Making Patient Experience Initiatives Stick

HealthLeaders magazine , November 13, 2009

A patient experience initiative can fail for many reasons. For starters, you can treat it like just another initiative—a fad that will inevitably fade from favor with the next change in the weather—or the C-suite. It can die from simple neglect—a lack of time, money, and attention—even if everybody understands and agrees how important it is. On the other hand, there are plenty of ways to make patient experience more than just another initiative, to weave it into the very fabric of your organization's culture, and ultimately to reap the rewards of a healthier bottom line and a reputation that people will talk about with anyone who will listen. HealthLeaders recently convened a panel of experts who shared their best tactics not only for making patient experience a priority, but also for maintaining the momentum.

Panelist Profiles

Sean Keyser
VP, operational improvement & service excellence, Novant Health
Charlotte, NC

John Gnida
consultant, client education, Professional Research Consultants, Inc.
Omaha, NE

Rick Henvey
Regional COO-Community Hospitals, Parkview Health System
Fort Wayne, IN

Gienna Shaw
senior marketing editor, HealthLeaders Media
Marblehead, MA,

Janet Nystrom
HR director, Progress West Healthcare Center
O'Fallon, MO

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Roundtable Highlights

HEALTHLEADERS: What is patient experience and, perhaps more important, what is it not?

JANET NYSTROM: Patient experience is about the individual connections that our employees make with our patients every day. Regardless of your position, you want to create a story for that patient, something positive they will remember. Satisfaction is a lot different than experience. Satisfaction is meeting, not exceeding expectations. When we exceed expectations, we create loyalty. That is what we strive for.

RICK HENVEY: Patient experience is what happens at every touch point, from when you get out of the car to when you get your bill. So many healthcare organizations think it's about turning lemons into lemonade or smile school. It's about creating those "wow" experiences at every touch point. We send thank-you notes throughout the health system to 100% of our discharged patients from the inpatient units. This year, managers started including their business card with a personal note. Our cath lab director got a call from a man who had her card and wasn't feeling well. They called an ambulance, brought him in, and he ended up having a catheterization done. She walked him through it and now we have that great story about their experience to share.

NYSTROM: When patients write to us about their experiences, we call it "fan mail." We communicate our fan mail regularly. One story I can share to illustrate that employees are empowered to do whatever it takes to make the patient's experience an excellent one involves one of our maintenance mechanics. It was a Sunday afternoon—a really hot day. There was a family whose grandmother was in our hospital and she was dying. This employee was doing his rounds and saw there were a lot of kids in the family room. He brought them all ice cream bars—it was unexpected, and was a memorable experience for that family. We didn't train this employee to do that, we hired the right person.

SEAN KEYSER: Our vision is to deliver the most remarkable patient experience in every dimension, every time. We've pulled off customer service in a big way. We've pulled off quality in a big way. We've demonstrated excellent financial stewardship. How do we go beyond? It's the touch points. We ask "What happens here, what happens here, what happens here?" If you keep asking that question, you won't concentrate on customer service or quality or stewardship discretely. You're going to look at what's important at every point. Experience is holistic.

JOHN GNIDA: I've been to almost 400 hospitals now in 10 years with PRC and about 95% of the hospitals are on top of the latest buzzwords. So if you talk about patient experience, they've got it. Service excellence? They've got it. But do they really? When we talk to managers who are writing action plans or directors who are frustrated that they can't move their scores or grow their market, it turns out that they're not really doing service excellence work, which is creating remarkable experiences. Usually they're doing service recovery work instead. I don't want to denigrate service recovery, but it's a whole other strategy—it's not patient experience.

Creating the culture

HEALTHLEADERS: How do you create a culture of service excellence?

GNIDA: Make your mission part of everything you do. It's amazing how often you'll walk into a room and even though they say, "We're all about patient-centeredness," patient care is nowhere on the agenda. When the very first thing on the agenda is about care, it sends a message to everybody. People will start to buy the mission when our currency, our attention, and our time show our devotion to it.

NYSTROM: We have four service priorities, in order of importance: safety, courtesy, expertise, efficiency. Everything that we do is structured around those four priorities. Because they're in order of importance, you can make decisions and know that you're doing the right thing for the organization and, more importantly, for the patient. Efficiency, where finance lies, is our fourth priority. Courtesy and compassion, where service excellence falls, is ranked second under safety.

GNIDA: When I walk through the doors of a client who's scoring in the 90th percentile, I see it immediately. Everyone who wears a name tag, whether clinical or nonclinical, impacts patient experience. Because my perceptions of care are not just my nurse or my doctor, it's also how the person walking down the hall looked at me, how the people standing over by the elevator are talking, whether they appear to be interested in helping people or not.

NYSTROM: In our pre-postop area if one nurse doesn't feel like she's connecting with a patient, she'll say to a fellow nurse, "We're not connecting, I'm not feeling a relationship here, can you try?" Recognizing this is very important. Their scores reflect their commitment to creating excellent experiences.

Bottom line impact

HEALTHLEADERS: How does patient experience relate to the bottom line? What's the business case for creating "wow" experiences?

GNIDA: There's a tremendously strong relationship between quality and survey respondents who say they are likely to recommend a hospital. Based on that data, we can predict that clients with a lot of patients who say the care was excellent are going to be okay financially, even in this crisis. It's remarkable how many of our clients who are in the top percentiles are reporting that they're weathering the storms pretty well. If you get positive buzz from your community and your patients, not only do they have memorable experiences, but they talk about these experiences to other people, they recommend you to their family, their friends. That's how we grow. That's how we succeed.

HENVEY: We know excellence builds loyalty, which drives market share. I don't care if you're for-profit or not-for-profit. You're about market share when it comes to business. The numbers that PRC ran said that of the patients who ranked our care excellent, 80% were loyal to Parkview. Of those who said we were very good, only 20% said they were loyal to Parkview. If we're about building loyalty, excellence does that, which drives market share, period.

KEYSER: Reform or not, environmental changes or not, consumerism will have an incredibly strong presence in healthcare. As long as people are making choices about their care and making choices about where they want to receive care, then we owe it to them to create something extraordinary. Our vision isn't fashionable; it's not just rhetoric. It's intended to drive a business strategy—to create a remarkable experience that's going to lead people to tell other people "I wouldn't choose anyone else." That's the business case.

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