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'How' trumps 'what' in patient experience success

May 22nd, 2013

by Jason A. Wolf

Since my last blog post where I stressed the need for our continued commitment to push the patient experience movement forward I have had a positive, life-changing experience.

Early on Friday, April 19, as we were wrapping up Patient Experience Conference 2013, my wife called to let me know she was having contractions. "Nothing imminent," she calmly told me.

It is not often you spend three intense conference days stressing the critical importance of patient experience--of people and process, patient perspective, strategic imperative--only to turn around and be that patient or family member yourself. But those three days were followed by three days admitted to the hospital--experiencing labor and delivery (L & D), post-partum care and watching everything our caregivers did to provide for my wife, our new son and me.

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It reinforced the point I often stress--that we will all be patients and family members some day.

As I switched roles to the receiver of care, I keenly observed all I could in the hospital setting--the incredibly calming and intent support we received from the individual in admissions as she carefully but purposefully pushed my wife up to L & D.

As we went through the process of labor, delivery and our following two nights as inpatients, I saw all the things I know great organizations do--effective use of communication boards, purposeful hourly rounding, tent cards from housekeeping on the importance of cleanliness (including a seat band saying "Clean for You" around the toilet in the bathroom when we arrived in both our L & D and post-partum rooms), posters noting the importance of creating a quiet and healing environment, room service menus, and much more.

I realized those are nice things to do, the tactics or the "what." And while not always expected, they are emerging as central to patient experience efforts. Living in the patient experience world, I was aware of those whats, but as a patient/family member they were not explained to me, their purpose was not revealed, and so their impact, while still impressive, was not significant.

What stood out to me and what made my family's experience, was something much simpler, yet more significant. It was the "how" of our care--how our experience, service, quality and safety were handled made the impression on us.

From that admissions experience when Patricia calmly led us up to L & D to our L & D nurse Kristin who communicated clearly and set expectations (even when not easy to communicate) and from our anesthesiologist who followed up on my wife's procedure to the day and night nurses who rounded with care and gave their time to answer questions, provide a helping hand and support for new parents who were sleepless, overjoyed and overwhelmed.

It was the food service workers who took our order knowing my wife's allergies and asking to speak with me personally to make sure they could best take my dinner order. It was Sandra the housekeeper who in the midst of ensuring the unit sparkled, took the time to explain the family break room, help with extra needs for our room and check in time to time just to see how we were doing.

This is not a secret formula or a quick checklist of to-dos. Rather it reinforces all that's central to the definition of patient experience, that experience is the sum of all interactions, shaped by an organization's culture, that influence patient perceptions across the continuum of care.

What moved me most as a new father, and what caught my attention as a champion for positive patient experience, was that I saw these central ideas come to life. It was the interactions, it was the culture--the people who cared for us each day--that ultimately drove our perceptions and made our experience so great.

I do not wish to suggest tactics are not important or strategies for patient experience execution and improvement are not critical--they are. But it is truly the how in delivering experience that can have the biggest impact. In healthcare we are fundamentally no more than people taking care of people. Our family experience reinforced this more than anything. It was how it was done that made all the difference to us.

Jason A. Wolf, Ph.D., is president of The Beryl Institute, where he specializes in organizational effectiveness, service excellence and high performance in healthcare. Follow Jason @jasonawolf and The Beryl Institute @berylinstitute on Twitter.

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