HealthLeaders Media '09: Moving Forward, our annual gathering of top healthcare leaders, featured exceptional executives with compelling stories to share. Throughout the two-day event in Chicago, leaders from successful healthcare organizations—large and small, urban and rural—shared insights on becoming the hospital of the future now during panel discussions on leadership, design, culture, patient experience, outcomes, and talent. In addition, those honored as Top Leadership Teams in Healthcare provided real-world examples of best practices in action. For more on the event, please visit www.healthleadersmedia.com/hlm09/.
Patient Experience Panel: Whose Job Is It, Anyway
Patient Experience Panelists
Aurelia Boyer, Senior VP and CIO
New York-Presbyterian Hospital, New York City
Gar Crispell, General Manager
American Girl, Chicago
Bridget Duffy, MD, Chief Experience Officer
Sonia Rhodes, VP, Customer Strategy
Sharp HealthCare — The Sharp Experience, San Diego
Thomas Wright, President and CEO
Delnor-Community Hospital, Geneva, IL
Patient experience is fast becoming a strategic priority in hospitals and health systems across the country. What's not always so clear is what steps to take to get the job done right. Panelists discussing patient experience at the 2009 Hospital of the Future event tackled the biggest challenges, including the question: Who's responsible for patient experience?
"I used to not like people coming into my office saying 'It starts from the top,'" said Thomas Wright, president and CEO of Delnor Community Hospital in Geneva, IL. "I figured the whole organization was engaged just because you said so. But you really have to exhibit it from the top, being out there with the executive team, very visible, living your behavior standards."
Gar Crispell, general manager of Chicago-based American Girl—a business known not only for selling dolls to its customers, but also offering them an experience—says everyone in the organization must be committed to patient experience.
Hospital leaders should work to catch staff doing great things, recognize their efforts, and share positive stories with employees, the panelists said. That's one way to inspire everyone and convince even the most reluctant adopters that patient experience is important.
Bridget Duffy, MD, principal at DS Health Care Consulting, says that when she was the chief experience officer at Cleveland Clinic, a surgeon told her his patients should feel lucky to just be able to get up off the operating table and walk.
One way to cultivate buy-in that appeals to physicians in particular, said Aurelia Boyer, vice president and chief information officer for New York-Presbyterian Hospital in New York City, is to include patient satisfaction data in dashboards so that leaders, employees, and physicians can see steady improvement.
Hospitals must also create a structure that supports patient experience efforts. "It's all about alignment and what the organizational structure is," said Sonia Rhodes, vice president of customer strategy at Sharp HealthCare in San Diego. "For us, everything funnels under this notion of best healthcare experience," she said. "We set forth a vision for the organization and put together a structure that helps people understand their part in that. "
With staffing shortages looming across healthcare, hospitals may be tempted to focus more on quantity than quality when it comes to recruitment. But having the right talent matters. Finding it requires attracting employees who can live the organization's mission and values.
"Values are the foundation of everything else," said Joe Tye, CEO of Values Coach in Solon, IA, which provides training and coaching on values-based leadership and cultural transformation for hospitals. A hospital's values have to be internalized into its culture, and that starts with hiring, panelists said.
But it doesn't end there. Chris Van Gorder, FACHE, president and CEO of Scripps Health in San Diego, meets with top departmental managers at least once a month to talk about behind-the-scenes decision-making and reinforce the focus on patient experience and other priorities. This instills in managers a sense of importance about their jobs, he said.
In addition to being in short supply, today's workers are much more mobile and often less dedicated to a single job. Hospitals don't have to surrender to that dynamic, though. Trinity Health and Scripps Health still try to "recruit for life." Employees are encouraged to speak out if they aren't happy in their current position. Instead of letting them go, leaders will try to find another position that is a better fit, said Debra A. Canales, executive vice president and chief human resource officer at Trinity Health in Novi, MI. While they may change positions, they are still retained within the organization.
Progressive hospital and health system leaders are working diligently to embed quality improvement principles into the culture of their organizations not only because it's the right thing to do, but because future reimbursement and financial gains will depend on it.
Key to that transformation will be finding the right vectors to measure and acting on deficiencies found from that measurement. Kevin B. Churchwell, MD, CEO and executive director for the Monroe Carell Jr. Children's Hospital at Vanderbilt in Nashville, says his hospital finds quality improvement works best by finding the simplest programs that deliver the most returns—for example, handwashing by clinicians.
Ken Anderson, DO, chief quality officer for NorthShore University HealthSystem Medical Group in suburban Chicago, says a simple filtering system helps narrow down quality initiatives that offer the most return for the effort. Leaders should focus beyond hospital walls to patient communities and at-risk populations, he says, adding that quality improvement requires not only processes that will improve outcomes from procedures, but that it also means managing chronic conditions and improving health through behavior changes.
Jay Srini, chief innovation officer for UPMC Health Plan in Pittsburgh, suggests that telemedicine may help inject hospitals as well as health plans into quality care outside the four walls of the institution; however, the hurdle is designing effective reimbursement systems in partnership with healthcare providers so that such patient interactions are a priority, not just an afterthought.
Dan Varga, MD, chief medical officer for St. Joseph Health System in Lexington, KY, narrows nearly 300 indicators that are measured in its quality report to about 15 work processes to keep improvement achievable.
"If we can't design reliable clinical work, then the [outcome measurement] experience is moot," he said.
Healthcare facilities need to be healing environments that are energy efficient and adaptable to new care delivery processes and clinical technologies. Experts on the Design panel offered various strategies.
Conservation measures may not seem very exciting, says Jeff Thompson, MD, CEO Gundersen Lutheran Health System in LaCross, WI, which has a plan in place to be totally powered by renewable energy by January 2014. "But it has the fastest rate of return," he says. For instance, Gundersen found that the ventilation fans in one of its facilities were running 24/7. Engineers turned a knob so the fans were running 12 hours a day instead, and the health system saved $19,000 just like that. "Of our $5 or $6 million spend for energy, $1 million will have gone away because of retrofitting and doing things like this in our organization," he says.