Using Data and Empathy to Elevate Patient and Family Experience with Dr. Peggy Greco and Rachel Hamilton

Summary

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Using Data and Empathy to Elevate Patient and Family Experience

Becker’s Healthcare Podcast | November 20, 2025

Guests:

• Rachel Hamilton, Vice President of Customer Strategy, NRC Health
• Dr. Peggy Greco, Vice President and Chief Patient Experience Officer, Nemours Children’s Health
• Host: Erica Spicer Mason

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Episode Overview

This episode examines how Nemours Children’s Health, in collaboration with NRC Health, leverages data and empathy to improve patient and family experiences—particularly in pursuit of health equity. The focus is on how actionable data strategies and authentic partnership turn patient feedback into meaningful clinical improvements, culminating in initiatives that directly reduce disparities in care and improve patient safety. Dr. Peggy Greco and Rachel Hamilton share practical insights from their joint case study and offer tangible advice for healthcare organizations aiming to move beyond measurement toward system-wide change.

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Guest Introductions

[00:40] Dr. Peggy Greco:

• Pediatric psychologist, 32 years at Nemours Children’s Health.
• Roles: clinician, researcher, administrator, translating research on communication into practice improvement.
• Emphasis on teaching staff effective patient and family communication to support safer care and better outcomes.

[02:14] Rachel Hamilton:

• 20 years in healthcare, initially as a health system administrator, then focusing on patient experience.
• 8.5 years at NRC Health, working with premier partners to drive patient experience improvements.

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Key Discussion Points & Insights

Identifying Equity Gaps Using Data

Case Study Context

• In 2020, Nemours began dissecting survey data by race, ethnicity, and language with NRC Health's support.
• Discovery: Significant disparities, especially in survey item responses related to post-visit clarity.
  • “Did you know what to do if you had questions after your visit?” exposed the largest equity gaps.

Quote:

“We began to look at our survey responses through those lens. And what we noticed was that there were some equity gaps for some specific clinical areas.”
—Dr. Greco [03:58]

Turning Data into Action – Tackling Disparities

[07:01] Translating Insights into Improvement

• Spanish-preferred families scored 15 points lower; significant racial disparities found (21-point spread between highest and lowest groups).
• Actions taken:
  • Pre-visit: Organized questions at check-in, assessed language needs, interpreter access.
  • During visit: Leveraged best-practice communication (teach-back, clarification), ensured language interpretation.
  • Technology: EMR tools such as Medaction Plan Pro enabled translated medication instructions.
  • Discharge: Multilingual handouts, business cards, app-based messaging, a new central phone line to resolve confusion about whom to contact post-discharge.

Memorable Moment:

“It really was a comprehensive approach that involved pre-visit preparation... ensuring that we’re asking families when they check in to write down their questions and get organized.”
—Dr. Greco [08:09]

NRC Health’s Role

• Provided actionable reporting, making gaps visible for targeted improvement.
• Helped deploy custom surveys and virtual patient/family advisory councils to gather direct feedback on interventions.
• Developed a “fairness survey” and incorporated metrics into clinician summaries for greater visibility and accountability.

Quote:

“We have that opportunity to connect with [families] and ask them questions around those... strategic priorities... so they know and have the ideas around having those cards or just other areas providing a good phone number for those families.”
—Rachel Hamilton [10:53]

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Patient Experience Evolves into Patient Safety

[12:40] Linking Outcomes to Experience Metrics

• Explicit connection drawn between survey response and safety:
  • Families who understood post-visit steps had a 3% ED return rate within 48 hours.
  • Those who didn’t had a 6% rate; even higher for Spanish-preferring (9.2%) and Black families (8.6%).

Quote:

“We found that the question…was predictive of return to the ED within 48 hours. So those families who answered yes, they knew what to do had a 3% return rate… those who didn’t had a 6% return rate.”
—Dr. Greco [13:13]

• This data made the equity initiative personally relevant for clinical teams, driving engagement.

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Lessons Learned & Best Practices

[15:14] Dr. Greco’s Recommendations:

• Meaningful Goals: Focus on clinically significant measures over marketing-driven metrics.
• Ownership: Make goals system-wide, not the sole responsibility of the patient experience team.
• Persistence: Emphasize long-term commitment—tangible, systemic impact took three years to achieve.
• Storytelling: Consistently connect initiatives to patient and family impact to foster buy-in and drive transformation.

