Healthcare leaders spend their careers trying to optimize the patient experience, but executives can never truly understand what patients go through until they are on other side of the stethoscope themselves.
As part of an ongoing series highlighting speakers for the upcoming Becker's Hospital Review 9th Annual in Chicago from April 11 through April 14, 2018, 32 healthcare leaders answered, "What did you notice about your healthcare experience the last time you were at the receiving end as a patient?"
The responses are listed below in alphabetical order.
1. Joseph Anton, RN, MSN, Vice President of Clinical and Support Services, Thomas Jefferson University Hospitals (Philadelphia)
Even when the clinical care was optimal, there were many challenges with different aspects of experience. Although using the term "customer" in lieu of "patient" can feel awkward in a medical setting, there's no time we as consumers want or need better customer service than when we're in the doctor's office or hospital.
2. J. Bryan Bennett, Executive Director, the Healthcare Center of Excellence and also Adjunct Professor at Northwestern University (Evanston, Ill.)
I notice a lot of frustration from the providers and staff with technology and all the documentation requirements. Since most of the doctors I encounter know I work in healthcare, they are usually a bit more candid about their thoughts. In their opinions, which I tend to agree with, the EHR software over-promised and under-delivered. It's not user-friendly and it requires typing skills most doctors do not have. Voice or handwriting recognition would have gone a long way to alleviate much of the resistance faced in the provider community. This is not to mention the lack of true interoperability. In fact, the only way to achieve interoperability between providers has been for the hospital to integrate the different practices under one roof. The other issue we talk about is leadership. I've found that providers are more in tune with leadership issues at the corporate offices than many give them credit for. That is why leaders must make a point of providing opportunities for open communication throughout their organizations. Provide progress reports on major initiatives. Answer questions people might have. Connect with people and empathize with what they are going through.
3. Parag Bharadwaj, MD, FAAHPM, System Chief of Palliative Care Medicine, Sentara Healthcare (Norfolk, Va.)
I will deviate a bit from the question to sharing an experience as a family member of a patient. I had a family member who was admitted to a well-reputed hospital and was not responding to treatments. Our family was getting mixed messages from different clinicians. I tried very hard not to play the role of a palliative care physician. After weeks of turmoil within the family, I offered to be the spokesperson on its behalf. I ended up playing the role of my family member's medical power of attorney and also assisting with his comfort by recommending medications and dosages. Luckily, the team providing care was open to the suggestions. I realized that although the field of palliative care has made great strides, there is still a long way to go.
4. Mark Dooley, CEO and President, Wilson Health (Sidney, Ohio)
When I receive healthcare services I, of course, receive those services at the system I lead. What I noticed the last time is the same thing that strikes me every time – healthcare in general (and my system specifically) is blessed with some really incredible people. The combination of knowledge, caring and compassion that exists within healthcare workers is something that is hard to match in any industry. It takes a special person to work in a field that, more often than not, your customers are in a very vulnerable and difficult situation. Encountering people in those circumstances and turning that difficult situation into something positive is so rewarding. While none of us are perfect and not all outcomes are what we hope for, the caring and compassion shown in healthcare helps many through those times. I like to tell our staff that we are not just taking care of patients and families, we are changing lives. Every day.
5. Ellen Feinstein, RD, MHA, FACHE, Vice President of Cancer Services, The University of Chicago Medicine
Depending on where the care was provided — private office versus outpatient hospital setting — I've noticed appointment confirmation texts to prevent no-shows are more prevalent than ever, and private offices more often run on-time compared to hospital settings. As a first-time patient, I still marvel at the dependence on paper for patient self-reported histories, and the need to make appointments by phone, versus online — a la OpenTable for restaurants. Care coordination is a goal of most hospitals, yet they often struggle in how to deliver it. Though everyone's time is precious, I'm still surprised early morning, evening or weekend appointments are not always available. The use and acceptance of advanced practice providers (i.e., nurse practitioners and physician assistants) is definitely on the rise, which positively impacts access and service.
