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Press Ganey CMO Envisions 'Healthcare's Path Forward'

Analysis  |  By Christopher Cheney  
   March 03, 2023

The author of a new book expects the challenges facing healthcare before and during the coronavirus pandemic to persist for years.

Healthcare organizations should focus on four areas as they emerge from the coronavirus pandemic, the author of a new book says.

Healthcare organizations faced several challenges going into the pandemic, including the rise of consumerism and adoption of value-based payment models. The pandemic introduced new challenges such as widespread workforce shortages and severe financial problems.

Thomas Lee, MD, a primary care physician at Brigham and Women's Hospital in Boston and chief medical officer at Press Ganey, offers prescriptions for healthcare organizations in his new book, Healthcare's Path Forward. "The reason why I wanted to write this book is because we have been through a lot over the past few years, and I am hoping the pandemic will be winding down, but the fact of the matter is the stresses that became explicit the last few years are not going away in many ways. I wanted to come up with the path forward that we need to be pursuing in order to meet the challenges," he told HealthLeaders.

Drawing on the collective knowledge of colleagues inside and outside Press Ganey, Lee says there are a set of basic activities that healthcare leaders have to have in mind now that the crisis phase of the pandemic has passed. "One is building trust in the workforce. Second is building trust among patients. Third is developing a deeper and broader sense of patient safety. Fourth is understanding what consumerism really means—how do you build trust among people when they are not directly in front of you."

1. Building trust in the workforce

The first path forward is building trust in the workforce, Lee says.

"One definition of trust that I like is confidence that you are going to be treated fairly in circumstances you have not even thought of yet. We need everyone working in our healthcare organizations to feel that way about their organization. To do that, the organization and its leaders have to show that they understand what is important to the people working there, that they are authentic, and that they have a plan for making sure that the workers are taken care of. Those are the three key elements of trust building with the workforce," he says.

If healthcare workers trust their organization, it can promote pride and other positive factors, Lee says. "Data shows us that of course you have to pay people better, of course you have to try to do what you can to staff adequately, but the factor that is actually the main determinant of whether people in the workforce stay with your organization is the pride that they feel. It is the teamwork. It is the sense of inclusion. It is the culture. These are much more powerful determinants of whether people stay or go. This may sound like rhetoric, but it is supported by our data."

2. Building trust among patients

Patients want to know that their healthcare providers are well organized and efficient, Lee says. "Turning to patients, yes, patients do care about what their clinicians are like—are they showing empathy, are they coordinating with other clinicians, are they communicating well? But research from the past few years has shown that other things matter, too. The thing I would focus on is friction before the patient visit—chaos can shake patients' trust in the system. They want to know that their caregivers have their act together."

3. Developing a deeper and broader sense of patient safety

Attentiveness to patient safety is a crucial path in the way forward, he says. "Whether it is inpatient or outpatient, if patients see anything that shakes their confidence that things are excellent in terms of their safety, then they can't trust the whole system."

There needs to be a deeper sense of patient safety, Lee says.

"One of my favorite examples comes from the United Kingdom, where the nurses in one set of hospitals argued for switching to a disinfectant that did not smell like a disinfectant. After they switched, the patient experience declined, and there were increased complaints about cleanliness. That's because without the smell of the disinfectant, people did not feel safe. So, the thing that I emphasize is that we not only have to worry about keeping patients safe from physical harm but also keep them safe from emotional harm. We have to make them feel safe."

4. Understanding consumerism

For consumerism and people making choices, healthcare leaders must understand what builds trust among consumers, he says. "Managing what they see online, giving them lots of information such as comments and pictures, then giving them consistency by exporting those comments and pictures to third-party websites—it seems obvious that we are going to be moving in this direction, and some organizations are getting there faster than others."

Healthcare organizations need to revolutionize their customer service capabilities, Lee says. "Healthcare needs to go through what banking went through. Many of us can remember being agitated about whether we would get out of work in time to get to the bank to deposit a check. Now, there are digital interfaces to conduct banking. We need to get to the same place in healthcare, where consumers can get things done 24 hours a day, but we are not all going to get there at the same time, and organizations that get there faster are going to have advantages."

Related: Healthcare Executives Discuss the Way Forward

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


To build trust in the workforce, healthcare leaders need to have empathy, authenticity, and a plan to make sure workers are taken care of.

To build trust in patients, healthcare organizations must be well organized and efficient.

Healthcare providers need to develop a broader definition of patient safety that not only keeps patients safe from physical harm but also keeps them safe from emotional harm.

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