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The Patient Experience

by Barry Bittman, MD

World renowned business strategists, Deming, Juran and Drucker clearly shared a tried and true philosophical insight that finally seems to be coming back into vogue in our present healthcare system — quality and customer satisfaction are inseparable. 

As a physician who assumes the role of change agent, recognizes the value of shared responsibility with the hospital, and strives to optimize quality through creative healthcare delivery systems, I strongly support the notion that we need a guiding light to stay on track.

None is more powerful that what we refer to as the "patient experience."

As a healthcare executive, your leadership and facilitator experience will be called upon for a variety of projects and programs that will ultimately affect your organization’s relationship with its patients.  None will have more impact in this regard than a dedicated focus on improving the patient experience.  In order to succeed, you must see yourself as a champion or advocate for those you are privileged to serve.  Your responsibility includes the creation and development of novel strategies for the promotion of your patients’ interests.

Over the years, I’ve made it a habit to ask new employees to identify and discuss our competition.  Most simply shrug their shoulders and offer the obvious — a hospital in a neighboring community, the clinic down the block or the multi-specialty group in the professional building.  They typically focus on comparing similar services such as labs, x-rays, health screening, stress tests, etc.

On the most superficial level they are correct — people have a tendency to compare such services.  When I proceed to challenge them, and throw in a name like L.L.Bean, the new recruits appear perplexed.  Their reflex response is expected.  What does a sportswear store have to do with healthcare?

My answer is… everything!

It’s a fact that while people have a tendency to compare products, what’s often forgotten yet seems to matter the most is the customer experience.  In healthcare, we must raise the bar since it’s the best experience that stays in mind regardless of where it was offered.  It’s a fact that people tend to rate organizations to a great extent by the attitude through which goods or services are sold or delivered.  It should not be surprising that they compare us (our hospital) to those indelible best experiences that are difficult to forget.

Taken directly from L. L. Bean’s website, the following quote reflects both a philosophy and a real-world commitment shared by its employees, “A customer is not an interruption of our work... he is the purpose of it. We are not doing a favor by serving him... he is doing us a favor by giving us the opportunity to do so.”  

L.L.Bean refers to itself as “a trusted source for quality apparel, reliable outdoor equipment and expert advice for more than 95 years.”  The company, having grown from a one-man operation to annual sales of $1.5 billion, can teach us a number of important lessons.

Perhaps the best way to begin to understand our patients is to track them through existing processes.  When was the last time you observed the hospital registration desk or the lab waiting area?  How much time do your patients spend in the ER for both emergent and non-emergency care?  How long does it take to get lab and test results?  For someone in distress, when is the next available counseling appointment?  How long must a family member be separated from a loved-one post surgery (and why)?  Your answers are likely to uncover unnecessary sources of intense anxiety that have a tendency to weigh negatively on the overall patient and family experience.  Yes, the family is our customer as well!

Essentially these questions reveal only the tip of the iceberg.  Perhaps it’s time to dig a little deeper. What are the real obstacles to receiving care in your institution?  How many patients with potentially modifiable risk factors are lost to follow-up?  From a business perspective, why would your hospital even consider leasing a billboard, when a similar expenditure dedicated to improving customer service could yield a far greater return on investment… and a satisfied patient?

Is your hospital truly service oriented?

If you cannot answer these basic questions, perhaps it’s time to raise the bar on the patient experience!  

Every hospital must strive to improve its HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores.  For the first time, the patient experience, measured by the HCAHPS twenty-seven question survey, directly impacts reimbursement and your bottom line.

By now you’re probably reflecting on your hospital and realizing that room for improvement is so vast that a reasonable approach is bound to require a coordinated wide-ranging all-encompassing effort.  Undoubtedly you are correct.

The question that immediately comes to mind is, “how does your hospital set forth to accomplish this goal?”
The answer lies in developing a coordinated interdisciplinary patient experience strategy.

Consider the following steps:

  • Begin an interdisciplinary Patient Experience Council.  
  • Champion an ongoing institution-wide strategic initiative. 
  • Develop a unique set of comprehensive satisfaction metrics.  
  • Reward, report and celebrate innovation.  
  • Realize the benefit of creating a cohesive workforce.  
  • Inspire Leadership within the ranks. 

To learn more, feel free to contact me at bbittman@iihealthcare.org

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