6. Teri Fontenot, FACHE, President and CEO, Woman's Hospital (Baton Rouge, La.)
I'm pleased to say that the care was compassionate, prompt and professional, and a full recovery was achieved! But, it was so hard to observe firsthand how incredibly inefficient our health systems remain. The admission was after hours, and some imaging and lab work had been done at an outpatient center earlier in the day. If I had not known who to call to have it sent to the hospital, it would have been repeated. Fortunately, the hospitalist and nurses were focused on avoiding duplication, but I'm confident that if I had been a patient that didn't know how to navigate the system, the result would have been different. There were also many opportunities for important information to be overlooked. We've come a long way in patient safety, but we still have a long way to go until information flow is better coordinated and waste is eliminated.
One of my most cherished patient letters was written by a new father who had to leave his wife and newborn due to a family emergency. He wrote that he was not concerned about leaving her alone at Woman's because of the care he had observed during her delivery. Patients should not feel they need loved ones with them to guard against preventable harm.
7. Mudit Garg, CEO, Qventus (Los Altos, Calif.)
I have a two year-old, so that means a lot of trips to the doctor and the urgent care. Every time I am left wanting a healthcare system that just works better. Meaning, it just works for me as a patient and just works for those who deliver care. When I go to the doctor, the clinical advice is great and the staff work their hardest to make my experience a good one, but it all seems to require superhuman effort. As a patient, the process of making an appointment, waiting in the lobby when you are there and navigating the system, is often a struggle and it takes away from everything that the clinicians and staff are doing to deliver great care.
8. Sven Gierlinger, Chief Experience Officer, Northwell Health (New Hyde Park, N.Y.)
My last major personal healthcare experience happened during a time when I was a father of two young children and at the start of a new assignment with The Ritz-Carlton Hotel Company. First came a tingling in my fingers and toes; and within days, I was paralyzed. I was diagnosed with Guillain-Barré syndrome, a rare condition in which a rapid-onset muscle weakness caused by the immune system attacks and temporarily damages the peripheral nervous system. Suddenly, and for 90 days and nights, I was 100% dependent on my doctors, nurses, and therapists.
Believe it or not, I’m actually grateful for this experience, as it showed me that as a patient, you are challenged to heal in many ways – physically, mentally, and emotionally. My experience in these moments helped me understand the power of embedding both service and empathy into the clinical processes that truly can make or break a patient or family experience. Years after my own experience as a patient, I still believe healthcare is the noblest vocation in the world. When I reflect on the many milestones and accomplishments in patient experience at Northwell Health, I keep my eye on the horizon and challenge myself to ask what’s next. We know that, in healthcare, every moment counts—and success means making every role, every person, and every moment matter.
9. Kim Henrichsen, CNO, Intermountain Healthcare (Salt Lake City, Utah)
Recently, my dad experienced the classic symptoms of a heart attack — chest pain, shortness of breath, nausea and cold sweats. I escorted him to the emergency department and remained by his side as he received emergency treatment, surgery and follow-up care. He received great care, but I identified opportunities for improvement, both in care processes and with communications to family members and between facilities and caregivers. We are now working to implement enterprisewide solutions to address these opportunities. Another example is my daughter who is a [neonatal intensive care unit] nurse. She trained in one of our facilities, took a position at our children's hospital, and then transferred to another hospital in our system, essentially caring for the same type of patients in all three locations. She noticed some protocol and procedure differences between our facilities and identified opportunities for more standardization so our nurses can move around from facility to facility more effectively and patients [and] families have consistent care experiences.
10. Carrie Jeffries, CNO, U.S. Department of Health and Human Services and Health Resources and Services Administration (Washington, D.C.)