Quote:

“It really has to belong to the entire system. It’s not our goal, it’s your goal… And then lastly, I think I would say always coming back to the story, the human impact.”
—Dr. Greco [16:21]

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Preview: 2026 Pediatric Collaborative

[18:04] NRC Health Pediatric Collaborative

• Annual event; 2026 to be co-hosted by Nemours Children’s Health in Orlando, FL (March 25-26).
• Focus on data-informed decision-making and sharing innovative best practices.
• Includes tours of Nemours’ facility for in-person connection and inspiration.

Quote:

“Being on site really makes a pediatric collaborative powerful… to see other healthcare systems in action, to meet leaders, to hear about their initiatives.”
—Dr. Greco [18:52]

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Notable Quotes with Timestamps

• On the power of actionable data:
  “Once you have that data, what are you going to do with it? …turning it into action…” – Rachel Hamilton [05:54]

• On meaningful, clinical, equity-driven goals:
  “Shifting away from metrics that may relate more to marketing and instead finding more actionable measures that really have implications for safety and or outcome means you’re going to get greater engagement.” —Dr. Greco [15:18]

• On the urgency of clarity post-discharge:
  “If you have confusion after a visit or you’re not sure what to do, are you going to follow through with a recommendation?” —Dr. Greco [04:11]

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Important Timestamps

• 00:51 – Dr. Greco’s background and evolution into patient experience roles
• 02:14 – Rachel Hamilton’s background, current role at NRC Health
• 03:41 – Rationale and beginnings of the Nemours/NRC Health case study
• 07:01 – Detailed strategies for translating data into equity-focused action
• 12:40 – How patient experience became a patient safety imperative
• 15:14 – Broader lessons and best practice recommendations
• 18:04 – Preview and goals for the 2026 Pediatric Collaborative

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Conclusion

The conversation underscores that actionable data, combined with empathy and persistent cross-functional collaboration, can yield measurable improvements in both equity and outcomes for patient and family experience. By making the patient story central, tying metrics to safety and clinical relevance, and committing for the long haul, Nemours and NRC Health illustrate a model for systemic transformation in pediatric care.

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For more information:

• Register for the Pediatric Collaborative or read the joint Nemours/NRC Health case study at nrchealth.com [19:57]

Transcript

[A]

Hello everyone. This is Erica Spicer Mason with Becker's Healthcare. Thank you so much for tuning into the Becker's Healthcare podcast series today. So today we're going to learn how Nemours Children's Health and NRC Health are using data and empathy to reimagine the patient and family experience, moving beyond measurement to equity centered action. And joining me for this conversation we have with us Rachel Hamilton, the Vice President of Customer Strategy at NRC Health, and Dr. Peggy Greco, Vice President and Chief Patient Experience Officer, Nemours children's health. Rachel. Dr. Greco, it's so great to have you here with us. Thank you for joining Beckers today.

[B]

Thank you for having me.

[A]

So happy to have you both. And before we get into our conversation, I'd love to learn just a little bit more about you both your roles and your work in healthcare. Dr. Greco, would you get us started?

[B]

Absolutely. I've been a longtime healthcare advocate. I started when I was 20 and a college junior working at Eggleston Children's Hospital and evolved from there to, to become a pediatric psychologist. So that's a psychologist who specializes in working with kids with chronic illness and began working at nemours children's health 32 years ago. So at Nemours I've been a clinician, I've been a researcher, a healthcare administrator. And a lot of the research we looked at which focused on communication and the resulting impact on health outcome wasn't always translated to our clinical staff. So started to fill a translational role in terms of teaching our clinical staff more about communication and interaction that led to better and safer care and that opened up the whole new world of patient experience. So became more broadly involved in that as well over the last decade.

[A]

So great to learn that about you, Dr. Greco. I love when we have a leader on the line who has a lot of tenor at an organization. You know, you've seen it grow through the years and change and so we'll get some great perspective from you. And so glad to hear about this research and kind of data backed perspective that you're, that you're taking on at Nemours when it comes to staff communication and patient experience. So with that, Rachel would love to learn more about you and your work at NRC as well.

[B]

Sure.

