A 2017 Press Ganey report, "Achieving Excellence: The Convergence of Safety, Quality, Experience and Caregiver Engagement," found "cross-domain analyses suggest that these elements are highly interrelated with one another."
"When you look at the data from thousands of institutions, as we've been able to, you don't see tensions," Lee says. "There is no trade-off, for example, between having shorter length of stay and a worse patient experience."
At high-performing organizations, Lee says, you won't see, for example, that nurse engagement is high and physician engagement is low. "The most likely explanation for what really drives an improvement is the culture," he says.
"Basically, our hypothesis is that the organizations that seem to have their act together, are ones that have cultures that seem to be more focused on improvement and on idealistic goals that all the personnel believe in, like zero harm."
Lee recalls that when zero harm first came out as a concept, he saw it as statistically unattainable.
Now he says he embraces the reason why such goals work: because to accept any less would be unacceptable. He's optimistic that so much change is heading to the right point.
"I actually feel like it's a Golden Age of tremendous progress," Lee says. "But Golden Ages never feel that golden to people who went through them."
Jim Molpus is an editor for HealthLeaders.