The last time I was a patient, I was touched to see healthcare providers remained passionate about their work. I also identified missed organizational opportunities. I spent several hours in an emergency room staring at four walls and was a captive audience. There was no educational program running in the background; no hospital-sanctioned tablet with diagnosis, medication, or discharge information, and the throughput was slow. I wondered if the ED could have partnered with an outpatient clinic to learn what they were doing to capitalize on a better use of time, technology and innovative thinking.
11. Jen Johnson, CFA, Managing Director, VMG Health (Dallas)
I pulled a muscle but it hurt so badly, my primary care doctor directed me to the hospital for x-rays. I decided to have my first freestanding ED visit and WOW, there was no one there, service was exceptional, they even took my payment (hi co-pay), while I sat comfortably in my room with a warm blanket!
12. Jim Keller, MD, MHSA, Vice President of Medical Management, Advocate Trinity Hospital (Chicago)
While recently undergoing a minor procedure at one of our health system's larger hospitals I was acutely aware of the adherence to scripting. Everyone introduced themselves with a smile. I was offered an earlier appointment when a cancellation occurred and everyone foamed their hands. But what I remember the most as I was walking out was a receptionist asking me if I wanted her to cut my wrist band off before I left. It was such a simple yet sincere gesture which saved me the hassle of looking for scissors or yanking on the close to unbreakable piece of plastic. I wish I had acknowledged this simple act at the time.
13. Stephen Klasko, MD, President and CEO, Thomas Jefferson University & Jefferson Health (Philadelphia)
I had a procedure [done] at Jefferson [Health] last year, and the coolest thing we started was ""virtual rounds."" While I was in the recovery room with my surgeon, I had all three of my children on iPads while my surgeon was explaining my [post-surgery] recovery. Of course, having done it a few minutes after anesthesia, [my family] claimed I offered them all new cars! But more importantly, they could talk to the surgeon and be reassured. Then it struck me — it wasn't the technology that enabled that — we could have done it with Facetime three years ago or Skype five years ago or with the phone anytime in the 20th century. We just didn't think consumerism was important.
14. Tim McGill, MPH, CEO, Livingston (Tenn.) Regional Hospital
I observed focus on the details of consent, my health history, the patient identifier process and the repetition it takes to reduce human error. I was impressed.
15. Justin Meadows, Manager of IT Service Management, Mission Health System (Asheville, N.C.)
My last experience as a patient was interesting in that the waiting room was relatively empty, I did not wait long in the exam room, lab results arrived on my physician’s laptop while we were still talking and the overall transaction felt friction-free. While this was a small family practice, I could not help but wonder what add-ons that would be valuable to me and profitable to the practice were now possible without all the noise, chaos and confusion I remember from just a few short years ago.
16. Nathan Merriman, MD, MSCE, Chair of Physician Leadership Network Governance Committee, Christiana Care Health System (Wilmington, Del.)
When I was a patient recently, I noticed a clear need for a patient care advocate and system navigator due to the complexity of care coordination from the patient perspective. As a physician, I was able to serve these functions myself as I contacted different offices and coordinated my appointments in a time efficient way, and I knew the specific questions to ask and language to use when I conveyed the severity and personal impact of my symptoms as well as the urgency of my appointment needs. I offered to be put on the waiting list for an earlier appointment since I know that many offices have this capability if there are late appointment cancellations but many offices do not have a way to consistently offer this cancellation list service. I received outstanding medical care from all of my providers, and I trusted each of their clinical opinions and expertise. However, I did experience a difference in opinions regarding the best course of action among the physicians I was working with, partially because my symptoms as a patient evolved over time between the appointments. This difference in clinical opinions was challenging to navigate as a patient and provider who personally knows each of the physicians involved in my care, but I combined and compared the provider opinions, did some online research on my own, and made my decisions as a patient based on what I thought was the best course of action for me.
17. Sherri Peavy, COO, UIC Mile Square Health Center (Chicago)
How smoothly it went. This is something we have been working on for some time now. I appreciate the efficient service and respect for my time as well as the convenience of the patient portal.
