In my career, I have had the privilege of serving as the chief experience officer for two of the top five hospitals in America: Massachusetts General Hospital in Boston and now at NewYork-Presbyterian in New York City. At both places, we measurably improved the hospital experience for patients and families because we had the right team and approach in place. There's been some debate about the CXO role, but in my experience, it's needed more than ever.
Over my 20 years in the industry, I have seen our understanding of patient experience in healthcare deepen. I've witnessed an era of greater transparency and accountability unfold, resulting in the public reporting of metrics and the connection of these metrics to reimbursement. I've watched the dynamic of consumerism come to our industry. And, alongside these trends, I have seen an articulated body of knowledge develop about how to improve patient experience. The advent of the chief experience officer, or CXO, in healthcare is perhaps a tangible expression of all of these developments.
Any discussion about the CXO role should begin with clarity about what we mean by patient experience in the first place. Often, we hear it described as 'satisfaction' or 'making patients happy.' While I am all for 'happiness' and 'satisfaction,' my colleagues and I know that these words can actually aim organizations in the wrong direction. We know that many patients and family members will not be 'happy' when they are with us. They are often sick, scared, worried and stressed. A focus on happiness also frustrates caregivers. Does that mean we give patients things that aren't good for them, or that aren't medically indicated? Happiness at all costs can lead to harm.
We are striving for something more profound: confidence. We work together to help our patients feel that they are in good hands — that they are safe, cared for and surrounded by a highly competent team. When we gain the confidence of those we serve, every patient experience metric goes in the right direction.
The CXO's role is to strategically guide their organization towards greater patient and family confidence. It's our role to bring specific expertise — the body of knowledge I referenced earlier — to this work so that organizations are focused on the right things, in the right combination, at the right time. Many leaders in healthcare are charged with improving patient experience. However, very few have had the training and experience to know how to focus leadership and care teams' work. Great CXOs know that physician and nurse leaders want to provide the best experience; they just don't always know how. The CXO makes this work an 'open book test' helping leaders to understand data and deploy evidence-based interventions that move the needle.
Over the years, I've also learned other factors that make for a truly effective CXO. A key starting point is that the role is structured correctly. To be effective, the CXO must be a strategic leader — at the same level as other key strategy leaders like the chief human resources officer, the chief nursing officer, the chief quality officer and others. They are part of the senior team, leading the development and deployment of an articulated patient experience strategy, but also an active partner in the development of all other strategy, including employee engagement, technology, care models or even capital planning.
The CXO brings their expertise to these discussions and assures that all strategy remains patient-focused and integrated. I can tell you from experience that patient experience work dies on the vine when it is not connected and integrated. A CXO's work is to ensure this integration happens. This is how my role is structured at NewYork-Presbyterian. As a member of the senior team, I have access to our organization's CEO and COO. I work in equal measure with my peers. I am accountable to our board of trustees. Because we have it organized correctly, we have had success. Our metrics continuously improve with each passing year.
The right structure is critical to the successful integration of a CXO. I have seen CXO roles fail when this is not the case. But there are also other success factors for CXOs. Here are a few, both from my own experience and from working alongside other superb CXOs from across the nation.
Patient experience is not improved with posters and slogans. It is improved in the workflow of our teams. Often the issues we are trying to improve involve communication with patients and families and, also, with each other. To do this right, you have to truly understand the workflow and have fluency with what our physicians, nurses, transporters, social workers and team members do each and every day. Effective CXOs understand or, even better, have tangible experience in hospital operations. In this regard, they can speak to the realities that our teams face and they understand how to make processes run optimally and with improved efficacy.
Successful CXOs also use their expertise to provide clear plans and direction for their organizations. They assure clarity around relevant patient experience data (HCAHPS data for example) and the priorities for improvement from this data. They ensure that their organization has targets for improvement and interventions to address the targets. They build structures to foster accountability for results. They connect patient experience goals to the other goals every healthcare organization is working on — clinical quality and safety, employee engagement, efficiency, etc. In other words, effective CXOs have a plan. These plans are based in hardcore performance improvement methodology. Furthermore, they make sure the plan is supported at all levels and that targeted focus is maintained over the long term.
Effective CXOs also keep themselves and their roles relevant in an ever-changing and perpetually challenged healthcare landscape. We need to be able to prove that our work and contributions actually add value for our patients, families and staff. This is borne out in our organizations' metrics, bottom line, reputation and in our culture. Successful CXOs never lose this mindset. Part of adding value also includes understanding what is happening in the world around us. For me, that has meant developing expertise in healthcare information technology and artificial intelligence, understanding how to address consumer dynamics in healthcare, becoming a leader in nurturing a safe and respectful culture in our organization and leading efforts to improve access.
My role has grown and developed as the needs of my organization have changed. The new areas I have taken on, or have influenced, still relate to my core functions as CXO, but they have also evolved alongside NewYork-Presbyterian's commitment to putting patients first and have kept my work and contributions relevant.
In closing, the CXO role is really not dramatically different than many other key roles in healthcare; it's just newer and, therefore, less understood. But like these other roles, the function has to evolve to remain relevant and impactful. Its unique skill and knowledge set needs to be more sharply defined. Think of how CIO, CNO, CQO and other roles have changed over the last few years in healthcare. Chief experience officers are no different.
Having said that, before judgments are made about the worthiness of this role or its function, let's make sure we are evaluating using the right set of standards and viewpoints. Given trends in healthcare toward greater consumerism, transparency, deeper patient engagement and patient centeredness, I believe the CXO role, when properly structured and focused, can only become more critical to all of our success!