Feedback Fanatic: Leslie Nestor Amplifies Patient Voices at EVMS
Our Feedback Fanatic award recognizes experience champions that are striving to innovate and improve patient and employee experiences, transform culture, and use feedback for positive change.
Leslie Nestor, Assistant EVMS Medical Group Quality Officer at Eastern Virginia Medical Group (EVMS) makes it a priority for patient feedback to be heard, continually sharing patients’ voices, their experience, and their perception. Leslie focuses on constantly sharing and highlighting the patient perspective institutionally and in individual departments with a commitment to continuous improvement and patient-centered care. Recognizing staff and creating more visibility to patient comments fosters a competitive yet motivating culture. Plans to involve residents in the surveying process will provide valuable learning to create meaningful patient relationships. Overall, the integration of patient feedback is driving positive changes institution-wide at EVMS.
Learn More About How Leslie Nestor Amplifies the Patient Voice in this Q&A:
Q: Can you share how you use patient feedback to inform action?
Leslie: With Feedtrail, our main goal is to understand the patient experience and hear their perspective. We analyze feedback institutionally, highlighting clinicians and staff—such as front desk, receptionists, schedulers, and medical assistants. Each department and the institution publicly showcase positive feedback on plasma screen TVs. This approach has been successful, influencing more patients to leave reviews and showcasing other offerings or departments patients may not be aware of, like physical medicine, where patients are having great experiences. We discuss feedback in various meetings— whether in departmental meetings, safety committees, or quality improvement discussions — adressing issues and highlighting successes. We make it a priority to share patient’s perspectives, the good with the bad.
We heard our phone call system was a bit of a barrier and patients were waiting for extended amounts of time. So we worked with marketing to advertise our Follow My Health platform more so patient can self-schedule their appointments and don’t have to use the phone. We’re using those forms of action to highlight our patients’ feedback.
Q: You’ve been focused on improving care access and getting people in the door. How’s that going?
Leslie: It’s early to tell, but we’re gathering further data. We used CG-CAHPS scores, in-person conversations with patients, and Feedtrail surveys in six departments and results are showing we do have a problem with access to care. And that’s a great way to be able to combine some of those different data points and making sure you’re getting that full picture.
One thing that we’re really super excited about is our no-show survey. We have gotten quite a few responses back from the no-show survey to learn the reason why patients have been unable to attend their appointments, which were primarily transportation, childcare, or they forgot about their appointment.
We addressed the forgetfulness issue by improving phone number accuracy in our system so people would receive phone call reminders. We found we had many wrong numbers due to manual entry errors and implemented a forced field in our EHR that has a 10-digit requirement. We’ve tweaked our messaging to our patients as well. We’re now sending more frequent appointment reminders to our patients. We were sending the first reminder notification five days out, but we found that that wasn’t working. Now patients receive a message at seven days out, then five, then three, and then one day out. We’re still collecting that data to see if that’s going to help us as well. A subcommittee is addressing transportation barriers, exploring insurance benefits for free patient transportation and potential reimbursement for using services like Uber.
Q: How can others effectively share patient experience progress with leadership or broader teams?
Leslie: We make it a priority for our patients’ voice to be heard. We’re consistently advertising our patients voice, their experience, their perception. In every meeting, whether we start or we finish with it, Feedtrail is brought up and we’re sharing patient feedback from our no-show or patient experience surveys. We want everyone to know what our patients are experiencing, what their perspective is. Everyone knows that patient feedback is invaluable and all of our value based care programs have a huge patient experience component. So we know how valuable it is financially if our patients are satisfied, otherwise we’re not going to see the shared savings that we would like to see back.
Q: How are you strengthening your culture of recognition?
Leslie: Recognition occurs at departmental and institutional levels. It’s something that we’re consistently doing. Our Patient Safety and Quality Committee awards breakfast monthly to the department with the highest scores. So that’s been very competitive and we all do have a little bit of a competitive bone in our body. We’re seeing a lot more surveys. I think we’re at 14,000 surveys completed so far, which is a huge number we’re very proud of.
We highlight not just physicians but also ancillary staff like registration and housekeeping, fostering a culture where everyone’s contribution matters. When we see a staff member that is consistently mentioned, such as a medical assistant in psychiatry and a receptionist in gynecology, we make sure everyone in the department knows these people are being consistently mentioned. You know it’s the little things that matter to patients, it’s their smile, the way they interact with them, the time that they’re giving the patient. So we constantly are bringing that up as well.
Q: What’s the impact this visibility across the institution to patient experience numbers has had?
Leslie: You’re solidifying that “why” and they’re very thankful for it, but also now staff is more aware of it. I think they’re more willing to go above and beyond because they want that positive patient feedback. I share patient comments in a Word document and staff and clinicians absolutely love to see how many times their name was mentioned. It definitely boosts morale and, like I said, everyone has this little competitive streak and they want to see their name.
Q: How are you involving residents in the surveying process?
Leslie: We’re super excited about adding residents to this program. Many departments reached out and asked “can the residents be added to the survey?” It’s part of their learning and will prepare them for going out in private practice. They want to know how they’re doing and patient feedback is invaluable.
They want to make sure that they’re building meaningful relationships with their patients, if they’re communicating effectively, and if they have a compassionate experience with their patient, and we were unable to give them that information. Obviously, our residents are very, very intelligent. They know that when patients have a good experience they’re more likely to comply with their care, they have better outcomes. It’s all proven, so we need to make sure that they do have a good experience.
Dermatology will be the first department surveyed, followed by family medicine and other practices. It’s already difficult enough going through medical school, and then your residency and often you only hear from your peers, or your precepting physician, of what you’re not doing correct or maybe what you are doing correct. But then to actually get some patient’s feedback that you made their day, it definitely puts a smile on your face and continues to push you on your journey through residency.
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