18. Shaun Phillips, Vice President of Clinical and Pharmacy Services, Bronson Healthcare Group (Kalamazoo, Mich.)
I had recent outpatient knee surgery due to sports-related injuries. It was a great experience, as I was fortunate to get everything taken care of quickly and efficiently. The problem is our support services — home care, rehab, etc., are not geared towards middle-aged, busy people. We have many of our services and support systems built to support our core demographic—aging populations with older or grown children. We need to consider what are the needs of families with young children and perhaps limited or no family support in the area. How do we help a single mother continue her own care and care for her kids after an appendectomy? How do we support a family with a dad who just had back surgery and can’t do home repairs like before? If either of these folks try to do their usual activities too soon, they will be readmissions too. We as an industry need to consider our after-care, post-acute systems to take care of our traditional populations as well as the kinds of barriers to younger patient populations face.
19. Giovanni Piedimonte, MD, FAAP, FCCP, Pediatric Institute's Chairman and Physician-in-Chief, Cleveland Clinic Pediatric Institute
I can safely say that most of what I know about healthcare derives from two personal experiences I had on the other side of the fence: I am a cancer survival and father of prematurely born children. When my babies were in the NICU, I certainly gained new appreciation for the miracles of modern medicine, able to give a chance of life even to babies that have spent in the womb only half of the time they are supposed to be there. But I also experienced and understood firsthand the sorrow of parents that know their child is sick and may die, and they cannot even be there all the time. They may have jobs, other children at home, and other responsibilities. Every minute they are away they suffer, and when they make it to the hospital they often have to deal with inefficiency, miscommunication, and sometime even rudeness.
Similarly, when I was diagnosed and treated for cancer, I experienced personally the blessing of having access to therapies that were unavailable just a few years ago, but also touched with my own hands the frustration and despair associated with lack of access, poor communication and information, obsolete facilities, limited interoperability, avoidable medical errors, and the many other issues that still plague the delivery of healthcare in our country. Since then, I have paid even more attention in using all available tools and strategies to satisfy an essential human need, and in doing so, putting patients and their families first. At the end of the day, taking care of patients is the highlight of my life. It helps me keep my sanity.
I don't suffer from burnout, because I have incredible fun doing something that gives me pleasure every day, and the older I get the more I understand that when you do something that makes your heart beat a little faster, you will do it better than anyone else. Last but not least, my experience on both sides of the fence, as a doctor and as a patient, has allowed me to interact with many others who have shared similar stories, and this priceless human material has progressively formed the platform for a book I have been writing over the past year about the good, the bad, and the ugly of modern healthcare. More to come...
20. Stonish Pierce, System Vice President of Specialty Services, Beaumont Health (Royal Oak, Mich.)
My last healthcare experience was a visit to a dental practice that I've remained a loyal patient to for the last several years. I would describe my entire experience as pleasant and consumer-focused, but this is due in large part to the fact I selectively research my healthcare providers based not only on clinical credentials, but also, and most importantly, on the ""service"" experience that I can anticipate receiving. Researching the service experience may include, but is not limited to, online ratings from prior patients and families, social media, promoted service amenities, ease of access and ease of interfacing with the provider on an ongoing basis given my busy schedule.
The practice is very modern in both its physical and virtual forms. From a pre-arrival standpoint, I was able to complete new patient paperwork, obtain information related to insurance coverage and even view photos of the practice's modern facilities online. Upon arrival, parking was easy to secure, comfortable seating was provided along with free Wi-Fi access and manageable television noise, but most importantly, the wait time was less than five minutes. The staff were all professional, introduced themselves by their name and their role and informed me as to how they would be interacting with me as a patient during my visit. Following my appointment, the practice provided me with immediate access to schedule future appointments during convenient evening and weekend hours that accommodated my schedule.
