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Reframe hospital business objectives to rebuild trust

October 31st, 2012

by Doug Della Pietra

In the opening pages of their book "Reinventing the Patient Experience: Strategies for Hospital Leader" published in 2007, Christianson et al state that 56 percent of the American public trusts hospitals "somewhat," "not much" or "not at all."

Even more distressing are the descriptions the majority uses for hospitals that were once perceived as altruistic, humanitarian institutions:

  • Hospitals have been "transformed from charitable institutions to purely business enterprises."
  • They are "impersonal and detached from the community."
  • Hospitals "put economics ahead of patient care."
  • They have abandoned the "traditional role as advocates for patient needs."


Admittedly, such a public perception is disturbing and disappointing! Most of us who chose to work in healthcare did so for far more profound reasons than a balanced scorecard. We wanted to be a part of a "healing enterprise"--positively contributing to the improved health and wellness of the communities in which we live and serve.

While I don't want to oversimplify the problem before us, reframing hospital business objectives and connecting them back to purpose can positively contribute towards improving the perception and trust that the American public and even hospital caregivers have in our healthcare system.

Let me be clear: The business objectives that reveal a hospital's present and trending condition--such as patient satisfaction, retention and loyalty, employee satisfaction and engagement, clinical and service excellence, safety, quality, financial health, days of cash on hand, borrowing capacity and profit margins--are not to blame. However, without tying them back to purpose and mission, business objectives can become--or be perceived as--ends in themselves.

For example, emphasizing the 90th percentile in patient satisfaction and the positive effect on a hospital's Medicare reimbursement, profit margins, market share and competitive position in the community is only part one (and the lesser one) of the full story we need to tell.

More important is part two, which requires leaders to frame patient satisfaction from the "outside-in" (community/customer) viewpoint. In other words, top-performing patient satisfaction scores symbolize the community's widespread and positive perception (and appreciation) of the care and services provided by the hospital and its vote of confidence and trust--the highest compliment the public can give a healthcare organization!

Even when it comes to reducing the rates of readmission, hospital-acquired infections, patient falls and mortality, their altruistic purpose can be lost if their benefits for the organization overshadow the more fundamental purpose, namely, improving the community's health.

So, instead of focusing on the significant cost-benefit to the hospital associated with reducing 30-day readmissions and patient falls, consider reframing such an "inside-out" (organization-centered) view of quality and safety outcomes into an "outside-in (community-centered) one:

Hospitals are places of healing; it's the reason they exist! Reframing hospital business objectives and connecting them back to purpose and mission is an important step in tapping the passion and original motivations of our caregivers and helping to rebuild American trust in and respect for our hospitals. By doing so, we can strengthen the foundation on which true and long-lasting healing (and reform) of the healthcare system in the United States will stand.

Doug Della Pietra is the director of Customer Services and Volunteers for Rochester General Hospital in New York, where he co-chairs the hospital's Patient Experience Team, in addition to responsibilities for an intentionally-designed patient- and family-centered volunteer program and front-line First & Last Impression initiatives. Follow Doug @DougDellaPietra on Twitter.


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