[C]

Wonderful. So I've been in the healthcare industry for about 20 years now. Started with actually going to Indiana University for my healthcare administration degree and have worked in health systems for the majority of those 20 years and turned into a patient experience role within that, within my last organization and got to see insights and oversight of the patient Experience program at that system. And then it led me to a role here at NRC Health, where I've had the pleasure of working for the last eight and a half years. I've worked with many of our premier partners like Nemours Children's Health and have just really enjoyed working alongside, helping them achieve their goals, and obviously improving patient experience across the health care continuum. So it's a pleasure to be here today.

[A]

Oh, it's great to have you here too, Rachel. And with all of your experience and the line of work that you're in, you're going to offer that great high level perspective in our conversation, just with the sheer number of partners I know NRC is working with. So, excited to get your perspectives on this as well. But I did want to start our conversation by talking a bit about a case study that I understand Nemours Children's Health and NRC Health collaborated on. And so this case study, I understand, focused on improving clarity and equity in both patient and family experiences. So, Dr. Greco, can you first give us an overview of why you pursued this work at Nemours Children's Health and what really prompted this focus?

[B]

I'd be happy to. So, as everyone knows, the patient and family voice is very important to integrate into improvement work in healthcare settings. And a key part of that patient family voice comes to us in the form of survey responses, both responses to questions and open ended information as well. And one of the things we started doing in 20, 2020, thanks to NRC Health's responsivity to our request to break out data based on race and ethnicity and language, was we began to look at our survey responses through those lens. And what we noticed was that there were some equity gaps for some specific clinical areas. And that ability to identify the gap then motivated us to look at improvement opportunities specifically for the question that had the highest gap, and that was, did you know what to do if you had questions after your visit? And as you might guess, just from the implications from that question can be pretty significant. So if you have confusion after visit or you're not sure what to do, are you going to follow through with a recommendation? Are you going to give the medication as prescribed? Are you going to reach out? Are you going to call the right person so that confusion and perhaps misunderstanding can have some safety implications as well. So given that it was a question that tapped into safety as well as with the identified equity gap, we knew that this was an area we wanted to focus on for improvement.

[A]

Yeah, Dr. Greco, thank you so much for the overview and great to learn how you uncovered some of these important gaps and what it means for safety as well. Rachel, do you have anything that you'd like to add to from NRC's perspective and how you contributed to the case study?

[C]

Sure, yeah. So we meet with our partners on a very regular cadence and basis. And so one of the opportunities we have during those discussions is to hear about kind of what are those strategic initiatives our partners are focused on and or what are the problems that they're trying to solve. And so through these ongoing discussions with Peggy and her team, we really collaborated to say, okay, we see the gaps. One is, how can you see the gaps? So making sure that our reporting provides the visibility for them to see where they need to focus and hone in on and then once you have that data, what are you going to do with it? Right. And so what are those steps and how can we walk with them through that process of taking that data and turning it into action? Whether that's through some custom surveying to identify what are those needs that maybe those patients from those different, whether it's racial disparities or language disparities and gaps, what are those things that they need? And so we can help partner with them to get additional information, information and feedback to help support them in supporting their patients.

[A]

Fantastic. Thank you for those add ons, Rachel. And I want to just highlight something you said which is this important piece of turning data into action. So I'd love to go a little bit deeper that. And Dr. Greco, maybe you can give us your perspective first. You know, what steps did Nemours Children's Health take to translate that insight into action and would love to also know, Rachel, how NRC helped to drive that change as well.

[B]

We use the information on disparities to shape our improvements. And we knew that from the data that our Spanish preferring families scored 15 points lower on average, which is very significant for a survey item than our English preferring families. A number of our intervention aspects really focused on language and assuring that every family, despite background language, left with a clear understanding of what to do next and how to get questions answered. We also saw significant difference along race and ethnicity lines. There was 21 points between the highest top box score and the lowest. We designed really a full enterprise wide approach that touched every clinical area in terms of adapting different tools. It really was a comprehensive approach that involved pre visit preparation. When you think about did you know what to do if you had questions after the visit, that it's Tempting to think, oh, that that's something that is only pertinent at the very end. But actually if we're preparing beforehand, for example, making sure we have interpreters and preferred language needs are being met, ensuring that we're asking families when they check in to write down their questions and get organized, they're going to be more likely to know what those answers are responses before they leave. Within the visit, we make sure they've got the language interpretation. We worked with our clinical teams on teach back and clarification. So best practice communication techniques that make sure that we're communicating in ways that are comprehensible and that families are getting all of that information they need. And then technology support. So there are some EMR based tools that are very helpful for multiple languages, such as Medaction Plan Pro. We looked at all the different tools we could use that would translate some of the recommendations and medication instructions in multiple languages and then focused on discharge communication tools in terms of handouts, business cards, app based messaging so that it was really clear who to call, what to do and sometimes even establish new processes. So for example, our hospitalists at one of our hospitals established a new phone line since often families didn't know which clinic to call since they were followed by multiple clinics and that way had one central phone number to call with any post discharge confusion. So comprehensive approach, really across the board.

