Hospital Chief Experience Officer as Head Rule Breaker

A hospital's CXO is often the one person who can coordinate cooperation among departments to ensure patient experience problems get resolved before they impact HCAHPS scores, which can affect reimbursement.

Sometimes, the only way forward is to break the rules.

After years yearning for a child, and less than three weeks after finally giving birth, Allana Guidry was diagnosed with acute lymphocytic leukemia. Guidry needed immediate treatment, but the Cleveland Clinic, where she was being treated, does not allow visitors under age 18 to stay overnight in the oncology ward.

That meant she would have to be separated from her newborn. And Guidry was reluctant to be treated for her cancer if she couldn't have her baby with her.

After some deliberation among departments, including nursing, housekeeping, and the office of patient experience, it was decided that being near her family was an integral part of Guidry's healing process. Guidry's husband and baby were got the OK to live with her in the hospital while she received a bone marrow transplant and chemotherapy.

If James Merlino, MD, chief experience officer (CXO) at the Cleveland Clinic, and others in his position have their way, the days of rigid adherence to outdated rules are numbered.

"The Cleveland Clinic began emphasizing patient experience about eight years ago," says Merlino. "Back then, our patient experience rating [determined by HCAHPS scores] was among the lowest in the United States. You can't be a top brand and have patients walking away with a bad experience."

"Now," he says, "it's important from a revenue standpoint, as the government has aligned Medicare reimbursement with patient experience." While the Cleveland Clinic is widely considered a pioneer in patient experience, other hospitals have begun realizing the importance of creating roles around patient experience, too.

Some initiatives developed under the guidance of CXOs have included expanded quiet hours, nurse hourly rounding to ensure patients feel they are being properly looked after and better communication systems so patients can feel confident in the ability to summon a doctor to their bedside at any time.

Innovations like these don't just make patients feel less frustrated during an already difficult time—they also foster better care.

Most importantly, though, the CXO can be the one person—maybe the only one—who can coordinate cooperation among departments to ensure problems get resolved before they begin impacting patient experience.

Sometimes the CXO is the only one who can find or create a solution in exceptional situations like Allana Guidry's.

What Makes a Good CXO?
Given the newness of this role, HR departments are still figuring out the formula for the perfect CXO.

Donna Padilla, senior partner at executive search firm Witt/Kieffer, says she's seen many people with operations on their resume make their way to the CXO office, but hospitality management is also a much-sought after background.

But Merlino insists that someone with a strong medical background would be the best choice. "I think they have to have an understanding of hospital operations… You can't just take tactics from hospitality industry and relate them to hospitals. This needs to be a medical professional."

He also suggests that if CXO who are physicians be partnered with someone from the nursing side of the hospital and conversely, CXO who are nurses be partnered with a physician.

What Merlino and Padilla both agree on, however, is that CXO must have a strong, personable demeanor with excellent people skills. "They need the ability to form relationships and high emotional intelligence. They have to have successfully led change and managed change in complicated organizations," says Merlino.

Additionally, the ideal candidate is someone who doesn't need a lot of time in the spotlight. They may never see credit for the improvements made—the applause will likely go to the nurses or the physicians or the IT team or even the janitorial staff.

The CXO needs to be someone who is comfortable being behind the scenes, always being a team player, finding ways to improve processes to benefit patients and bring together departments that need to communicate.

Recognition may be sparse, but the reward is in seeing warm relationships form between staff and patients, insists Merlino. "Every caregiver [at the Cleveland Clinic] communicates with heart. For physicians, this helps them build better relationships and improve communication with patients… They're there for the patients. It's all for the patients."

Even if hiring a C-level employee to manage patient experience isn't right for your organization, don't you think someone should be designated to make sure the patient is never forgotten? Let's not lose sight of what this industry is really all about—the well-being of the patient.

Padilla cites another force behind the rising stakes in patient experience. "It really is the rise of social media… Now, patients can post or tweet about their experience and reach lots of people." As a result, hospitals now have to work harder to protect their brands—or face the consequences after the patient with 10,000 Twitter followers leaves the hospital unhappy and digitally broadcasts it.

"Hospital leaders need to recognize that [patient experience] is not about making patients happy. [The highest priority is] delivering safe care, then high quality care, then patient satisfaction, but satisfaction is never more important than safety or quality," said Merlino.

The sort of rule bending that kept Allana Guidry and her baby together in the hospital can make the difference between a patient getting treatment or not getting treatment—and the CXO is the perfect person to be the advocate for the patient and ensure he or she gets what they need in their unique situation.

While Guidry is now on the road to recovery, she says in a video testimonial that she and her family will never forget the good experience they had at the Cleveland Clinic. She believe that the hospital going the extra mile positively impacted her cancer recovery.