Two Critical Steps toward Exceptional Patient Experiences

The central focus for virtually all healthcare organizations is (or should be) the patient. Healthcare leaders know that if they can improve the patient experience, they can improve clinical outcomes and bottom line results, but healthcare organizations often struggle with improving the patient experience.

Do you ever feel like your tactics for improving the patient experience are somehow missing the mark? Would you like to see more significant results? Chances are you answered “yes” to both of these questions.

So, how do you do it? Fix the culture first. Culture drives employee action, which leads to patient satisfaction. The first step is determining whether your culture is conducive to a great patient experience.

At the Baird Group, we have been helping healthcare organizations transform their culture and shape the patient experience for more than 10 years. Over that time, we’ve refined a process that has resulted in proven and measurable success for our clients. It’s a process that focuses on two primary steps:
1. Understand the current reality. What is the culture today and what are the norms within that culture, dictating attitudes and operations?
2. Close the gap between the current reality and your stated vision.

Importantly, while our focus is on the experience of patients, we long ago recognized that improving the patient experience starts internally with your staff. A service-focused culture drives exceptional patient experiences. That culture requires the engagement of staff—both clinical and administrative—at all levels of the organization.

As Stephen Covey has said, “Seek first to understand.”

Understand the Current Reality:
We conduct culture assessments to better understand the unique nature of the organization. Through focus groups with staff and managers; in-depth interviews with stakeholders (including physicians, board members, and senior leaders); and a review of existing data, including HCAHPS, employee, and physician satisfaction data, we shed light on the unique strengths, weaknesses, and opportunities each of our clients have. We are often able to reveal common threads running through the culture that have made it okay to behave a certain way or acceptable to, unwittingly, be more provider-centered or employee-centered than patient-centered. A fresh pair of eyes can often reveal the unstated, off-balance norms.

For example, we recently conducted a culture assessment in an organization that was struggling with patient satisfaction. Their core values included compassion and sensitivity. In one of our encounters, we noted that the registration desk was staffed by a grouchy individual who didn’t look up and acknowledge people until they were standing there for several seconds. Her expression and total demeanor were severe at best. When she asked for the patient’s referral, it was more of a demand than a request. There were several signs plastered around the counter about co-pays, referral requirements, and other demands. Each sign contained words like “must” and “every.” These signs, combined with the staff, created an unwelcoming first impression, far removed from their vision of compassion and sensitivity.

When I talked with the staff about these things, they made several telling comments, including, “Patients need to understand that this is their responsibility, not ours;” “We don’t have time to hold their hand through this;” and “Our patients are manipulative and will try to get us to do their work.” Oh, and by the way, this was a cancer center. Just imagine the psychological issues that the patients were facing as they approached the desk.

In this example, we were able to put the focus on the culture that made it acceptable for this type of environment. Of course, there were systems and processes that needed to be re-evaluated in order to manage the patient experience, but the bigger issue was the cultural norm. The vision was far removed from the thinking and the practice. The leaders had an “Aha!” moment when I pointed these things out and said that, in their culture, they had made it alright to post signs with negative and almost threatening messages…that it was completely acceptable for staff to behave in the manner described. Of course, they argued it was not acceptable, but the reality is that it was happening daily and was not being addressed; therefore, their culture was that these things are all in a day’s work.

Mystery shopping is an important component of the culture assessment and is one crucial method we use to understand the patient experience. While not the only technique we use, our mystery shopping expertise helps us ferret out things about the patient experience that can either build or erode trust.

Mystery shoppers’ results can include things about the environment, navigation, processes, or interactions that occur between patients, family members, and visitors while guests at your hospital. We know it’s sometimes the seemingly “little things” that can have a dramatic impact—either positive or negative—on the patient experience, and our clients are often surprised at what we find as we view their operations and interactions through fresh eyes. Leaders typically have a number of “Aha!” moments as we review the findings from the culture assessment. What we are able to reveal is the underlying attitudes and beliefs that are preventing positive movement forward.

Close the Gap:
It is this assessment that leads to recommendations of the specific steps needed to close the gaps between your current reality and desired performance. The closing-the-gap phase is a comprehensive approach that includes:

  • Leadership development
  • Employee engagement
  • Service strategies

There is no magic wand, and these processes take time and commitment. Many leaders want us to come in and do “smile lessons” with the frontline staff, but teaching them to smile and be nice won’t shift the culture without leadership practices that set the stage for accountability and engagement. There is a process for this change, and it involves working with senior leaders to articulate a compelling vision for service excellence and then helping them to operationalize the vision. The service strategies are developed by a “grassroots” team, which helps to advance the vision. The team creates systems and processes that make the organization a place where patients choose to come for care, where providers want to practice, and where employees want to work. The team also focuses on standards for service excellence, recognition, communication, innovation, and turning your satisfaction data into action.

Simply stated, our model is to first understand, then improve. We help bridge the gap between what you say you are as an organization and what your employees, providers, and patients really experience. There is nothing more gratifying than to see our clients make tangible progress. We’re passionate about our work, and the impacts we’ve had on patients, employees, and organizations. We’re committed to transforming the culture in order to shape the patient experience, one organization at a time.
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