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Leaders of the Wilmington Veterans Affairs Medical Center reached
out to the University of Delaware in 2018 to bring its Patient
Experience (PX) Academy to help VA staff care for veterans better by
bridging hospitality and healthcare.
When a person is told they have a life-threatening illness, they won’t hear anything else.
But what a doctor or medical provider says next is pivotal. That’s where empathy comes into play.
“The doctor or the medical provider must really stop and ask
questions of the patient: what are they thinking? What are they feeling?
And really build that relationship,” said Sheryl Kline, deputy dean and Aramark Chaired Professor in the University of Delaware’s Alfred Lerner College of Business and Economics.
Some people possess empathy naturally while others need time and
space to develop it. That’s one intricate piece of the all-encompassing Patient Experience Academy, an interdisciplinary collaboration between UD’s Lerner College, the College of Health Sciences, the College of Arts and Sciences, and the Division of Professional and Continuing Studies.
“The foundation of empathy is in being an active listener and really
focusing on what the person is saying to you. To be empathetic, you must
be vulnerable, and for a lot of people that’s very hard to do,” Kline
said. “In our classes, we practice and provide space so that someone can
be vulnerable. We work on how you talk, really sit with a patient so
that they know you’re on their side and help them develop the skills and
behaviors that help the patient.”
Twenty-seven years ago when registered nurse Laura Selwood first
began working in healthcare for the U.S. Department of Veterans Affairs
(VA), empathy wasn’t a focus.
“Now, when a veteran has an issue regardless of whether it involves
primary care, the buck stops here. I tell them: ‘I’m sorry you’re having
this problem, or I’m sorry this is happening to you. I can see this is
frustrating. Let me help you.’ That validation of their feelings is
important,” Selwood said.
Move this whole section up, swapping places with the section above it.
Registered nurse Laura Selwood (right), who has been with the
Wilmington VA Medical Center for 27 years, is taking virtual classes
through UD’s VA Patient Experience Academy. She’s learned no matter what
the veteran’s issue may be – the buck stops with her.
Registered nurse Anne Anyanga, who has worked with the VA for more
than three years, has learned calming tactics and enhanced her
“The training has given me an opportunity to reflect on how we
deliver care and how we use our values as an organization to show that
we really do care,” Anyanga said. “We treat veterans for a variety of
mental health conditions based on their past experiences, and I’ve
learned how to lower the temperature when they’re upset. I used to keep
quiet, but I’ve learned your tone matters in how you interact with them
and resolve their issues.”
Both learned that in the Patient Experience (PX) Academy, which was born in 2014 and first launched with ChristianaCare,
where 1,000 staff and medical providers were trained in hospitality
healthcare. The pillars of the PX Academy are based on managing changing
expectations, excellent customer service, service recovery, openness to
experience, comprehensive listening and empathy.
“The program drove ChristianaCare’s patient experience scores over
the 90th percentile as measured by more than 8,000 patients who
responded to the surveys. This level of achievement is the goal for
almost every healthcare organization,” said Ali Poorani,
the academy’s faculty director and principal investigator, who’s also
an associate professor of hospitality business management in Lerner.
Based on the success of the program, the Wilmington VA approached the
University in 2018, seeking to bring the PX Academy to its healthcare
system with the curriculum tailored to meet the needs of the VA’s unique
“The VA is very conscious that veterans sacrificed for our country
and to give us freedoms, and so our program focuses on taking care of
veterans and their unique needs,” Kline said. “We’re helping the people
who help the veterans, and these healthcare providers are doing more
than just providing medical care. Many veterans have profound and
emotional experiences, and so the training focuses on emotional aspects
Registered nurse Anne Anyanga (right) at the Wilmington VA Medical
Center says the VA Patient Experience Academy has made her consider her
tone and built up her confidence in providing healthcare to veterans.
Vincent Kane, director of the Wilmington Veterans Affairs Medical Center, said one of the center’s strategic initiatives
is to improve trust between the medical center and the veteran
community, putting veterans and their families first – and what matters
to them – at the forefront.
“Having the veteran’s voice at the center of our relationship and how
and where we deliver healthcare is critical,” said Kane. “When you
define exceptional healthcare, you must ensure that it’s
research-informed, evidence-based and state-of-the-art, but it also has
to be delivered in a caring, compassionate and respectful way. If you
don’t have both, then you don’t have exceptional healthcare. To work
with UD to build up the hospitality component of healthcare delivery to
improve the overall veteran healthcare experience was just a great
The VA Patient Experience Academy launched initially with managers and saw astounding results.
