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The power of paradox in patient experience

March 24th, 2016

by Jason A. Wolf

I have often found that the distinctions we draw between concepts seen as opposites are truly opportunities for alignment, improvement and sustained performance. This is no less true than in addressing the patient experience.

In the last week, I have had the chance to listen to the insights of two leading healthcare thinkers, former U.S. Health and Human Services Secretary Michael Leavitt at the American College of Healthcare Executives Congress 2016 and former Institute for Healthcare Improvement President and CEO Maureen Bisognano at the American Society for Healthcare Engineering PDC 2016. These talks raised two ideas that I think are central to healthcare and ultimately experience excellence.

Leavitt talked about having an awareness of weak signals (a term he learned during his cabinet tenure) in our current healthcare environment. He urged healthcare leaders not to miss the quiet and disparate ideas and occurrences that when connected, could lead to big things. In patient experience context, I refer to these ideas as “the spaces in between.”


In contrast to the weak or nearly invisible, Bisognano urged us to consider another key construct--that we must work from a place of abundance. She said we must escape the tyranny of the “or” and begin to act with the intention of “and.” This idea has been central to our work at The Beryl Institute as well.

As I considered these two ideas I felt the pull they could have on each other, from connecting the dots of weak signals to managing the “ands” of abundance. These two ideas could cause us to travel different pathways, generate different plans and tear at the seams of what we are ultimately trying to accomplish in healthcare. While the ideas may seem to be in contrast, the paradox--that of hidden quiet signals balancing with broadly shared ideas through abundance--provides an avenue to experience success, and in doing so to driving the best in healthcare outcomes overall.

First, we must come to an agreement, that in all we do in healthcare, whether planned or not, people receiving care or providing care or supporting our care systems are ALL having an experience at every moment. Right now as you read this, someone in your healthcare organization is having an experience whether you planned for it or not. And in considering the reflections of these two leaders, that opportunity is too fragile to miss and the opportunity is too great.

In all we do in providing for the patient experience--for every interaction that takes place across the continuum of care, for all the touch points of quality, safety, service or cost--we must be aware of the weak signals that exist. This is organizational self-awareness at its highest level; it represents listening to all that is happening, to the voices of patients and families, to the voices of associates and team members, to the voices of our community. It is in that chatter that we can connect that dots on what we are doing right and where we can improve.

Likewise, we must also address the other side of this balance--in not just listening, but being willing to share broadly, to spread ideas, to act with abundance. This is represented in a commitment to open access, a spirit of generosity and the active invitation to engage and contribute that will continuously expand reach and sustain growth. This is the very foundation of our existence at The Beryl Institute and in our gatherings such as Patient Experience Conference. There are truly no secrets or silver bullets to experience success, and we should not be fooled in believing one model will work for all organizations. Rather in our sharing of ideas, we can achieve the greatest in outcomes.

So the implications are palpable. If we are to achieve the greatest in experience results, we must hold the power of paradox and use the balancing it challenges us to face to make critical choices in how we lead in healthcare today. We must both listen carefully and share broadly, and we must acknowledge that experience is happening and it matters in healthcare today. The reality is if we capture the power of this paradox, we may have two of the most significant keys to healthcare success--an awareness of all that challenges us and the knowledge of all that can support us. This is our collective cause in healthcare today. It is now up to us to embrace the paradox and act.

Jason A. Wolf, Ph.D., is president of The Beryl Institute, a global community of practice focused on patient experience improvement and founding editor of Patient Experience Journal. Follow Jason @jasonawolf, The Beryl Institute @berylinstitute and Patient Experience Journal @pxjournal on Twitter.


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