by Anthony Cirillo

That is until you experience it firsthand. Which brings me to the last couple of months. My mom, Philomena, lives in Florida. She is 89. She has COPD, some CHF, has fallen a few times. You get the picture. In fact, I joke that the tar from her cigarette smoking is what holds her joints together.

Anyway, in February she took her latest spill. Initially she was fine. Then she started getting shooting pains up and down her legs, which she described as electrical shocks. My sister lives nearby mom, and one Sunday she called to say she was taking mom to the hospital. Well the ED dismissed her, essentially treating pain symptoms, not root causes.

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The next Sunday, mostly through my sister's patient advocacy efforts, she had mom admitted to the hospital. On Monday she called me. "Get down here!"

The neurosurgeon had laid it out plain: Since mom had refused to have an operation a few years back to fuse her neck, her neck has become increasingly unstable with each fall. Have the operation now or face certain paralysis from your neck down. ...Well that will get your attention.

So down to Florida I drive. Mom is a trooper. She wants the operation, even though for two weeks the neurosurgeon and pulmonologist keep telling us about the odds. She could come out fine. She could come out on a ventilator. She could come out paralyzed anyway. She could die on the table. But mom wanted to give herself a shot at a quality life.

For 10 days leading up to surgery, for 10-12 hours a day, we sat in a room with her. Because deep inside I thought it would be our last time together, every moment was precious. You learn a lot about patient experience and hospital care when you spend that much time in the hospital. What I thought I knew and what I learned were vastly different. And I have been in healthcare for 25 years, worked in hospitals, talked to hundreds of patients, and witnessed procedures. But you truly don't know what is going on until it happens to you.

You quickly find out which nurses you want and don't want. You understand that you may have to wait five to eight hours before a physician shows up to give you the latest. You realize just how uncoordinated supposedly coordinated care can be.

And the crazy thing about perceptions and what you remember: It often comes down to one telling moment that defines the patient experience. Let me first tell you how mom did, and then I will tell you about that defining moment.

So of course mom makes it through the operation. She doesn't even need to go to ICU after. Straight back to her room. No ventilator. And all the limbs were moving. It was actually pretty miraculous. I think it shocked her because the biggest thing for her has been coping with the fact that she still has a life to lead. She is now in rehab, another story for another day.

No doubt the neurosurgeon I would follow to the ends of the earth. He did his job. In fact he was surprised by the result. So my mom must have done her mental preparation job too.

Now don't get me wrong. There was good care in the hospital. But there was also bad. And while I am an educated, rational human being, someone tuned into healthcare, I nonetheless left the hospital with a certain impression.

You see, leading up to the surgery, during a time when my sister and I slipped out of the room for a breather, someone from finance approached my mother. Here is mom lying in bed, contemplating dying. And here is the person from finance wanting to know how she was going to pay her Medicare deductible! It was all I could do from holding my sister back from taking someone out!

And you know what, for me, that is what I remember about the hospital experience.

If people ask me about mom's stay, I respond that we would take the neurosurgeon any day but the operation would have to be at another hospital. Of course, I know better and that you may not have that choice. Still, that is the simple conclusion I came to. I believe most patients and families compartmentalize and summarize their experiences similarly.

So, I say honestly most of us who work in healthcare don't know "jack" about how it is really delivered. Keep your metrics, those consultants who want to come in and show you how to score better to attract patients, and all the rest of the positioning.

Hospital marketing comes down to word of mouth, and that word of mouth is generated from the experience people have at the facility. And if any one component breaks down it will affect perception, reuse, and of course impact the ultimate question--will you recommend us to others?

For me, doctor yes, hospital no.

Anthony Cirillo, FACHE, ABC, is president of Fast Forward Consulting, which specializes in experience management and strategic marketing for healthcare facilities. He is also author of the expert guide in Assisted Living. He will be speaking at the Cleveland Clinic Patient Experience and Innovation Summit this month.