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Experiencing What the Patient Experiences

Anthony Cirillo, FACHE, ABC, for HealthLeaders Media, January 28, 2009

Last week I prayed with a patient at the Cleveland Clinic. And it moved me. Deeply. As someone who spends a lot of time with infirmed older adults, I was surprised at the impact. Maybe it was the fact that the Healing Solutions team at the Clinic formed a circle with me and two patients, six of us praying. Or maybe it was the cancer patient with her head half-shaved telling us how grateful she was for the angels before her who came into her life at just the right moment.

I visited the Clinic to learn more about how they operationalize the concept of a Chief Experience Officer. As a marketer I feel simply that the best marketing is word-of-mouth and that you spread it by offering a great experience. And I contend word-of-mouth marketing could be operationalized and leveraged.

The Clinic created this position and, going in, I could not envision the extent to which this concept has played out. But at the end of it all is the patient. And when you pray with a patient, realize their life is on the line and how grateful they are to have every breath and every day; this is not about marketing at all. It is about remembering why we are in this business.

All else falls into place from there.

It Starts at the Top
Bridget Duffy, MD, is the Chief Experience Officer for the Clinic. And that in itself tells a story. Dr. Duffy believes that the Chief Experience Officer is a position that should be in every hospital in the country. And it needs attention from and buy-in of the board—it must come from the top. No surprise, then, that the Clinic board has a committee focused on the patient experience and that Duffy reports directly to Toby M. Cosgrove, the CEO of the Clinic.

It is comprehensive and holistic
The experience is approached in three ways: the clinical experience, the experience of the physical environment, and the emotional experience. It starts with the employee experience and leads to the patient experience. And it is not just about what is done. How it is organized sends a message about the commitment and the culture.

Mila Henn is the senior director of operational support services. She handles 1,800 hourly workers, of which 1,600 interact directly with patients. These include greeters, parking attendants, volunteers, patient transport, supply delivery, police and security, food delivery, and environmental services. In other organizations these departments don't always work together. Not here. Employees self grade themselves at the end of every shift, so that improvement comes daily. And soon they will start "rounding" just like clinical staff.

It starts with the employee
There is a 50-bed hospital near my house that was built by Presbyterian Hospital and I have friends who work there. Employees are hired for both their clinical ability and their attitude, using sophisticated screening tools. The Clinic hires for those attributes as well. When you hire right people, says Donna Zabell, who oversees the employee experience, everything else falls into place. The Clinic does not want mere satisfied employees. They want satisfied and engaged employees and they measure that satisfaction and engagement. One day, employees will earn black belts in patient experience.

One thing I missed (because I arrived too late the night before) was a program called their Healing Partners Awards. During Patient Centered Care Awareness Month, all levels of the organization were solicited for stories about employees who exemplify the patient experience and live it every day. Doctors nominated administrative assistants and vice versa. The winners ran the gamut of hierarchy and crossed a spectrum of touching and compelling stories. Several recounted the act of one employee who was in an elevator with a patient. The patient was enjoying the smell of the lunch the employee had and wished out loud she could get something to eat like that. The employee gave her his lunch.

It keeps design in mind
The Miller Family Pavilion and Glickman Tower are brand-new building additions. To use a term we marketers hate, they are truly state of the art. Single rooms offer a lot of amenities and hidden features make the room look a little less like a typical hospital room. A pneumatic, computerized tube system delivers blood and other items to all parts of the hospital. And even security features enhance the patient experience. From sign-in, a specific staff person is assigned to each patient. Eventually, when a patient activates their call button, a message will be sent to their caregiver directly, making responses that much quicker.

And speaking of design, the Clinic is working with a renowned shoe company to design a sneaker for staff and with a well-known designer to re-engineer the patient gown. And did I mention that the executive chef, William Barum, used to be the private chef for Queen Noor of Jordan? Space does not allow me to elaborate what will be happening to the food experience, but it will be exceptional.

It doesn't overlook the clinical
Each service line has an advisory board and screening criteria for the patient experience and patient experience team members are embedded into the service lines. Patient experience also oversees HCAHPS. There are clinical navigators, as in other hospitals, but also service navigators that greet every patient and assess their needs off the bat. Patient education plays a large role and their patient education center is fully equipped. Patient education channels feature clinical videos that are also piped into the Intercontinental Hotel on the property. And I'm only scratching the surface here.

It's about healing solutions
Let me end where I started—with the emotional experience of the patient as attended to by Michele Cameron, assistant director of the Healing Solutions program. It includes chaplains, social workers, a holistic nurse, and massage therapists, all of whom are cross-trained.

There are massage rooms for patients, staff, and visitors. A healing consult is a standard order on charts. Healing staff round with clinicians and when there is an emergency, a "code lavender" is sounded.

Does Healing Solutions impact care? Cameron recounted the story of one patient who was featured in a USA Today story. Clinically, she was considered a drug-seeker, hospital lingo for a patient who constantly asks for pain relief. It turned out that she had three heart surgeries. She had also lost three children in her life. Any connection? A clinician would not have connected the dots. Healing Solutions did. The two must work together: The psychological outlook of that patient changed forever after they identified the root cause of her problems.

Care is not a just sterile and clinical. There are real patients that administrators and marketers seldom see. And those patients need a complete healthcare solution and experience. So as we start a new year let's remember why we do what we do and not be so inclined in a bad economy to eliminate those positions and departments that have equal weight in delivering the patient experience.


Anthony Cirillo is president of Fast Forward Strategic Planning and Marketing Consulting, LLC in Huntersville, N.C. He may be reached at cirillo@4wardfast.com.
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