Health systems are giving patient experience executive privilege

Her title may be chief patient experience officer, but Dr. Shannon Connor Phillips oversees much more at Intermountain Healthcare.

Phillips not only leads the patient experience agenda, but safety and quality priorities in this first-of-its-kind role for the Salt Lake City-based health system.

Phillips, who joined Intermountain last year, said the broad responsibilities make sense.

"(My role) is truly about delivering an extraordinary experience for patients, and you can't do that without (considering) safety and quality," she said.

Phillips is part of a small, but growing group of executives charged with understanding the totality of things that impact the patient experience. It's a subtle, yet substantial evolution. Providers now recognize that patient experience is more than just whether or not care met the patients' expectations—often called patient satisfaction—but it's also closely tied to an organization's safety and quality performance.

"To say patient experience and just be thinking about patient satisfaction is not right, and I think that's why there is a lot of transition with the role right now. The definition of patient experience has changed," said Dr. John Bonamo, chief medical and quality officer of RWJBarnabas Health. Like Phillips, he oversees the trifecta of areas that most influence the patient experience—safety, quality and satisfaction.

Chief experience officers first popped up in healthcare roughly 10 years ago. The role has only increased in strategic importance for healthcare organizations since implementation of the Affordable Care Act, which tied patient satisfaction scores to reimbursement.

Health systems now face greater expectations from patients to provide a positive experience as shopping for care becomes more common with the prevalence of high-deductible health plans and online reviews. "Patients are becoming consumers as well," said Eileen O'Donnell, senior client partner in the global healthcare services practice at Korn Ferry.

Depending on the health system, CXOs report to the CEO, chief operating officer, chief administrative officer or chief medical officer, said Daniel Young, senior associate at Witt/Kieffer's healthcare practice.

CXOs don't typically have a large team of their own to command, but leverage internal resources and expertise to execute their initiatives. They work closely with the top human resources official, the chief quality officer and the chief safety officers because so many goals overlap, O'Donnell said.

Similar to their C-suite colleagues, CXOs attend executive leadership meetings and report to the board on initiatives.

"If an organization is truly invested in the CXO role, the CXO will have a top cabinet seat and exposure to the board," Young said.

The decision to combine the quality, safety and experience roles depends on the health system's strategic priorities, Young added.

For organizations that have a competitive marketplace, an executive solely focused on how to attract more people to the system through consumer-friendly services is probably beneficial, he said. These experience officers still work closely with the clinical team but focus on issues directly related to patient satisfaction like promoting better communication between clinical staff and patients and hiring support staff like greeters.

Health systems with a dominant force in the market like Intermountain may not need to invest as much in services to attract patients, so the experience officers can broaden their scope.

"I think everyone is looking for a best practice (to implement the CXO role), but truly it's about what they (health systems) need. Every system is so unique," he added.

Separate roles for safety, quality and experience duties usually work well for organizations if each has a clear understanding of their responsibilities, O'Donnell said.

"If the role is clearly defined, there is a place for each of them, and a need for each of them, especially as health systems continue to grow and expand," she said.

The executives in combined roles argue, however, that their position has allowed them to reduce inefficiencies and make more headway with staff.

Dr. Leslie Jurecko, who is Spectrum Health's first vice president of delivery system quality, safety and experience, said her training as a pediatric hospitalist helped her attract more interest from front-line caregivers in patient experience work.

"To get buy-in from our physicians and our care teams (around patient experience), they really need to respect their peer, so there is a reason why they put a practicing physician in the role," she said.

Physicians tend to think patient experience doesn't have much to do with clinical care. The perception that experience relates to the quality of the food or the parking services isn't unusual among doctors.

To break down those misconceptions, Jurecko's office presents data to clinical teams that show how a positive patient experience can improve patient outcomes.

Her staff also coaches caregivers on ways to engage patients in their care because data show that more engaged patients are less likely to experience harm. "We give them (clinicians) a lot of credit about how they interact with patients and how that interaction can drive loyalty," she said.

Since Jurecko started her role less than a year ago at the Grand Rapids, Mich.-based system, she's noticed the physicians pay closer attention to the patient experience.

Additionally, the role is a way to streamline initiatives to help clinicians do their jobs more effectively, Jurecko said. Clinicians can get overwhelmed or confused when the leaders of each quality, safety and experience department present different messages or agendas, Jurecko said. "It just isn't creating any type of sensitivities to our teams that are trying to care for our patients."

At Intermountain, Phillips' department is assessing all the tools used for safety, quality and experience work and finding opportunities to combine them.

For example, Intermountain is currently applying the safety principle STAR— Stop, Think, Act and Resolve—to the patient experience.

"Many of the tools we use in high-reliability training can be applied to experience," Phillips said. "We have an opportunity in healthcare to streamline and make it easier for our caregivers to do the right thing."