I have the honor of meeting hospital leaders from all over the world. The actions of these leaders represent some of the defining differences between hospital leaders who "get it" with respect to what it takes to improve the patient experience, and those who don't.
In fact, I have developed what I refer to as my "60-second rule." I can tell within the first 60 seconds of interacting with a hospital leader if he or she has the ability to lead meaningful patient experience improvement. If, at the outset, the leader demonstrates concern for patients and understands the connection between the patient experience and how well (or poorly) their hospitals deliver care, I know they "get it."
I recently had the opportunity to sit down with the CEO of a large hospital system to talk about patient experience strategy. He is not only a very successful hospital executive, but an important thought leader in the industry. While I am experienced in the C-suite of major medical organizations, this was my first meeting with him and, admittedly, I was a little nervous. I knew that the future of his organization—specifically, its ability to transform to a more patient-centered environment—depended on several things. First, the patient experience had to be directly linked to what I term "hard-core hospital operations." Second, the CEO needed to lead the effort. Enhancing the patient experience in a large, complicated hospital system cannot be delegated outside the CEO's office.
After the introductions and hand-shakes, the CEO immediately launched into, "I recently received two letters..." One of the letters, he said, described a patient's consternation with the lack of communication and care coordination in one of his hospitals. He equated the patient's experience to a basic failure of care delivery. "My family uses our facilities; this is not what I would want them to experience!" He described how his hospitals had to do a better job of ensuring that their caregivers communicate and work together more effectively.
My fears immediately melted away. He was talking my language. He understood the need to listen to the patient's voice. He used words like our "caregivers," and equated the work to treating all patients as he would want and expect his family to be treated. He had also successfully articulated that the patient experience is not about delivering happiness; it is about how we improve operations to deliver on the patient promise of safe, high-quality care, in an environment where patients feel cared for. He knew that caregiver communication and coordination is as much about good care delivery as it is about the patient experience. This guy got it!
Another CEO I met recently sends out communications to all of his employees and frequently includes not only patient stories, but personal reflections of his own health care and that of his family. He uses these stories as a way to get others to think about how their families would be treated in his organization, and he challenges his employees to raise the bar on consistent delivery of the experience.
I've heard from other CEOs that they open every meeting—board, executive or large group gatherings—by reading a patient letter—either good or bad—and talking about the operations that either enhanced or failed that particular patient or family's experience.
Collectively, these CEOs not only possess that critical understanding of the importance of the patient experience, but are all equally passionate in their desire to enhance it. They also understand that the patient experience is not just about the care delivered to their patients, but it also directly impacts the care that they or their families will ultimately receive. This fact is what should make improving the patient experience very personal for every hospital leader.
A great patient experience is not about being nicer to patients, although being nicer is a component of it. At the end of the day, it is about how we improve our operations to better deliver health care. Creating a patient-centered focus also requires retooling the hospital's organizational culture so that every employee is putting the patient at the center of their work, which is not an easy task in complex, legacy-steeped industries such as health care.
Cultural and operational organizational improvement and transformation of this magnitude requires senior leaders to drive the work. It starts at the top, with the hospital president or chief executive officer. Like any other major organizational initiative, if the top person is not talking about, leading and directing the strategy, people across the organization will not pay attention. Lower-level leaders will not adopt the work as a strategic priority and front-line caregivers will quickly recognize that the messaging of patient-centeredness is a shallow promise with no consequence for not paying attention to it.
Demonstrating the primacy of patient experience as a strategic objective in the C-suite is not complicated. To keep the health care customer top of mind to senior leadership and employees, CEOs can regularly leverage the patient's voice using enterprise patient experience data and patient stories. A leader's willingness to discuss their personal stories inserts their personal vulnerability into the discussion and demonstrates true empathy for patients. This level of authenticity helps to reinforce the priority.
Reading patient letters is a good first step towards understanding what patients and families say about the organization. Making patient experience improvement a top priority by opening every meeting with a progress report on the current state of improvement efforts and affirming work that needs to be done helps remind people that achieving sustainable gains requires constant attention.
Enhancing, or in many cases fixing, the patient experience requires that senior leaders bring the same attention and operational rigor to the patient experience agenda that they bring to market share and finances. These types of initiatives cannot be delegated to a single stakeholder, such as nursing or operations. Addressing the issue requires much broader scope. Patient experience must be owned by the senior person responsible for the health of the organization. In today's healthcare environment, the patient experience is not only a strategic imperative and a critical organizational differentiator. It is the right thing to do for patients, and importantly, it reflects the way we as leaders want ourselves and our families treated.
Dr. James Merlino is an accomplished surgeon and industry leader in improving the patient experience, drawing from more than two decades of health care experience to oversee Press Ganey's consultancy division. Prior to joining Press Ganey, he served as chief experience officer and associate chief of staff at the Cleveland Clinic health system.
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