementation of care delivery practices at an organizational level, and facilitates compassionate human interactions at a deeply personal level. Our philosophical conviction that patient centered care is the “right thing to do” is supported by a structured process that enables sustainable change.
Singularity of Purpose that Drives Industry-Leading Quality Results
Like all healthcare organizations today, the team at Northern Westchester Hospital must balance a multitude of demands to consistently deliver exemplary medical treatment that combines leading edge technology with compassionate human interactions. A Planetree member for more than a decade, the Planetree philosophy has been a powerful lens through which to plan, prioritize and evaluate what it means to provide high quality patient- and family-centered care.
Drawing on the principles of staff engagement, patient activation and patient-centered process redesign, the hospital has re-designed care processes, caregiver roles and the environment of care to ensure that "putting patients first" is not merely a catchy expression, but a true depiction of the NWH experience.
For instance, as part of the hospital's comprehensive Inpatient Process Redesign, all key stakeholders worked together to develop a single plan of care, i.e. an interdisciplinary record where all disciplines document their plan of care. This effort has improved communication, coordination and patient confidence that all their caregivers are on the same page with regard to their needs and preferences. In addition, a patient-designed discharge checklist and bedside tablet where patients can access real-time aspects of their medical record further engage patients and family members as integral members of the care team. A Patient-to-Nurse Call System underscores that meeting patients' needs is NWH's top priority and has enhanced responsiveness. And the hospital's Food is Care initiative emphasizes the connection between the hospital dining experience, quality and outcomes. By working in partnership with nursing staff and patients, food personnel is better able to understand and accommodate patients' individual food preferences while supporting dietary changes and providing education to advance individual health aims.
These individual initiatives have been successful because the hospital's culture is fertile breeding ground for this type of innovation and end-to-end process re-design. A Shared Governance Model and a robust Patient and Family Advisory Council has provided numerous opportunities for all staff and patients to be directly involved in the design of systems and processes. A staff coaching model and patient inquiry process support staff during periods of change, analyze the impact of the changes and obtain real-time patient feedback. Together, these approaches have provided essential tools for hardwiring patient-centered processes and building accountability among the NWH team.
Today, Northern Westchester Hospital is one of 63 healthcare organizations worldwide to have earned recognition for patient-centered excellence through the Planetree Designation Program. It continually surpasses national standards for quality and patient experience. The hospital has been recognized as one of U.S. News & World Report’s “Best Hospitals 2013-2014, one of the “Most Connected Hospitals,” and it has received Magnet Recognition of excellence in nursing services and overall quality of care.
That’s what “the industry” says about Northern Westchester Hospital. Here is one patient had to say about their experience at NWH: “I don’t know what my destiny will be when I leave here, but what I do know is that I’ve been cared for here.”
“Planetree provides the roadmap to creating an experience for patients and families that is centered on the right thing – the needs and expectations of patients and families” –Joel Seligman, CEO, Northern Westchester Hospital
Located in Quebec, Centre de réadaptation Estrie provides rehabilitation for individuals with motor, hearing, visual, language or speech impairments, largely in an outpatient setting. In 2004, the center was struggling. Budgetary restrictions and staff shortages demanded that the CRE team find ways to do more with less. By joining forces with Planetree, a new path unfolded for CRE to take on this complex mandate. A goal was established that within five years, CRE would be among the top employers in Quebec and the center would become a leader in patient-centered care
To achieve this goal, the CRE team started by identifying a series of attributes and behaviors aligned with this vision of humanizing care. This exercise informed the development of patient-centered quality improvement tools, notably client and personnel satisfaction surveys , focus groups and key competency profiles that helped to define what it means to deliver person-centered care. In addition, the hiring and onboarding processes for new employees were redesigned to emphasize each employee’s role in fulfilling the organization’s mission. Relationship-building took precedence over skill building during the employee’s orientation. Focused efforts to create more transparency in communication between management and staff were implemented, and structures were created to actively solicit the ideas and insights of all stakeholders to advance the organization’s strategic priorities.
The CRE story demonstrates the power of comprehensive culture change. Discrete interventions were all implemented within the framework of a much broader vision for change centered on both improving the client experience and nurturing and developing staff.
