My dearest friend recently received news that her breast cancer is back after 11 years of remission. She struggles daily with eating enough to maintain a healthy weight, feeling strong and motivated enough to walk in the pool to build her strength, and to find relief from the constant pain. I’m not sure the word happy is in her vocabulary these days.  But expressions of gratitude, a decrease in her anxiety, and a feeling of comfort are certainly emotions she has experienced when interacting with her healthcare team.

During the past several years in my various roles leading patient experience efforts, I have had frequent conversations with physicians, leaders, and clinical staff about what patient experience is, what it’s not and why these efforts are so important.  

Some physicians express frustration about measuring patient satisfaction.  After all, "It’s impossible to make every patient happy, why are we spending so much time and money sending surveys?”  I have also experienced hospital administrators share their belief that if staff would just be nicer to people, the scores would improve. And, I have witnessed nurses and other clinical staff push back on patient experience activities saying, "We are not Disney, we are not here to make sure people have a good time, we are here to take care of patients.” 

As I think about the evolution of the Patient Experience (PX) movement, I understand these various viewpoints. My PX journey began when the organization I worked for hired a consultant to teach the importance of customer service.  After about 18 months, this turned into an initiative called "Service Excellence: Our Values in Action”.  We continued on this journey for 5-8 years and recently the language and movement changed to what we know today as Patient Experience. I fully embraced this change, as it is a demonstration of applying our ongoing learning of what PX is really all about.

I don’t believe the goal of delivering the best to the patient and their families should be framed within the context of making them happy. I don’t believe patients give us the gift of their feedback, respond to a survey or write a heartfelt note because people simply made them happy. I believe it’s about so much more. 

I tell physicians that patient satisfaction surveys do not measure patient happiness, but they can determine whether you listened with a compassionate ear as they expressed their concerns and worries.   

I vividly recall reading a letter from the niece of a patient after her uncle died. She expressed her deepest gratitude not only for the care and compassion her uncle received but also for the care and comfort she received at a most difficult time in her life. The letter she wrote focused on the nurse who called to inform her that her uncle passed away in the middle of the night. This nurse went on to explain that he did not die alone. Hearing this brought instant comfort to the niece. Was she expressing happiness in her letter? Of course not. Rather, she was thanking this nurse for the compassionate way in which she shared this difficult news.  

I’m not saying that in healthcare we should not be nice to people or that those simple courtesies are not important parts of the way we deliver care. What I am saying is that we must reach higher, go deeper, and deliver care in the most compassionate way. That is why I fully embrace the next evolution in our PX journey. 

Fred Lee talks about this in his three levels of care framework. Wendy Leebov’s works with clinicians building their skill in compassionate communications and Colleen Sweeney raises awareness in patient’s biggest healthcare fears in her Empathy Project.    

Hospitals, clinics, outpatient centers etc, do not have the same goals as Disney.  We must look beyond the happiness factor.  We must comfort, care, listen and convey compassion in every interaction. That is what the patient experience is all about and why I’m more than happy to listen to what our patients have to say about their healthcare experience.

Deanna LW Frings
Director, Education & Professional Development
The Beryl Institute