[A]

Yeah, comprehensive is the right word for it. Dr. Grackenow, I appreciate all the specific examples and what struck me as you were describing all of these tools and support systems, they seem quite empowering not just from the patient perspective, but from your staff's perspective as well to really support better communication. Absolutely. And Rachel would love to learn a little bit more about the role NRC played as.

[C]

Sure. So again, partnering with Peggy and the team one to after we understood where those gaps were at, how we can get more around the what, the why and the how to help support in making sure that these families know exactly what to do when they leave and where to go to if they have questions. And so we have the wonderful opportunity of engaging with their patients and families after they leave in more of a virtual patient and family advisory council. So we can recruit patients and family members to be a part of their virtual advisory council through their surveys. And so we have that opportunity to connect with them and ask them questions around those strategic priorities and initiatives that Nemours Children's Health would like to incorporate patient and family feedback in. And so we have that opportunity to field questions to those families to understand what are their needs? Why do they have questions? And how can Nemours help them? And so we take that data from those studies and we give it right back to Nemours to help them guide what those action plans were so they know and have the ideas around having those cards and or just other areas providing a good phone number for those families. By doing those custom studies and getting that additional feedback, it just helped provide a little more clarity as to where they can help their patients and families.

[B]

And I wanted to emphasize a few points you made, Rachel, because I think we can't overemphasize the engagement of our NRC health team and the impact that they had on our overall success. And so just a few specific examples for what Rachel was touching on. They helped us create a fairness survey, which provided a lot of insight, insights from our families. They also helped to develop more visibility for our clinicians on this goal. So it became part of our clinician summary and highlighted so that it was very clear how we were making progress. And just overall, the collaboration was very close and there was a lot of responsivity when we needed new tools to develop those.

[A]

What a great partnership and collaboration your organization's had here. And Dr. Greco, I wanted to go back to something that you had touched on earlier. Earlier, when we first started touching on the case study, you'd mentioned that the initiative, something that started as a patient experience, focus, kind of evolved into a broader patient safety priority. So can you share a little bit more about that evolution and the impact that it's having internally across your organization?

[B]

Absolutely. And I think that has really been key to its success. Given my background as a clinician, I think our team tends to really take clinician perspective into account. And in fact, we have clinician liaisons as part of our team, which really makes us more fully integrated. And we knew that this needed to be a meaningful goal. And so we looked at a couple of health outcome metrics and we found that the question of did you know what to do if you had questions after the visit was predictive of return to the ED within 48 hours. So those families who answered yes, they knew what to do had a 3% return rate within 48 hours to the ED. Those who answered that they didn't had a 6% return rate. Well, not only did we find that the return rate was doubled as they didn't know what to do, but we found some differences based on race, ethnicity and language. So for those families who preferred speaking Spanish, they had a 9.2% emergency department return rate within 48 hours and families identifying as black had an 8.6 or almost 9% return rate. So we knew that that difference was exacerbated for certain families and really highlighted the need to change our processes and our communication and interaction styles in order to prevent that return to the ed. Again, I think having some clear tie in with a clinical outcome engaged our clinical teams. We didn't have to do a lot of explaining about the why. It was very clear in terms of the need for clear communication and lack of confusion and understanding of how to get that confusion clarified. And so with those statistics we had really good participation and engagement across the board clinically as well.

[A]

Yeah, these are really significant outcomes that you uncovered here, Dr. Greco. The double return rate to the ED when folks didn't know or weren't sure what to do after a visit. That's a really compelling stat to highlight and I'm sure sounds like it resonated with your clinical team just as well. And I know you've given already some really great tidbits and best practices as to how this worked for your organization. Sharing those clinical outcomes or those goals with your team seem to be really helpful with buy in but would love to know what other important lessons or recommendations you'd share with others that are hoping to improve equity and ensure that every family leaves with clarity and also confidence.