A 2013 study of CRE concluded that investing in this comprehensive approach has paid off richly. Since implementing Planetree, the number of complaints and the number of staff vacancies have decreased (this, despite a healthcare worker shortage in Canada), while the employee retention rate has improved: from 94% in 2005 to 98.7% in 2010. Employee satisfaction at CRE consistently exceeds that of comparable establishments. Four years after setting the goal to become an employer of choice, CRE was awarded first prize for the Quebec-based "Best Employer's Challenge" in its size category.
This positive employee experience is also reflected in client satisfaction. Steady increases in client satisfaction have been noted that correlate with Planetree implementation.
Most impressively, these gains have been achieved while concurrently managing to reduce costs. Improvements in employee retention have yielded a savings of 82.51% in costs associated with recruitment and employee onboarding. Finally, a better working atmosphere has also contributed to a reduction in occupational health and safety costs.
Part of the 42-hospital Carolinas Healthcare System in North and South Carolina, Carolinas Medical Center-Mercy is a 180-bed, adult acute care hospital located in Charlotte, North Carolina. In 2007, a leadership change and facility renovations prompted the hospital to seek out a partner to provide a framework for a rebuilding effort that would extend beyond the physical environment to transform the culture as well. The Planetree Designation criteria became that framework, offering up a structure for improving the patient experience while driving quality, positioning the hospital as a destination for treatment.
Over a three-year period, a multidisciplinary steering team to lead the effort was created, co-led by an administrative director and a physician, and comprised of a mix of senior leadership and front-line staff. A community advisory council of past patients and their loved ones became a sounding board and platform for idea generation grounded in the patient experience. Naming a Medical Director of Patient-Centered Care proved to be a solid strategy for engaging the medical staff in the change effort. A patient-centered curricula was developed for new physician orientation and Planetree updates at the Medical Executive Committee meetings became standard. A Planetree hallmark, patient-centered retreats, were instituted, and within two years, 94% of staff had attended these days focused on supporting individual staff members to reflect on how they can embody the values of patient-centered care in their interactions with patients, family members and colleagues. Phase Two retreats followed to ensure that the enthusiasm and momentum of early efforts not diminish over time. A departmental certification program was created to engage all departments in improving their practices and processes to be more patient-centered. These infrastructures positioned the organization to accelerate implementation of high impact patient-centered programs, such as Care Partners, bedside shift report, and the shared medical record. Within three years, the hospital had earned recognition as a Planetree Designated Patient-Centered Hospital.
In that three year period, performance on a range of quality, safety, patient satisfaction and employee engagement measures improved. The hospital’s performance on the “likelihood to recommend” question on its patient experience survey increased from 61% to 80.8%. At the same time, 90% of employees participated in the employee engagement survey and the workforce commitment indicator score rose to the 89th percentile.
These improvements have been achieved as the hospital has experienced a 20% increase in elective surgeries. Its Planetree affiliation, and its reputation for patient-centered excellence, has become a differentiator for the hospital. Beyond adding services and expanding the facility to support growth, the hospital’s comprehensive efforts to engage patients and family members and deliver a truly patient-centered care experience continues to propel CMC-Mercy’s reputation as a hospital of choice.
“We believe that dialogue and the exchange of information with the care team empowers patients. It allows patients to become active participants in making healthcare decisions. We recognize they are experts on their experience of health and illness; therefore, rather than directing all of the care, our position as healthcare providers is one of partnering with patients towards maximizing their healing and wellness.” -- Dael Waxman, MD, Medical Director, Patient-Centered Programming at CMC-Mercy
Planetree was founded in 1978 by Angelica Thieriot, after she suffered series of traumatic personal health care experiences. These experiences served as the impetus for the development of the Planetree model. The organization vowed to reclaim for patients the holistic, patient-centered focus that medicine had lost. Everything in the hospital setting was to be evaluated from the perspective of the patient. Every element of the organization’s culture was to be assessed, based on whether it enhanced or detracted from personalizing, demystifying, and humanizing the patient experience. A premium was placed on making information available to health care consumers, enabling them to be informed partners in their care.