While not a "traditional" health system encounter, what I derived from this experience, as well as other healthcare experiences, is that we're fortunate to serve the overall experience that today's patients expect to receive at Beaumont. As the largest healthcare system in Michigan — based on inpatient admissions and net patient revenue — with eight hospitals, 36,000 employees, 5,000 physicians and nearly 200 outpatient care sites, I'm inspired to translate my personal experiences into motivating our employees to assist Beaumont in reaching its goal of being a national leader for patient- and family-centered care over the next five years.
21. Michael Privitera, MD, MS, Professor of Psychiatry and Medical Director of Faculty and Clinical Wellness, University of Rochester (N.Y.) Medical Center
I appreciated how much stress he was under from our healthcare system, yet he was trying to take care of me. I appreciated his hard work to get everything done that was required for him to do, and yet also address the reason I was there. He got past all those distractions, yet I could see it was hard.
22. Michael Ries, MD, Medical Director of Critical Care and eICU, Advocate Health Care (Chicago)
The lack of communication and coordination, especially by the hospitalist approach to inpatient care. Much of this can be facilitated by technology as the optimal process is laid out by the stakeholders of the process.
23. Cindy Russo, MS, FACHE, CEO and President, Baystate Franklin Medical (Greenfield, Mass.)
The last time I was at the receiving end of healthcare it was to assist family members needing care. Trying to help both my elderly parents navigate the healthcare system was extremely frustrating. Even though I understood the ins and outs of how our business works, I found myself needing to ask many questions. It was not infrequent good meaning caregivers were impersonal, attending to my parents needs as a chore. Providers and offices were not available to see my parents at times that were convenient for them or me. I am fortunate I can be flexible with my work schedule. I often thought about those who jeopardize their jobs when deciding to help with the healthcare needs of their family members. I also thought those who did not have the same background in healthcare as I did and wondered how they could possibly understand what they needed to do. As healthcare leaders, we should work to make our processes more user friendly and less complex and confusing.
24. Dennis Shelby, CEO, Wilson (N.C.) Medical Center
I recently had an EGD performed on me at the hospital where I am the CEO. Every staff member was friendly and engaging. The Patient Financial Services staff was professional, friendly, and helpful as they registered me. Everyone asked if I was comfortable and in need of a warm blanket. The room I was in was extremely clean. The surgical nursing staff, nurse anesthetists, and physician asked all of the right questions to ensure I could have the procedure performed (i.e., no eating, drinking, allergies, etc.) The physician provided me with his findings/impressions, which were reassuring, but sent off a specimen just to be sure.
I received a thank-you card in the mail signed by the surgical team wishing me well and thanking me for using Wilson Medical Center. Some may wonder if I received extra special care because I am the CEO. The truth is, the staff treats all of our patients as if they were the CEO or a VIP. I am proud to lead such a fine organization that delivers friendly, family-oriented, quality services.
25. Terre Short, AVP of Patient Experience, HCA Healthcare (Franklin, Tenn.)
I noticed a disconnect between all of the various caregivers regarding the details of my care, forcing me to have to take on connecting the dots and coordinating my care. I believe this is a big part of what we need to fix. We have yet to properly leverage technology to improve the teamwork and collaboration of caregivers, as well as free them up a bit to make a personal connection with the patient.
26. Jaspal Singh, MD, MHA, MHS, FCCP, FCCM, Pulmonary, Critical Care and Sleep Medicine Physician, Carolinas HealthCare System (Charlotte, N.C.)
I continually seem surprised at how increasingly expensive healthcare is becoming. Medications are difficult to afford even for those with financial means. Minor procedures can cost tens of thousands in the current environment. Moreover, since costs are being passed to patients, I can see why many patients refuse or delay services. Similarly, my family members and I have personally delayed elective procedures and refused expensive medications even though we think in the long-run these might be helpful. Added to the expense is the lack of complete cost transparency in cost transactions in healthcare. We believe this is a very treacherous situation for patients and families, and are hopeful the current focus of our organization to evolve to more cost containment and increased transparency will be helpful to our communities.