“After the first phase of training nearly 400 medical providers at
the Wilmington VA Medical Center and five satellite locations, the
results as measured by veterans were outstanding, outperforming national averages by about 2.5%.
That was a huge improvement,” Poorani said. “They also became number
one in terms of patient experience in Delaware — better than other
healthcare systems, so that’s something we really are proud of.”
Kane is proud of the center staff’s efforts to improve the veteran’s
overall experience, but knows more work is needed, noting the VA must
constantly innovate and improve.
“All of our metrics went up dramatically, including how the veterans
perceived their provider,” Kane said. “But these training sessions can’t
be a one-and-done. They must be hardwired into how we help and support
our staff during onboarding.”
While the program was paused during the COVID-19 pandemic, its
success spawned a new two-year contract between UD and the Wilmington
VA. Classes got underway again in October. The twice-weekly entirely
virtual training will reach as many as 700 Wilmington VA employees in
the region, including doctors and nurses.
The interactive interprofessional education program creates a bridge
between hospitality and healthcare and involves the dynamic Healthcare Theatre program, a joint venture between CHS and CAS.
“From a human-centric perspective, we need to be mindful that
patients are human first and a patient when they seek out healthcare,”
Poorani said. “But after they leave the hospital or the primary care
office, they’re also consumers. So, they are seeing a lot of things
happening as a consumer in other industries, and they expect that from
Healthcare Theatre trains students to be patients and family members,
who then take part in simulated healthcare encounters, so learners can
practice their medical and communication skills in safe, but highly
realistic, healthcare encounters.
By incorporating Healthcare Theatre in the PX Academy curriculum,
providers are placed in challenging situations, and instructors observe
how they react to patients. Allan Carlsen, director of Healthcare
Theatre, said he and other instructors are watching for certain things.
“We want to make sure that doctors introduce themselves well, present
a plan of care, ask the patients if they understand it and accept it,”
Carlsen said. “These scenarios give providers an opportunity to practice
what’s being taught— empathy, advocacy, and all the communication
skills, and service recovery. When things go south in these interactive
freezeframe encounters, the providers can stop and start the simulation
and talk amongst themselves. The doctors have an opportunity to help two
different vets, each with varying issues, and they get to practice
talking to them.”
One “tougher” scenario Selwood and Anyanga faced included a veteran
from out-of-town coming in for care with a family member with no medical
“That scenario helped us learn how to coordinate care and interact
with our veterans to instill confidence that the VA really is a
nationwide healthcare system,” Anyanga said.
Selwood said that scenario encouraged her to change her approach with new patients and their families.
“Previously, I used to have loved ones contact eligibility with their
questions,” Selwood said. “Now, I’m equipped with more knowledge and
can make contacts directly for them and provide better service
connections, helping them feel more empowered.”
Poorani said through the PX Academy, the faculty and VA staff are bridging hospitality and healthcare.
“Though hospitals are not hotels, our investigations show nearly 70% of what hospitals do is rooted in hospitality,” said Poorani.
The success of the academy is data-driven and based on numeric and comment-based pre-and post-assessments provided by VA staff.
William Sullivan, adjunct faculty at Lerner and managing director of the Courtyard by Marriott – Newark University of Delaware, said the academy’s success relies strongly on data, and that data, thus far, “has told a great story.”
“This is exactly what we do in the hospitality world,” Sullivan said.
“When we marry the concepts together, there’s a lot of great positives.
But most of our guests come in healthy, and unfortunately, in the VA’s
case many come in with illness. So, we must be different, but we also
apply some of the same tools to the measurement process.”
All VA Wilmington staff will ultimately undergo training in the VA PX Academy which brings comfort to Selwood and Anyanga.
“The care starts in the call center, when a veteran or their loved
one makes that first call and the first words and the tone that they
hear: ‘Hello, how can I help you?’” Anyanga said. “By the time they get
to a nurse, I could be the third person they’re talking to, so it’s
beneficial that we’re all on the same page in care delivery.”
Paul Weaver was a senior chief petty officer in the U.S. Navy. He
retired in 1992 after 23 years of service and uses the VA healthcare
system. He’s now an actor with UD’s Healthcare Theatre Program and
called the program a “natural application” to fix some of the issues
he’s seen first-hand.
“It gives me hope that the next time I go to the VA, things may be
different,” Weaver said. “The caregivers and staff must realize how
important they are to the veteran. They depend on VA employees to solve
their problem, and employees must realize they have a responsibility to
provide a solution or seek the answer to the veteran’s problem. Even if
they can’t provide a solution for every veteran that walks through the
door, they must satisfy them, so they don’t walk away feeling defeated
Article by Amy Cherry, photos by Ashley Barnas
Published December 07, 2022