Planetree's first step was to establish a consumer health resource center, which opened in San Francisco. The resource center initially offered users a library of over two thousand health books and medical texts, a clipping file of current medical research, a catalogue of support groups and agencies, and a bookstore. Such a wealth of health information resources was an unheard-of luxury at a time when patients were still routinely barred from entering a hospital or medical school library. The Planetree Health Resource Center became a national model, subsequently helping other organizations establish successful libraries throughout the country. The center developed a widely used consumer cataloging system known as the Planetree Classification Scheme, which continues to be used by health resource centers around the world.
With funding from The Henry J. Kaiser Family Foundation and The San Francisco Foundation, a major milestone was reached with the opening of the Planetree model hospital unit. The first of five Planetree model hospital sites, the thirteen-bed medical-surgical unit at Pacific Presbyterian Medical Center in San Francisco, California, was like no other hospital unit in existence at that time. This unit was the culmination of years of grassroots effort to create a truly new model of care in the hospital setting. Its creation launched one of the most far-reaching experiments in the realm of consumer-responsive, patient-centered care ever attempted in this country. Using findings from numerous focus groups with patients, families, and staff members, the innovative medical-surgical unit was designed to offer the latest medical technology in an environment that was comforting and supportive. The thirteen-bed unit was a pioneering effort to change the way patients experienced hospitals—from impersonal and intimidating institutions to nurturing, healing, and educational environments.
Four additional model sites implemented the philosophy between 1987 and 1990 to refine the model in diverse settings.
Griffin Hospital pioneered a new relationship with Planetree, becoming the first affiliate to institute the model and philosophy across their entire organization. Hundreds of tour groups from hospitals across the country and around the world had visited the model sites and worked with the Planetree organization to enhance patient care at their institutions. Managed care was rapidly expanding, hospital budgets were shrinking, the number of beds was declining, and competition for patients was growing. Executive teams were looking for innovative strategies to improve patient satisfaction and differentiate their hospitals in an increasingly competitive health care marketplace.
Rapid expansion allowed for the creation of a vibrant community of professional caregivers. Given this more flexible approach to Planetree implementation, additional hospitals and health systems followed suit, forming what has become a community of patient and resident-centered hospitals, health systems, long term and continuing care facilities. The membership network is a rapidly growing coalition, advancing innovative solutions to the changing needs of health care consumers.
- The first edition of “Putting Patients First”, a comprehensive guide on how to design and practice patient centered care was published.
- Angelica Thieriot, who founded Planetree in San Francisco was honored at the 2003 Planetree Annual Conference and Twenty Fifth Anniversary celebration
- Planetree expanded internationally, with the opening of a partner office in the Netherlands
- Susan B. Frampton, Ph.D.; Laura Gilpin; and Patrick A. Charmel, CHE, are the winners of the American College of Healthcare Executives 2004 James A. Hamilton book of the year award for Putting Patients First: Designing and Practicing Patient-Centered Care.
- Planetree developed its patient centered Designation program which offers organizations an operationalized methodology to guide their performance. With over 60 criteria, Designation is a true mark of patient centered achievement.
- A long term care pilot brought the Planetree philosophy of care across the healthcare continuum.
- Planetree was awarded the International Health & Medical Media Award in the category of Advertising and Public Relations for the film “Why Planetree”
- Planetree partnered with the VA to develop the Office of Patient Centered Care
It is absolutely about leadership. It’s not about how much you know, but how much you care. And you hit different units and you see it all the time but it starts at the top. The leader has to be out there leading with their heart. And you’ve got to feel it and you better have the courage to step up and make changes and show your staff consistently that you’re sincere about this.
~ KennethMizrach, Director, Department of Veterans Affairs (VA) New Jersey Health Care System
- The Planetree Patient Preferences Passport featured in the Wall Street Journal as promising tool for engaging patients and families in their healthcare
- Planetree awarded a grant from the Patient-Centered Outcomes Research Institute to work with a national network of patient and family advisory councils to build our knowledge of how they access and use patient-centered outcomes research data, and to co-develop a tool that will support awareness and use of such data more effectively.
- Planetree hosts the 24th World Health Organization Collaborating Centre’s International Conference on Health Promoting Hospitals and Health Services
- Planetree President Susan Frampton invited by the National Academy of Medicine to chair its Scientific Advisory Panel on the Evidence Base for Patient and Family Engaged Care