27. John Snyder, FACHE, COO, Carle Health System System (Urbana, Ill.)
What I noticed the last time I was a patient was how much the little things matter. Quality care should be a given. What makes the difference between a good and excellent experience are a couple of things. Being treated as a partner in your own care, and being educated about what is happening and why it is happening makes a big difference in patient engagement and satisfaction.
28. Donna Sollenberger, CEO and EVP, The University of Texas Medical Branch (Galveston)
While the care delivered by the provider was excellent, I think we can do a much better job of coordinating each patient's care and involving them in the development of their overall plan of care. As patient care has become more complex, I find that patients prefer to have a coordinated plan. Additionally, patients have questions that should be answered by a single provider who is reviewing all of the patient's care when it occurs in multiple settings and is delivered by different providers. They need a single point of contact who can assess their test results overall, as well as their medical history, to help better educate the patient about their health condition(s).
29. Eric M. Stone, Co-Founder and CEO, Velano Vascular (San Francisco)
I have been a chronic disease sufferer since I was a teenager. This has given me a front row seat to the evolution of the patient experience in healthcare today. Coupled with my journey as a healthcare entrepreneur, I've been able to peek behind the curtain a bit and connect the dots between innovation and experience. Over the past few years, I've noticed a dramatic movement to build on improvements in environmental comforts by advancing the actual standards and practice of medical care. These include everything from new bedside diagnostic tests to our own advances in blood draw technology.
In fact, that goal of reinventing the medical care experience is why we, at Velano Vascular, are focused on blood draws. Our inspiration dates back to when an elderly patient asked our founder and inventor why she needed to be stuck with another needle for a blood draw when she already had an IV line in her arm. We believe that by treating patients as consumers and as people — and re-imagining every facet of their care — we can significantly advance the healthcare experience in the years ahead.
30. Laura Swaney, Vice President of Women's and Children's Services, Medical City Healthcare (Dallas)
As a patient, I personally felt the lack of coordination between primary care, specialists, and hospital despite a unified EMR. It was apparent that the patient must be vigilant to ensure communication among care teams is occurring and must remain the driver of their healthcare experience or it feels as if they’ll slip through the cracks. Despite the utilization of technology designed to aid in communication, healthcare feels so big business, uncoordinated and sterile.
At the time of my experience, I did not receive care within my own system, however the takeaways for me are something I use daily when considering new programs, processes and the patient's experience. I remember how alone and frustrated I felt and I worked in healthcare.
As healthcare leaders, it is our job to walk in our patient’s shoes. We are not there to simply heal them. We are there to care for them at a time that is usually fraught with fear and significant stress. Ensuring a well coordinated, seamless, efficient clinical experience delivered with passionate care and empathy is exactly what our patients deserve and need.
31. Erin Tritch, Executive Director of Strategic Sourcing and Supply Chain, University of Chicago Medicine
For more common everyday care, patient experience is about ease and flexibility of access, good communication and quick and effective care. When you have a need for more complex services, then you need a patient advocate to guide patients through the process, help make care decisions, understand costs and insurance impacts and ensure the patient and family get the care they want and understand the costs of it.
32. Bart Walker, JD, Partner, McGuireWoods (Charlotte, N.C.)
My last trip to the urgent care was eye-opening and highlighted for me that integration of technology is finally happening in healthcare. First, I searched for the nearest urgent care location on my phone. The search results not only showed the location, hours and providers, but also the current wait time. The web interface allowed me to sign in online and the system texted me 15 minutes before they would call me back to be seen by the treating physician. This allowed me to wait at home and arrive at the urgent care just in time. I was running late, and the text-based system allowed me to notify the provider in advance. This kind of process integration with technology is going to become more and more of a differentiator (and a patient expectation) as the market evolves in the future. The industry has progressed so far from the days when I watched my primary physician hunt and peck at a brand new laptop-based EHR system for 15 minutes trying to figure out how to write a prescription.