Letters: Improving the patient experience isn’t about the title

The patient experience movement has never been about a title. As Rick Evans said in the July 29 cover story, it is much more than a position. It is a strategic imperative for organizations that want to transform healthcare. It is about creating ideal healthcare experiences with compassion, trust and respect, in addition to providing high quality, safe and efficient care. While some organizations think experience initiatives can be split or managed by other roles like a chief quality officer, the focus is distinctly different.

The question is, “What does it take to commit to improving patient, family and staff experience, and sustain that commitment?” For some hospitals, this mission is already so embedded in the culture that a dedicated chief experience officer may not be necessary because patient experience is owned by each employee at every level of the organization. Yet, these organizations are rare. Therefore, it is still necessary for most hospitals to have a dedicated leader with a laser focus. Even though everyone owns quality, few health systems, if any, would suggest eliminating the chief quality role.

That said, the role of the CXO has evolved. Having a dedicated leader with a title that reflects the mission is needed. If responsibilities are split, so is the focus. Whether we call this person a chief experience officer, a chief consumer officer or something else, hospitals and health systems need a leader whose primary responsibility is ensuring an ideal healthcare experience remains a top strategic priority for all. If more hospitals start eliminating dedicated experience-improvement roles, we will be wondering where the humanity in healthcare went.

Dr. Bridget Duffy
Chief medical officer
Vocera
Co-founder
Experience Innovation Network

Regarding the July 29 cover story, “Shared experience: Use of CXO role fades as other leaders take on responsibilities,” before leaders of hospitals and health systems make the critical decision of redistributing the responsibility for patient experience to other team members or forgoing the role altogether, one needs to look at the evidence.

My dissertation, written while I was recently pursuing my executive doctoral degree at the University of Alabama at Birmingham, examined the association between an established chief experience officer position and hospital patient-experience scores to determine whether having an individual in the formal role made a difference. My study was conducted using primary data collected on hospitals and health systems in three states: California, Florida and New York. Using Hospital Consumer Assessment of Healthcare Providers and Systems survey data, I found that hospitals with a formal CXO role reported scores that statistically were significantly higher for both the patient recommendation question (No. 22) as well as the hospital overall rating question (No. 21) when compared to hospitals that either did not have a CXO position or had a shared position.

I presented these results at the American College of Healthcare Executives’ 2019 Annual Congress and will soon be publishing an article to further disseminate my study’s findings so leaders can apply evidence-based empirical research in their decisionmaking.

William Breen
Market president
Prime East
Memphis, Tenn.

The July 29 cover story “Shared experience: Use of CXO role fades as other leaders take on responsibilities” posits that if a positive return on investment isn’t attached to a chief experience officer’s involvement, a healthcare leader may decide it no longer makes sense to keep that CXO on board.

The continuing national decline of HCAHPS response rates makes it harder for CXOs to show positive results. Low response rates mean only the most vocal opinions are present, leading to overrepresentation of negative opinions factoring into HCAHPS scores. Ten vocally livid patients may not look terrible when sampling 1,000 people, but 10 people responding negatively in a 100-person sample paints a different picture.

That different picture becomes more realistic in the face of dropping response rates. Indeed, low response rates produce inaccurate representations of sampled patients, and cause current measurements of results to place CXOs at a disadvantage to show positive ROI.

Joe Inguanzo, Ph.D.
President and CEO
PRC
Omaha, Neb.