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June 28, 2017 01:00 AM

Guest commentary: Patient experience defines brand, culture defines patient experience

Dr. James Merlino
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    Dr. James Merlino is president and chief medical officer of Press Ganey Consulting Services.

    The patient experience isn't a singular, static event. Rather, it's a dynamic relationship influenced by patient-provider interactions at every point along the care continuum, including clinical activity.

    If a patient suffers a serious safety event, that person's experience is degraded. If a patient has a poor surgical outcome, the experience is sub-optimal. If a patient or family member has a poor interaction with a provider who lacked compassion or empathy, patients and families leave that encounter dissatisfied. In each of these examples, the converse is also true. Safe, high-quality care, delivered in a compassionate and empathetic fashion positively influences the patient experience.

    Each of these experiences can also influence an organization's brand positively or negatively.

    Because patient experience is dynamic along the continuum, this interconnectivity requires that we broaden our definition to include not only an exceptional service experience, but also safe, high-quality care. Improving patient experience means understanding the relative importance of each of these patient interactions, identifying unmet patient needs, and developing strategies to meet them.

    When considered this way, it becomes clear that transforming patient experience is fundamentally about operationally improving healthcare delivery to be more effective, efficient and value-driven, while maintaining the " true north" for meeting patients' needs-safe, high quality, compassionate care. Focusing on these things enhances the brand and makes patients and families more confident in their care.

    For true improvement, look to culture

    There is no playbook for transformation, but one thing is certain: To change healthcare, organizations must return to the fundamental goal of reducing patient suffering. This can be done by understanding the elements that support safe, high-quality, compassionate care and integrating the efforts required to optimize all of them.

    Recent research on national data demonstrates that safety, quality, experience and even profitability are tightly linked to caregiver engagement. When caregivers are engaged, the safety, quality and experience of care improve. Data also reveal that high caregiver engagement and performance on these measures are directly linked to lower costs. The findings are not a coincidence. They make sense intuitively.

    When people are highly engaged, they do better work. Engagement is a marker for cultural health. Achieving high engagement requires organizations to think more strategically about talent management. Many human resource leaders are focused on the mechanics of hiring, performance management and payroll. Organizations need to shift to a more strategic approach centered on selection decisions, on-boarding, developing critical healthcare competencies, and aligning them to organizational goals and values.

    Healthcare cultures must also focus on zero harm and patient-centeredness, two organizational frameworks that lead to enhanced employee and physician engagement. These efforts must be genuine and caregivers must adopt them as fundamental strategic priorities. Every executive and manager must drive them as part of their operating responsibilities.

    We have to instill the value of teamwork into caregivers at every level and transform the systems in which teams deliver care into high-performing, highly reliable operating models. Further, to drive true transformation, leaders need to instill the critical competency of performance improvement across the clinical and nonclinical workforces. Every caregiver should have the basic skills to be problem-solvers so they come to work asking, "How can we improve what we are doing for the people we serve?"

    While performance improvement is innate to some, these skills don't come naturally to everyone. We have to provide a framework to teach caregivers and other staff members how to think differently about their roles. Harnessing the power of front-line caregivers by creating an army of problem-solvers will help accelerate improvement and identify opportunities to truly transform care.

    Finally, we have to care for our caregivers. We are seeing record levels of compassion fatigue, burnout and depression–particularly among nurses and physicians. When our workforce suffers, caregivers are unable to consistently and reliably deliver safe, high-quality, compassionate care, which means patients will suffer.

    Leaders must recognize that this problem exists and is influenced by drivers within our control. We have a responsibility to think about ways to streamline care, improve processes, and invest in the health of our people to build caregiver resilience.

    I and others have long recognized the incredible opportunity to transform healthcare by analyzing the patient experience and continuously improving every aspect of it. This doesn't mean working to make patients happy. It means striving to deliver on the promise of safe, high-quality healthcare in a compassionate and empathetic care environment. Doing so will allow us to meet patients' needs and drive brand strategy.

    Reducing patient suffering by meeting their needs is our collective goal as healthcare providers. It is what patients demand of the healthcare system. The best place to start is by tackling our own cultures and developing caregivers who are eager, able and ready to deliver safe, high-quality, compassionate care to every patient, every day.

    Dr. James Merlino is president and chief medical officer of Press Ganey Consulting Services.

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