Use of CXO role fades as other leaders take on responsibilities

As healthcare becomes more focused on improving the patient experience, the need for having someone solely in charge of that experience appears to be shrinking.

While roughly one-third of health systems have a C-suite leader in this position, many have done away with the role entirely after trying it out, instead distributing the responsibility for patient experience to other C-suite leaders or senior managers.

Chief experience officers and consultants say the role is evolving and perhaps going away not because patient experience is less important to health systems—quite the opposite. Instead, expectations about what’s required to impact patient experience have changed.

As a result, responsibility for improving patient experience is increasingly being integrated across entire organizations.

“As this role was being created it wasn’t necessarily ingrained from its inception into the business strategy,” said Christopher Rowe, a managing director of executive search firm Korn Ferry. “Today most executive leaders are thinking about experience and not just the patient experience—but your employee experience, the physician experience.”

Baylor Scott and White Health recently went through such a transition. The Dallas-based system had a chief patient experience officer until earlier this year when she left and wasn’t replaced. Now those responsibilities are in the hands of a system vice president who works closely with the chief quality officer, the chief nursing officer and several hospital operations leaders. This kind of role-sharing also can occur when chief patient experience officers are charged with quality and safety efforts at their organizations.

Baylor also created systemwide goals that frontline employees are charged with to ensure “everyone in the organization feels a responsibility for the patient experience,” Baylor spokeswoman Julie Smith said in a statement.

The approach taken by Baylor also played out at Nemours Children’s Health System. When the chief experience officer departed in January 2017, responsibilities were spread out among directors at its campuses in Delaware and Orlando and Jacksonville, Fla., according to Karen Bengston, a system spokeswoman, in an email.

Those types of changes are likely the result of stronger focus on patient experience by senior leadership, said David Boggs, senior partner at executive search firm WittKieffer. Once the concept of patient experience is established and hardwired into system operations, management can slim the role of patient experience down to something less weighty.

“But in order for it to get hardwired, you need that senior leadership support,” Boggs said.

There are also likely situations in which health systems fire or choose not to replace the chief experience officer because they can’t evolve with the demands of the role, said Colleen McCrory, a coach in Huron’s Studer Group business.

When chief experience officers were first hired by health systems, the focus was largely on improving performance on the CMS-mandated Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS, survey, she said. These surveys are inpatient-focused and have incredibly low completion rates.

Given the movement of healthcare to the ambulatory setting and increased attention on consumerism, some health systems realized they needed an experience officer who focused on more than just the hospital experience. Some chief experience officers likely weren’t up for that new challenge, McCrory said.

“The role is so much more than just HCAHPS,” she said. The health system “might not have hired the right fit or thought of what the long-term goals for the role are, which is a strategic partner who has that exposure and awareness of the consumer market.”

Even with the recent turnover in the role, plenty of health systems still have chief experience officers. Those who have been in their position for several years deploy key tactics to ensure they are relevant and impactful to the organization.

Rick Evans, who has been in the role since November 2015 at New York-Presbyterian, participates in all strategic decisions at the health system. He works closely with his colleagues in the C-suite to offer insights into how their proposals will impact patients. 

“A lot of places haven’t done that, and I think it doesn’t work as well,” Evans said. “This is not a role that is a couple layers down, it’s part of the senior management team and you’re a strategic leader alongside other key strategy leaders.”

Furthermore, all of the work that comes out of his office must improve not only patient experience but other aspects of the organization like quality of care or finances. “You aren’t going to people hat in hand asking for their collaboration. You are partnering with them on key initiatives that are a mutual benefit,” Evans said. “Interventions have to be evidence-based, data-driven and implemented into the workflow and the organization’s priorities.”

For instance, Evans is heavily involved in the implementation of tools and tactics for clinical staff that help them communicate better with patients. The interventions also help clinicians do their job better.

Evans’ team has coached physicians in the clinic who are crunched for time about how to make the most out of a 20-minute visit with the patient. One tactic is to tell the patient upfront that there isn’t enough time to answer all their questions, so patients are asked to pick their top questions for the doctor to address during the visit. Evans said the approach helps doctors stay on schedule and encourages a feeling of accomplishment. And patients feel better about the experience too because expectations are set early on.

Chief experience officers also need to effectively convince frontline staff that what they do matters because so much of the strategy affects them. In fact, some chief experience officers are in charge of employee experience as well as patient experience.

Some in the role are able to achieve buy-in because they have a clinical background. But for those who don’t, it can be a challenge, which was the case with Sven Gierlinger, chief experience officer at Northwell Health.

Gierlinger started his career in the luxury hotel business. He connects with clinical staff by sharing a personal health experience he had in which an illness left him paralyzed for a brief time. He experienced all segments of the healthcare system including inpatient care and rehabilitation. “I think that gives me the credibility I need,” he said. “You have to know what it’s like to be a patient when you don’t have that clinical background.”

Gierlinger also intentionally asked for team members with clinical expertise. The vice president for patient experience at Northwell is a nurse by training and works on strategies that affect nursing. The office also has a medical director of patient experience who is a full-time physician at Northwell and helps Gierlinger organize physician training related to patient experience.

“I’m purposeful about making sure that our team is balanced, that I’m surrounded by people who have the clinical background,” he said.

Another way to get buy-in from clinical staff as well as the board is to show that initiatives lead to positive outcomes, which can be a challenge for chief experience officers.

Laurie Brown, chief experience officer at CHI Franciscan since March 2017, said it takes time before data can show things have improved, but there is a “need for instant results.”

Rowe at Korn Ferry said that’s a common problem in this role. “It’s very easy to see a return on investment for a new partnership or a new joint venture. This is truly change management and it does take time. There needs to be the willingness of the organization to see the change through,” he said.

Brown said she deals with that by bringing up her work at every leadership meeting to ensure it stays top-of-mind for the organization. She also encourages storytelling from frontline staff about positive interactions with patients. “Sometimes they (clinicians) forget how impactful they really are, so being able to remind them of that has been helpful,” she said.

Even so, chief experience officers can still see resistance from clinical staff on this kind of work. Physicians or nurses may say it’s not their job or they don’t have the time to provide patients with a good experience.

Dr. Greg Burke, chief experience officer at Geisinger Health, said he combats that by encouraging staff to do simple things like sitting next to patients or making eye contact. “It doesn’t take you more time to sit, and it sends a message to the patient,” he said.

Chief experience officers also don’t need a huge team or budget to make an impact. Evans at New York-Presbyterian said his team is relatively small, but works with others to be influential in the organization.

Brown said in times of shrinking margins for health systems, it’s better to work with what the organization has instead of asking for more. “You want to preserve the resources at the bedside. You don’t want to build overhead,” she said.

And even given the challenges of the role—and the apparent dwindling number of executives who hold the title—chief experience officers are confident they are needed.

Burke said he’s the one who speaks with upset patients or informs physicians about the work underway to improve patient experience.

“I think there will always be the need for someone who can answer those questions and be available to walk into the difficult situations,” he said.

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