[B]

So I think there's some broader lessons and I try to take those lessons forward with some of our current initiatives and one is what I just touched on. I think goals really have to be meaningful clinically and so shifting away from metrics that may relate more to marketing and instead finding more actionable measures that really have implications for safety and or outcome means you're going to get greater engagement. I think ownership of an initiative we're always very careful that it's not a patient experience goal, it's a noirs goal that belongs to everyone. There's really cross functional involvement and so we made sure that there's really shared ownership for the goal. It really has to belong to the entire system. It's not our goal, it's your goal. Staying the course is important. This was a three year initiative and I appreciate the great senior leadership support we had for this initiative because sometimes there is pressure to do something different annually but the long term persistence really led to the success. It does not come overnight and I would say we really didn't see system wide consistency and impact until year three. Again, that improvement focus really has to be persistent long term. I think sometimes to get the impact you want. And then lastly, I think I would say always coming back to the story, the human impact. So how does your initiative, your focus, impact patients and families? I think if you can make it clear what an improvement initiative will do in terms of that impact, you'll always get buy in. And I think that's when you get transformation, when there's the understanding that you can impact lives, that this matters. So those are some of the broader lessons we took from this three year initiative and hopefully we still hold on to as we move forward.

[A]

Yeah, that's such a great point. And I'm glad that you highlighted the fact that in that, that broader recommendation to stay the course and to be patient, you know, the fact that perhaps results might not become apparent until the third year of a three year initiative, that I think that's important for organizations to hear because there is such a pressure for, you know, immediate roi, I think on a lot of initiatives that leaders are carrying out. So love to hear that best practice about staying the course, communicating impact, driving ownership across teams, not just the patient experience folks, and having meaningful goals. So thank you Dr. Greco. And before we wrap, I understand Nemours is also partnering with NRC Health to host a 2026 pediatric collaborative. So Rachel, I'd love to learn more about the collaborative and how the work that we've talk talked about today connects to the themes of that event.

[C]

Yeah, absolutely. So our pediatric collaborative, we host it annually and we are very excited to partner with Nemours Children's Health to host it this coming year. It will be March 25th through the 26th in sunny Orlando, Florida. So at their Orlando facility, our pediatric collaborative is a wonderful event to be able to connect with with others that are doing this work. A chance to collaborate and share ideas, best practices and talking about how each organization is focusing on their data informed decision making within each of their organizations. And to top it off, we get a wonderful tour of the Nemours Hospital as well. So we're all very much looking forward to being in sunny Orlando in the end of March.

[B]

I'd love to add that being on site really makes a pediatric collaborative powerful and the previous ones I've attended to be able to see other healthcare systems in action, to meet some of their leaders, to hear about their initiatives when you're on the ground to tour and to see, for example, in one of the recent tours we saw a sibling care center, just really innovative strategies to take care of patients and families. So I really appreciate the in person learning opportunity that go beyond what a traditional conference would provide.

[A]

Absolutely. Well, it sounds like a fantastic event and I'm so great. It's so great that you'll both be able to see one another in person. And, Rachel, take that tour of the Nemours facility. How exciting. It's been a really great time talking to you both today. I really appreciate all of the insights and how you've candidly shared how this initiative has gone and the successes that you that you've seen. Before we wrap, Rachel wanted to see if you could just share with our listeners how they can learn either more about the event that we've talked about or even the case study.

[C]

Sure. Absolutely. So our Pediatric collaborative, you can Register [e-mail] We have an events page where you can go and you'll find the collaborative and additional information about that as well as on our NRCH health.com website. You can also go to that and find the case study that just went live that we just discussed with Nomours Children's Health.

[A]

Fantastic. Thank you for highlighting that. Rachel and Dr. Greco, I want to thank you again for joining the podcast today. It's been great having you both with us.

[B]

Thank you very much. I've loved being here.

[A]

Yeah.

[C]

Thank you so much for having us.

[A]

And we'd also like to thank our podcast sponsor for today, NRC Health listeners, be sure to tune into more podcasts from Becker's by visiting our podcast [e-mail].