Happy Patient, Healthy Hospital: The Patient Experience

Customer service, long an afterthought in the healthcare industry, is now very much on the front lines of hospitals’ strategic planning. Evidence of this can be seen in hotel-like lobbies, restaurant-grade menus, concierge amenities and the growing number of chief patient experience officers being hired by health systems.

A number of factors are fueling the hospitality trend: Competition with other health systems, worry over new healthcare entrants like retail clinics and telehealth firms, reimbursement changes that incent hospitals to improve the patient experience and increased transparency via Yelp and other social media outlets.

According to a report by Deloitte, hospitals with excellent ratings on CMS’ Hospital Consumer Assessment of Healthcare Providers and Systems patient satisfaction survey had a net profit margin of 4.7%, on average, compared with just 1.8% for hospitals with low ratings during the period 2008-2014.

Hospitals are realizing that great clinical outcomes are just not enough to create brand loyalty between them and the patient, says Paul Roscoe, CEO of Boston-based Docent Health. The startup, which last week received $15 million in Series A round funding from Bessemer Venture Partners, New Enterprise Associates, and Maverick Capital Ventures, is developing software and mobile applications to create a good experience for every patient at every stage of their hospital visit.

A tailored experience

“One of the challenges that we see is that hospitals are invested in the electronic patient record and big data and healthcare analytics focused on the clinical domain,” says Roscoe. “But there hasn’t been the same focus on creating the technology platform or the services to be able to manage the nonclinical patient experience.”

Key to Docent Health’s formula is understanding patients as individuals. If they’re a tennis player having an ACL repair and they want to be playing again in three months, then that’s a goal, Roscoe explains. “Those are the things that aren’t captured in an EMR today.”

Once hospitals know the patient’s preferences, concerns and anxieties, Docent’s platform helps them design a stay tailored to that individual. For example, a patient in his or her 20s might have a very digital experience while someone in their 60s or 70s might prefer a more human-centric trip. This “journey,” as Roscoe describes it, can also be tailored along service lines, such as touch points that would ease a first-time mother’s experience versus what a second- or third-time mother would prefer.

Next is delivering and implementing the journey through a combination of digital and human interactions, and the final piece is what Roscoe calls “this continuous improvement cycle” — knowing which are the journeys that are delivering higher patient satisfaction scores and which are the ones that aren’t, and working to improve on those.

A significant part of the platform uses a sentiment index, which can help health systems understand a patient’s satisfaction level in real time, rather than learning about it through the patient satisfaction survey. “With that we can identify and create dashboards to identify hot spots of patients inside the hospital and improve their experience before they are discharged,” Roscoe says.

Paul Westbrook, founder of Westbrook Consulting and former vice president of patient experience at Inova Health System in Northern Virginia, says technology has a “huge” role to play in increasing satisfaction, but is currently being underutilized. “Texting surgical procedure updates, iPAD/TV surveys to respond to issues prior to discharge, automating registration via kiosks, education video links, abnormal symptoms/side effect reporting via texting for support or escalation, and post-discharge followup” all can help to pinpoint issues and correct a patient’s journey before they go home unhappy vowing never to return.

Build a patient-centric mindset

Westbrook, who joined Inova in 2012, applied his 27 years of hospitality experience with Ritz Carlton and Marriott International, to transform the health system from one that had been yielding 30th percentile performance, on average, across five hospitals, to one that was performing at the 70th percentile level.

To guide that change, Westbrook started by forming a senior leadership Patient Experience Transformation Team to develop a three-year strategic plan. The plan had five workstreams — culture, communication, human resource processes, leadership development and service excellence — each with an “owner” who was accountable for accomplishing certain goals. Resources were allocated to support each plan, including a patient experience leader assigned to each hospital, who reported directly to the hospital’s CEO. They, in turn, reported to Westbrook at the system level.

By increasing awareness from the top, “it was soon understood that PE cannot be delegated … rather it is ‘who we are,’” Westbrook wrote in an email. “This mindset transition from a provider-center to patient-centric [approach] was critical, particularly as healthcare becomes more consumer-driven, where branding and reputation management become critical in an ever-increasingly transparent, value-based era.”

Hospitality Quotient, a subsidiary of Danny Meyer’s Union Square Hospitality Group, offers services ranging from training hospital staff to feel more empathy for patients to a nuts-to-soup assessment of an organization’s culture and what it would take to build a strong culture that would improve patient experiences.

“Every person in the chain of interactions that you encounter along the way … has to have the same mindset, the same skills and be delivering on the same vision of the patient experience,” says Susan Reilly Salgado, managing partner of the New York-based business. “And that requires the values and the belief about what the patient experience is all about to be embedded in the culture of the organization.”

Take time to plan

One of the problems Westbrook sees with clients looking to improve their HCAHPS scores is the desire for a quick solution, rather than taking the necessary time to assess leadership competencies and how they align to the desired cultural norms. “I often see a hierarchical top down, command-and-control leadership style that does not engender genuine care for the staff at all levels,” he tells Healthcare Dive.

And just like with hospitality, a disengaged staff member can’t provide genuine personalized care, Westbrook adds. “Only those staff members (at any level in the organization) who feel respected, valued and cared for can extend the same to their ‘customers’ [and] only then are memories made and stories told that build the brand reputation.”

Eyes on the goal

Whether it’s creating a more welcoming environment by sprucing up the hospital lobby or collecting nonclinical information about patient that can improve their stay, the goal should be the same, says Westbrook.

“The key is personalized, anticipatory service to relieve fear and anxiety through clear, easy-to-understand communication and coordinated care between providers and facilities,” he says. “If concierge services (vs. amenities) intersect with improving communication and coordinated care for patients/family members, then great.”