Academic journal article Frontiers of Health Services Management

A Systematic Approach: The Path to an Exceptional Patient Experience

Academic journal article Frontiers of Health Services Management

A Systematic Approach: The Path to an Exceptional Patient Experience

Article excerpt

LIKE Wolf AND GulER , the authors of this issue's feature articles, I include the patient experience on a short list of important indicators of performance-along with clinical outcomes, an engaged workforce (including the medical staff), and sustained financial performance. My comments here focus on the reasons some healthcare organizations have cracked the code to providing a better patient experience-and why others, despite working on the problem, do not have much to show for it.

The path I recommend to greater and more sustainable results comes with the challenge that it is not a quick fix. This fact limits the odds of success right from the start because healthcare leaders are busy people, burdened by overflowing plates and frequent interruptions.

However, the responsibility for creating a great patient experience cannot be delegated. Senior leaders, including the CEO, must own responsibility for their patients' experience. And the positive bedside staff-patient interactions that result from their efforts will not be sustained long term without continuing attention.

In my experience, leaders of successful organizations commit to three important practices:

1. They use data and images to continually paint a picture of the results they wish to achieve.

2. They build a system that creates higher performance on key indicators.

3. They patiently improve their system as they learn more on their journey.


Excellent case studies of organizations that have built a better patient experience come from recipients of healthcare's Malcolm Baldrige National Quality Award. But as I tell many of my clients, you do not have to be on a formal Baldrige journey to benefit from its insights.

Baldrige is all about process (how you do things) and results (the impact of those things). Work on process leads to improved results. But instead of jumping right to process, you must first focus your people by painting a picture of the results you wish to achieve.

I have seen the most success when leaders paint that picture in two ways. Right-brained employees will relate best to an image you create of a great patient interaction. Guler's Adventist Health System draws on the image created by its bedside nurse: "treating the patient as you would the person whom you love the most."

Left-brained people, on the other hand, will relate best to data and seeing how the scores stack up in internal and external comparisons. More on this later.

Leaders who fail to paint the picture and jump right to changing processes too easily become dictators in the eyes oftheir frontline caregivers. For example, let's consider trying to get doctors to sit down to encourage the patient's perception of a more thorough interaction.

If you preach "sit when you're with a patient," doctors may perceive this direction as micromanaging by someone who is out of touch with the realities offrontline caregiving. A doctor may do a token "quick sit" only because it is required. The result is behavior that feels (and is perceived as) unnatural or scripted. Doctors who already do well with patients may waste time and energy thinking about sitting instead of focusing on other behavior modifications more tailored to their personal opportunities for improvement. Then there is the logistical challenge: You're not a fly on the wall in the patient room, so you really cannot know who sits and who does not.

In short, a plan that leans too heavily on process modification will likely not lead to the desired change in results. And who wants to be a leader who nags about a checklist of things to do?

Instead, lead with results. Inspire individuals with stories about wonderful patient interactions and then hold departments accountable for achieving a defined result, such as improved physician scores on a key survey indicator. Once you adopt this perspective, you do not need to worry about how those results are achieved (sitting, standing, doing cartwheels) as long as it is done ethically and legally. …

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