The Patient Experience Industry – Blessing, Menace, Both?

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As noted in a previous post, “patient experience” has become a new buzzword in healthcare.  It is also showing indications of becoming a new industry.  Here are some examples:

There is an Association for Patient Experience, a nonprofit open to “any healthcare provider or representative who impacts the patient experience” (apparently that does not include patients).  From their website, one can learn “the business case for patient centeredness,” how patient centered improves HCAPHS scores, why employee engagement is key to patient satisfaction, and other such things.  All very true, though one may wonder why it took an APE to promote them.

A search on “patient experience” on Indeed.com produces over 3,200 jobs – directors, coordinators, specialists, advisors and so on.  A Google search on “patient experience” + webinar gets 79,600 hits.  A similar search on “patient experience” + consultant generates over a million.  One consulting firm that has entered this area is the Disney Institute.

A patient might read all this and think, “Wow – everyone is so concerned to make things better for me” (though on second thought doubts might arise about all the expense).  But a healthcare work might ponder it all and say, “Wow – everyone is trying to take my job away” (somehow all those experts and consultants have to be paid for and cutting other staff might be the means).

After all, whose job is it to provide for a good patient experience?  To answer, just take as a thought experience the point made by one APE writer: how does it look it look from viewpoint of the patient in the bed? Clearly, those who see and talk to the patients are the chief influencers.

Although numerous studies have been made, it is easy to see that nurses are number one in this respect and doctors a close number two.  Attendants of various sorts are also important.  Of course there are many other actual and potential role players who impact the patient experience:  technicians, relatives and visitors, chaplains, researches, lawyers, insurance agents – even patient advocates.  But, while the overall picture is very complex, the paramount importance of nurses and doctors is patently – and “patiently” – obvious.

So, if there is concern for good patient experience, why isn’t the remedy to train and manage doctors and nurses on patient communication?  Actually, the HealthLeaders Media 2012 report on “Patient Experience and HCAHPS” says that 96 percent of the health care leaders who were surveyed believed that training is an important part of efforts to improve patient satisfaction (unfortunately, the report does not indicate how much of that belief has been translated into practice).

Endeavors to improve patient experience may be laudable. (Still, if the idea is just to improve scores, then one might predict the same unintended negative effects as occur in education reform measures undertaken primarily to raise test scores.)  

But almost all organizational change efforts fail and the primary reason is that employees are not involved in the design of such efforts and hence don’t “buy in”.  For successful improvement in patient satisfaction, then, why not put the issue to nurses and doctors and at least be guided by their reaction – even before the consultants are called in.

It’s really the nurses and doctors who will most determine whether patient experience efforts really succeed or not.  And even if others are involved, the plans won’t succeed if they don’t support them.  If, say, communication training is so important, first check whether the doctors and nurses see it that way, because training never works if those being trained are not motivated to it.

HealthLeaders Media says that “sparking employee engagement can elevate patient satisfaction”.  So engage nurses and doctors in deciding whether consultants, training or something else is needed and what kind of consultants, training or other resources should be obtained.  And, yes, ask patients, too!

 

 

 

 

 

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7 Responses to The Patient Experience Industry – Blessing, Menace, Both?

  1. Lucy Pilon says:

    Hi Jim! Thanks for responding to my posting…I am not used to getting responses as a new blogger! I love your suggestion to have interactive role plays within the environment. It is also true that motivation and money are key obstacles to affect change; however I plan to pursue this in my work community as well as in the environment where my students get their clinical practice. I plan to follow the developments on this site in the future! Lucy

  2. Lucy Pilon says:

    Jim…this is definitely an appropriate topic and you have pointed out the current gaps in determining what is required to improve the experience of patients who enter the health care system. I wonder if engaging our new nurses and doctors in more advanced communication skills training as part of their basic educational path would help this problem. This approach would support future practice however you are absolutely right that current frontline workers need to engage in this type of training. Employers need to make a concerted effort to ensure this type of professional development is available for frontline workers. Thanks for sharing your insights on this topic! Lucy

    • Jim Murphy says:

      Thanks, Lucy!

      I concur in what you say. Indeed, we could all use more training in communication, especially with new forms of communication constantly developing (a point on which I hope to write some more).

      However, training does not work if people are not motivated and if there are no action outcomes. Here is one way it could be done effectively in hospitals: Develop some “patient scenarios” like the many posted by Beth on the blog that illustrate the difficulties in communication. Have teams of doctors, nurses and other staff act these out for an audience of their peers. Then have everyone discuss the problems shown and what can be done abou them.

      Such an approach would drive employee engagement. Still, I can imagine the usual objections based on “we don’t have enough time” and “it would cost so much”, But if we don’t invest resources in fixing problems they will only get worse.

      • Hi Jim and Lucy,
        I think role playing is extremely effective learning and the keys to doing this successfully in nursing and other healthcare professional staff involve time and facilitation. These are the resources Jim is mentioning….I think!

        It is critical to have a safe environment and engaged learners. I recently did a half day workshop with a group of nursing school faculty and students on ‘professionalism’ and used scenarios to role play common challenges. It was very successful and we actually ran out of time. But the PROCESS involved getting scenarios from instructors as part of the workshop preparation and designing a workshop that invited participation and helped folks feel safe. It was a 3 hour workshop. I could NOT have walked in the room with scenarios and had the same results.

        If you or other readers are interested you can see the workshop as well the feedback on my webpage: (Look at the bright yellow block on the right side of the page) http://www.bethboynton.com/bethboynton.com/Workshops_%26_Speaking.html

      • Lucy Pilon says:

        Hi Beth! Thanks for sharing this

  3. Oh Meg, this is a really important point. The circumstances surrounding a ‘bad outcome’ may be influenced by all sorts of stuff that clinicians have no control over. Displaced anger about being sick, lifestyle choices, access to care (or lack of) over the lifespan. With very few exceptions, patients would rather NOT be in the hospital and NOT be sick and this is an important difference in terms of comparing survey feedback in the hospitality industry or world of Disney. Do you have any thoughts about how healthcare professionals can be involved in the process? Thanks for your comments…Beth

  4. Meg says:

    If scores for good patient experience are to be obtained; and it is the healthcare professionals that actually help create these scores..then they need to be part of what compromises how these are obtained. What is called a “bad outcome” may certainly be a “bad experience” for patients and regardless of how perfect the job of caring was done..people with bad outcomes will always want to blame someone (the nurse, the surgeon etc) To get at what this means can’t just be obtained through a web site portal!! there are circumstances surrounding this outcome which must come into play and paint the picture of what happened. This cannot ever be one-sided: it really does take two people to create a problem; solution; and outcome..these do not occur in insolation. Almost always it started long before someone ever got to the hospital!!

What are your thoughts?