Peer roundtables will share insights and explore solutions, as health systems enter a new era of consumerism.
As patient experience moves center stage at many of the nation’s health systems, leaders responsible for this function are tackling issues related to a maturing discipline. Most have moved far beyond HCAHPS surveys and many are diving into the realm of consumer marketing.
The landscape is rapidly changing as a new generation of tech-savvy millennials is introduced to hospital services through maternity and pediatric needs and as companies such as Amazon, renowned for delivering exceptional consumer experiences, enter the healthcare space.
On September 19–21, more than two dozen patient experience executives will convene at an invitation-only forum during the 2018 HealthLeaders Media Experience Exchange in Scottsdale, Arizona, to discuss the challenges they face and solutions they’re exploring.
HealthLeaders Media spoke with a number of leaders at institutions across the country as a preview to the conference to gain insight into the commonalities they share and concerns they want to explore.
1. HCAHPS: An Antiquated Approach
The HCAHPS survey—the same instrument that gave rise to the patient experience function at many health systems—presents one of the greatest challenges.
Leaders point to the lag time created by "snail mail," as the primary culprit. To improve the patient experience, it is essential to take real-time action when problems occur. In an era of sophisticated technology, data received sometimes months later does not seem to offer meaningful opportunities for improvement.
"The surveys need revising; they need to meet patients where they are, and they need to ask meaningful questions," says Shannon Connor Phillips, MD, MPH, chief patient safety and experience officer at Intermountain Healthcare in Salt Lake City. "We need to be able to do all of the required surveys electronically and do more real-time, in-the-moment surveys."
Amy Thorson, director of patient and family experience at Dayton Children’s Hospital in Ohio, agrees, pointing out that her primary customers are millennial parents who represent the expectations of a new generation. "Current industry-standard survey tools lag behind what appeals to our millennials," she says.
The existing approach reduces response rates and feedback is not timely, she says.
2. Conquering Ingrained Processes
While HCAHPS surveys are relatively new, there is a tougher nut to crack at most health systems: processes that are deeply embedded in an institution’s history and culture.
"Many of our processes are built for our convenience—not our patients," says Kevin Gwin, chief patient experience officer at University of Missouri Health Care in Columbia, Missouri.
"Our processes are built for good reasons, to excel at clinical quality, to be efficient, and to hold down costs, but when we don’t align with our customer’s preferences where we could and it’s appropriate, then that’s where we’re feeling the tension between us and our patient customer," he says.
Piedmont Healthcare, an 11-hospital system based in Atlanta, experiences the same dynamic.
"Some of our larger challenges are adjusting our processes internally to better meet consumer demand and expectations," says Matt Gove, Piedmont’s chief consumer officer.
"Some of our processes have been developed around physician needs, around administrative needs, around EHR needs." While it is crucial to respect those requirements, "when you are trying to refocus everyone on the consumer journey and how to best meet that customer’s needs, it does require a change in mindset," Gove says.
3. Overcoming Administrative Burdens
If patient experience leaders could wave a magic wand and change one thing, many would make administrative burdens on clinicians disappear.
"If we could eliminate the extemporaneous expectations, and [clinicians] could only focus on the quality of the experience, as well as delivering a very personal, very compassionate experience each and every time, that would be ideal," says Rose Glenn, senior vice president, chief communications and experience officer at Henry Ford Health System in Detroit.
"But there are so many things that regulatory agencies and others require, that sometimes being able to deliver that individualized personal experience every single time becomes challenging," Glenn says.
One physician explained that for every hour of clinical time, she spends another two hours on medical record administration.
"They will not be able to keep up that pace," says Glenn. "They want to do the right thing, but the impact of all the changes and the increase in expectations makes it difficult to deliver a consistently exceptional patient experience. Unless we address burnout and help our staff become more resilient, I think that challenge is going to continue."
4. Forging a Human Connection
Administrative burdens diminish the human connection that is essential to a positive patient experience.
"Patients don’t want a medical transaction, they want a personal interaction," says Gwin. "They want a relationship with their physicians and their nurses, and they want to feel connected to their hospital and their doctor’s offices. If I could change one thing, I would make us better at discernment, at gauging ‘How is this relationship going?' "
"I want us to pick up on those cues that this is going really well, or this is not going well," says Gwin.
Conner Phillips says, "You don’t get great quality if you don’t have a partnership with your patients."
She wants people working in healthcare "to more intentionally see the connection between quality and safety and experience. You can’t have great experience if we fall short in quality and safety . We can give people great outcomes and keep them free from harm, but if we don’t connect with people and [employ] empathy, then we’re not establishing trust and being respectful. It’s not going to feel right to the patient. If it doesn’t feel right to the patient, they’re not going to participate in their treatment plans and keep themselves healthy or improve their chronic disease because they don’t feel connected to us."
Teaching hospitals have an additional challenge in this realm. Cindy Burger, MS, RN, vice president, patient and family experience at Dayton Children’s Hospital, sums up the concerns expressed by other leaders at teaching institutions, explaining that it is difficult to indoctrinate a philosophy when students constantly rotate in and out of the facility.
Students and residents "are part of our culture, but they are not quite as enculturated," Burger says. "Delivering consistency every time during every interaction becomes a challenge."
5. Expanding the Point of View
As health systems become more invested in the patient experience, the scope of work is broadening. Getting healthcare organizations to act like other consumer-oriented industries, however, is not easy.
"You cannot separate brand from experience," says Gove. "Most successful consumer-facing organizations understand that. But for most of its history, healthcare hasn’t even accepted that it’s a consumer-facing industry."
Piedmont is taking a holistic approach and examining every place people interact with the system—digitally, through advertising, and word of mouth, as well as billing and booking appointments. "There is an enormous opportunity for us to rethink what 'experience' means for a healthcare system," he says.
Henry Ford Health System is making similar inroads.
"As experience officers, we need to do a better job of understanding expectations before the consumer ever enters any of our facilities," says Glenn.
While hospitals are now doing a much better job of understanding patient’s preferences while they are in the facility, she questions how systems can proactively understand consumer expectations before they become patients.
"How do we hardwire the processes and the cultural standards that people expect, prior to the person ever coming into one of our medical facilities?" she says. With players like Amazon, Google, and Microsoft entering healthcare, the picture changes dramatically.
"They have a different take on addressing consumer needs. Healthcare organizations have to get up to speed and have that retail-oriented framework in order to deliver an exceptional experience," Glenn says.
6. Battling the Bottom Line
One final challenge patient experience leaders face is not new for those working in healthcare systems: financial.
"There’s a lot of competition for resources inside a system," says Gove. "As good stewards of the resources that have been entrusted to us by our communities, because we’re a nonprofit health system, how do we continue to convince the system to prioritize [patient experience] work? It does require an investment; technology platforms cost money. How do we keep [patient experience] high in the list of priorities so that we can continue to make the changes needed?"
The Experience Exchange
These are just a few of the issues to be explored at the Experience Exchange, along with solutions that are working for participating health systems.
The Experience Exchange is one of six healthcare thought-leadership and networking events that HealthLeaders Media stages annually. While the roundtables are invitation-only, qualified healthcare executives, director-level and above, will be considered. To inquire about the HealthLeaders Exchange program, email us at Exchange@HealthLeadersMedia.com.
Mandy Roth is the innovations editor at HealthLeaders.