A Growing Focus on the Patient Experience
The C-suite role of the Chief Experience Officer (CXO) is evolving in healthcare, and many new Vice President and Director roles are emerging focused on the patient experience. Because patient experience can directly affect patient outcomes, there is a trend in open positions throughout health organizations. A cultural shift is happening in healthcare.
In today’s world, patients have become consumers – whether we like it or not, whether that’s how we want to view them or not. They have a high deductible health plans, and they’re shopping around more in order to use those plans. What does it take to keep a patient satisfied? – Sarah Jane Tribble, WCPN, Cleveland
Sarah Tribble recently posed this question to a panel of “Chief Experience Officers” at the City Club in Cleveland. She says there are more than 50 Chief Experience Officers in healthcare C-suites today, and invited four to discuss their role and the patient experience. Panelists included:
- Adrienne Boissy, M.D., M.A., Chief Experience Officer, Cleveland Clinic
- Catherine Koppelman, R.N., M.S.N., NEA-BC, Chief Nursing and Patient Experience Officer, University Hospitals
- Sara Laskey, M.D., Chief Experience Officer, The MetroHealth System
- Sue Tyler, Executive Vice President and Chief Experience Officer, Medical Mutual
The Cleveland Clinic was one of the first to create an executive role focused on the patient experience, and Dr. Adrienne Boissy is the third person to hold the position. She says the role requires “a lot of creativity and on the ground wherewithal,” and the aim is to provide safe, high quality care in the context of patient satisfaction.
According to Boissy,
We used to be doctor-centric, and now we’ve swung to patient-centric, and I’m very interested in driving an agenda that’s relationship-centric – where both people bring value to the table.
Each year, about 30% of patients who receive a survey respond to the Cleveland Clinic, which amounts to 190,000 patients offering feedback about their experience. Boissy says the number one complaint is doctors not knowing how to talk to their patients. This is not exclusive to the Clinic, but a universal problem.
Communication in healthcare is a national epidemic. We are all trying to figure that out. – Dr. Adrienne Boissy, Cleveland Clinic
She says that clinicians’ biggest complaint is being pulling away from the very patients they want to serve by the assault of check boxes and requirements.
How do we improve communication in healthcare?
According to Boissey, the Clinic wanted to develop a program to meet the complexity of healthcare today. Initially, 1,000 physicians were trained voluntarily.
We thought a lot about creating a program that wouldn’t just give people skills, or give them a script and tell them how to do it. You are dealing with intelligent people. Intelligent people don’t recite scripts. They remain empathically curious about what’s going on with the human in front of them. They have a self-awareness to know what that patient may need to hear. They have an interest in understanding the fears, and worries, and expectations that are unspoken. And that’s the type of clinician we wanted to make an investment in. Those are the skills we wanted to evolve in our caregivers. And that became very interesting to me.
Catherine Koppelman of University Hospitals, says it is all about the culture,
It’s not about teaching people to practice scripts in talking to others. It’s genuine, normative values and beliefs. Culture starts with leadership. What leaders do, and invest their time in, is what the employees, the clinicians, know is important.
Koppelman explains that every administrative and management meeting, including those with staff, starts with some aspect of the patient experience, “because it’s that important.” She says that can take the shape of reading a letter that came from a patient or sharing a story from a patient’s perspective as told by the patient,
“But in many of them, we actually bring the patient in. And the patient speaks to the leaders. … We do retreats with patients and families. We have them tell their story. The power of storytelling is what reinforces the culture.”
She adds that at University Hospitals, “All of our leaders round in our clinical environment, and sit and talk with patients and families.”
Tribble says the confusing thing for the average person is that doctors and nurses need to be taught how to care, because that’s what they do. She asks, “Why do we need to address this in another way?”
According to Dr. Sara Laskey of The MetroHealth System,
I don’t think doctors and nurses need to be taught how to care. We need to work on creating an empathetic connection, which is a very different skill. In medical school, we don’t spend a lot of time on the empathetic connection.
It’s a skill that we use not just with our patients, but with our colleagues, we use in all of the different interactions we have within the healthcare environment, and within our personal environment. … It’s every single interaction that’s going to impact how the patient feels about their experience. All of them are important. Everyone is important.”
Differing Views of Patient as Consumer
The patient as consumer presents new challenges. Koppelman sees it differently,
Access to healthcare, ease of scheduling, waiting times – are comparable to consumerism. But where I react to that is it does not take into account that consumers are independent when they are out there shopping, They are making a decision to purchase something. When they are coming to a healthcare system, they are coming because they have a problem with their health, and with that, there is a whole different dimension, in terms of vulnerability that one has, the needs that one has, not just physically, but emotionally.
She says it’s very important for a patient to connect therapeutically, feel safe, and have a trusting relationship with their clinical staff, their physicians, and with anyone they come into contact. The patient needs come first.
Sue Tyler is a Chief Experience Officer for Medical Mutual. She explains that the insurer’s customers are not looking for a tangible product, but for “peace of mind.” She says her role was created for a number of reasons,
We did this before the ACA. But certainly, individuals buying their own coverage, becoming customers of health insurance has increased in the marketplace, and so that was a factor. All of our members whether they are individuals or part of a group of an employer-based plan, are seeing a higher personal financial liability for their healthcare, so their needs have changed, and evolved over time. Technology, the transparency around what is happening with services – you can read a review, you can shop online, you can tweet your experience, whether it’s good or bad, and with a push of a button share it with thousands of people.
There is more from the panel, including a discussion on patient satisfaction scores, that you can view on YouTube.
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