UCLA's reason for being
If Merlino sees patient experience as a critical part of the care process, David Feinberg, MD, sees it simply as the reason for being for Ronald Reagan UCLA Medical Center, for which he is the CEO.
Put simply, Feinberg is a believer that if patient experience is excellent, most everything else that's a priority for the hospital or health system will fall into place. Which is why he is self-deprecating about UCLA's achievement of 99th percentile in HCAHPS scores.
"Our HCAHPS scores are good, but we're not doing well in patient satisfaction," he says. "We've had a meteoric rise from 38% to 99th percentile. We perform at the very top regarding HCAHPS questions. That being said, we're terrible because to get to 99th percentile, you have to get 85 out of 100 people to give you that answer on their survey. That means we've failed even though we're the best, because we've failed with 15 people out of the last 100."
He says, with no hint of guile, that the scores need to be 100 out of 100 before he can boast that they've gotten anywhere.
Yet his hospital represents the top 1%, in a manner of speaking, meaning it must be doing something right.
His biggest challenge, he says, was instilling a team spirit about patient care throughout the organization.
One of the guiding philosophies is that it's not just about the people who touch patients. "Whether you're in IT, or billing and collections, or frontline nurses, docs—wherever you fit—you're part of a healing team."
That's fine for a major academic medical center in one of the nation's largest cities, which has far more resources than the average community hospital, but Feinberg takes care to mention that much of the work is commonsensical and that being attentive to the customer's needs doesn't cost much, if anything, and often leads to better, more coordinated care, and thus, a lower ultimate cost of care.
Anyone in a leadership position should be able to start with culture, anyway, says Steve Whitehurst, chief customer and strategy officer with BerylHealth, which consults with hospitals on patient experience.
"Of course, it all starts with the culture and leadership engagement," he says. "CEOs may talk about the patient experience, but if they don't drive this message down into the organization, it doesn't work."