Excellence in Action - University of Colorado Hospital

Patrick Kneeland, MD, Focus on Quadruple Aim

Move over mama, there’s a new idea gaining traction. Seems if your doctor ain’t happy… well, you know the rest. It’s a big issue with multiple stakeholders, from Medicare to private insurers, employers to individual patients, and they are all placing increased value on the experience of care. Nationally, as pressures to improve quality and safety mount, health systems are starting to add patient experience into the mix to differentiate the value of the care they provide.

Patrick Kneeland, MD, intends to bring into focus an improved aim for University of Colorado Hospital (UCH), by focusing on what he and others call the Quadruple Aim—an expansion of the Triple Aim which puts “provider experience” level with improved patient experience, improved population health and cost reduction as a path to health care optimization.​

Recently named medical director of patient and provider experience, Dr. Kneeland will be responsible for promoting organizational strategies and improvement efforts that enhance patient, staff and physician experience and engagement. He will work in collaboration with senior nursing and physician leadership and Amy Searls, executive director of service excellence at UCH.

Focusing on the Health Care Team

“We know that the three things that patients care about most are: 1) Confidence in their provider; 2) Perception that the care team is working together and is on the same page; and 3) Caregivers demonstrate empathy and a concern for patient comfort,” says Dr. Kneeland. He believes that to effectively provide patients the level of care they deserve and need to heal, we must break down some of medicine's traditional communication silos.

Nursing leadership agrees. “When all disciplines are talking together—when we all have seats at a big, round table and we’re all able to listen and be heard and everyone knows what’s going on—that’s patient care at its best,” says Cathy Ehrenfeucht, RN, MS, vice president of nursing and associate chief nursing officer at UCH. 

Dr. Kneeland and Ehrenfeucht want to make sure that everyone in the organization understands that meaningful improvement requires a team effort. “Everyone—from administration to staff—cares about our patients,” explains Ehrenfeucht. “Our partnership will build on this collaborative sense of moving forward as a team. It will require trust and compromise. Honestly, it’s going to be eye-opening, and it’s truly the right thing to do for our patients.”

Involvement in the Experience Innovation Network

Over the past year, Dr. Kneeland has represented UCH in the Experience Innovation Network, a group of forward-thinking and top-performing health care leaders dedicated to “disrupting” the status quo to improve health care for all involved. Dr. Kneeland has been serving as the director of patient safety and experience in the hospitalist group and is a founding faculty member of the Institute for Healthcare Quality, Safety and Efficiency (IHQSE​).

Dr. Kneeland is excited about his new role and the focus it brings to making health care better for everyone. “As we’re seeing from our partners in the Experience Innovation Network, when this type of work is done right, it makes sense on two levels,” says Dr. Kneeland. “First, it’s the right thing to do for patients and providers. And second, it makes good business sense.”

Next Steps

In his first few months as medical director, Dr. Kneeland will be focused on two important elements: increasing visibility and engagement and developing strategies that support mining meaningful experience data.

By increasing the visibility of UCH’s goals surrounding provider and patient experience and engaging physicians across the hospital and its clinics, Dr. Kneeland hopes to shine more light on the many providers and departments that exemplify UCH’s standards of excellence. “We’re doing things well in so many areas,” says Dr. Kneeland. “That’s why the School of Medicine Clinical Affairs department will continue highlighting providers and teams in its Excellence in Action column in this newsletter.”

Dr. Kneeland will also be implementing Patient Experience Rounding, where he will team with medical directors, nurse managers, and hospital leadership to speak directly to patients about what they are experiencing as it relates to communication, comfort, understanding of care plans and more.

The second phase will focus on collecting meaningful data and supporting improvement strategies that arise from this data. For example, by taking quantitative data from HCAHPS survey and combining it with qualitative data about patient experience, Dr. Kneeland will help departments focus on improvement targets that will have the most impact. For example, through an IHQSE project, the Infusion Center recently reduced patient wait time—an aspect of their patients’ care that was identified as needing improvement through patient experience interviews.

“Data had shown that, yes, Infusion Center patients cared about the respectful, professional communication they received. But the qualitative data is what revealed their priority—and that was getting in and out as quickly as possible,” said Dr. Kneeland. “This allowed us to prioritize QI initiatives and enhance the patient experience.”

Dr. Kneeland is excited to help UCH bring forward its strategic priority of improving the experience of all people.

“It’s the right thing to do.”