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Understanding expectations matters to experience excellence

Posted By Jason A. Wolf, Ph.D., Tuesday, February 10, 2015
Updated: Friday, February 06, 2015

In a recent personal encounter shared by our Director, Member Experience, Michelle Garrison, she told a story of her own healthcare experience related to a surgical procedure and how it made her feel as a patient in the process. Her experience and insights reinforced a critical point central to the conversation on experience excellence – expectations matter.

I first addressed this issue in the Patient Experience Blog two years ago when I wrote:

"Expectations are powerful. They influence what we see, how we act, and the way we react. They stir emotions and create real feelings from joy to anger, surprise to sadness. The reality of expectations is that they present an intriguing paradox in how they can and do influence the situations in which we find ourselves. Expectations are an individual and even very personal experience, yet at the same time they can be set by organizations, businesses and other people outside of one’s self. This makes expectation potentially the most valuable and perhaps most precarious tool in the discussion of consumer experience and in healthcare, the patient experience.”

As Michelle shared her story, she reinforced an important point from her personal experience. She noted, "We are continually looking for the best methods to help prepare patients and family members by ensuring they know what they are likely to face when they visit with a doctor, arrive at the hospital, leave a healthcare encounter and beyond. By setting their expectations ahead of time, we help prepare them and give them the opportunity for the best patient experience. However, even with the most comprehensive of processes in place, there are going to be times when expectations are not met and the patient experience will fall short.”

This was a profound statement for me as I realized in Michelle’s words reflecting on her encounter that she felt the provider would have provided expectations. It also raised an important point, and I dare say an opportunity. That in providing the best in experience we must also be willing to ask the questions and take the steps necessary to understand the expectations of those we are caring for.

In talking about her experience Michelle said "I was not the best of patients. Though, I am pretty sure if you were to ask my doctor, the nurses, anesthesiologist and the others who took care of me, they would not have anything bad to say about my behavior or me.” In asking why she felt that way, she added,

"Here is where I fell short. I did not ask enough questions and the questions that I did ask were not the right ones. I was not as informed as I could have been about what was going to take place and how I would feel after the procedure, and so my expectations did not match the reality of what occurred. I was given instructions both before and after, on the procedure and what to do if there was a problem, but there was nothing about how to deal with the lingering after effects and how I might feel. I mistakenly thought all of the information I needed would be given to me without my having to ask for it, but it was not. Of course, I could have reached out to my doctor, but instead I did what I am sure a lot of patients do, I turned to the internet to see if what I was experiencing was normal.”

This statement is powerful and eye opening in its potential reflection of the way many other patients or family members may feel in the midst of the healthcare system and their own experiences. This is a significant realization we may often miss, that while patients want to engage, they are not sure how to participate or what to ask. Or they believe what they need to know will be provided so don't think they even need to ask. In concluding her story, Michelle shared, "It is important to understand that patients and family members are not always going to ask all the questions they should or even the right ones. They may not know what questions to ask because they will assume, like I did, that the answers will be in that packet of paperwork they were given.”

I think we would all agree Michelle was not a "bad” patient, but perhaps quite the opposite, a patient that was trusting in the system to take care of her. Michelle’s procedure was successful and the system did its job, but the realization here is that there is an opportunity for much more. In many ways creating a process for clarifying and understanding the expectations of all participants in the care encounter be they patients or family members, doctors, specialists or support services and in doing so together could be one the most clear, simple and impactful ways to create the best in outcomes overall. Thanks Michelle for helping us to see and understand this point with greater clarity. You are the patient experience!

Jason. A. Wolf, Ph.D.
The Beryl Institute

Tags:  expectations  patient engagement  patient experience  process 

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