This has been an exciting year for the patient experience movement in which an unwavering commitment to human experience has been elevated and expanded globally. In our efforts at the Institute we have had the opportunity to engage the voices of healthcare consumers on their views of experience and what drives their decisions, we introduced the Experience Framework to reinforce the integrated nature of the human experience in healthcare and now just last week released our latest study on the influence factors on patient experience.
This is significant in that in linking these efforts together we begin to see for the first time in practice and evidence that there is alignment around what we can and should do to ensure experience excellence. This work lays out a pathway that while not surprising has been sometimes difficult to ensure a commitment to in a healthcare system driven by transactions, checklists and processes that overlook the very essence of healthcare itself – the human caring at its heart.
I shared a story to open Patient Experience Conference 2018 about how my son Sam taught me a valuable lesson in the power of human connection and how simple and brave we must be to ensure these connections occur. He showed me sometimes it just takes commitment, the willingness to reach out and acknowledge another human being in front of you for who they are, not what they have or what they do. This too is what consumers told us they wanted, and it is what we discovered in the findings of the Influence Factors Study as well.
For the Influence Factors Study, over 1400 respondents identified the factors of greatest importance to patient experience. In addition, almost 300 high performing healthcare units (as defined by achieving and sustaining high percentage of scores in the top box of 9-10 in the overall rating question on the CAHPS survey) representing 175 organizations provided input as well.
The study revealed that for both respondent groups how patients and family were treated and how they were communicated with had the greatest influence on experience. This was followed closely by the teamwork and engagement of care teams and core clinical indicators such as responsible management of pain and care coordination. Interestingly enough what was shared here, that is that experience is driven by 1) how we treat people we serve, (2) how we treat each other and (3) how we provide the quality people expect, perhaps provides the triangulation of factors that sums up the potential of and opportunity for an elevated commitment to the human experience in healthcare overall.
This discovery reinforces that at the end of the day our opportunity to care for one another as human beings is the essence of our work in healthcare. This was supported in the alignment of the influence factor responses with the voices in the study, Consumer Perspectives on Patient Experience released this summer, which found that that top-rated items of importance to consumers were, in order, ‘listen to you’, ‘communicate clearly in a way you can understand’ and ‘treat you with courtesy and respect’. The most significant realization in this finding in comparison to what were identified as the top influence factors was that not only were the top items nearly identical, in essence effective communication and respectful treatment, but also that these items scored significantly higher response percentages in both studies. This had them stand out clearly as the top items in both surveys and coming from two very distinct respondent groups.
What this means is that what people are asking for from healthcare, it is evident healthcare organizations know and high performers provide. So, then what has been in our way of meeting those expectations and needs? I offer it has been healthcare’s commitment to process at the expense of people and transactions at the expense of interactions that has undercut its very capacity to achieve this ultimate goal.
This is not offered to diminish the complexity of healthcare we face today, but rather to call us to ask if we are the reason for the very complexity that gets in our way. If we were to focus on these simple things, to build processes, programs, technologies and innovations to support and sustain this focus on the humanity in healthcare, would we see something very different in how we look to lead healthcare globally. That is our opportunity and the story I hope you will find of interest in our latest paper: To Care Is Human: The Factors Influencing Human Experience in Healthcare Today.
With this we are called in healthcare to come back to ground with three considerations that can help us all lead the experience effort forward. These include:
- Patient experience must be seen with an integrated focus that ties together the many facets impacting how human beings on both sides of the care equation experience healthcare. It must be operationalized with this broad and inclusive perspective.
- Experience excellence, at its heart, is about the relational interactions we have in healthcare. It is grounded in the kind of organizations we build to sustain quality, safe and effective healthcare for all engaged. We must move beyond simple transactions and find comfort in the human complexities that are at healthcare’s core.
- To care is human and above all else that must be a rallying cry for what healthcare can and must be. Yes, medicine is a complex science, but healthcare is not just about medicine. When we mix that science with the art that healthcare ultimately represents, we get a symphony comprised of the greatest experts, but one that only works when all those expert parts play together. And if we do that, the outcome will be truly magnificent.
The Dalai Lama is quoted as saying, “The human capacity to care for others isn’t something trivial or something to be taken for granted. Rather, it is something we should cherish.” I would add it is something we must acknowledge will require hard work, unwavering commitment, a willingness to try and fail and a focused commitment to excellence.
The things healthcare has shown it knows to be true and the things consumers are asking for consistently come down to something so essential I could be blamed for saying it too much – that in healthcare we are human beings caring for human beings. So, whether I am walking the halls of a VA facility or waiting in an essential hospital’s emergency room, seeking new research innovations from an academic medical center or being cared for in my rural healthcare center, or standing on any continent in any health system, in any healthcare setting across the continuum around the world for that matter, this universal truth remains.
It then is up to us to consider how we balance the science that has driven healthcare with the art that is what will enable it to ultimately succeed. We can no longer say that all people want is for us to make them better. That has been healthcare’s driving outcome, but for the patients and families we serve, it has been a fundamental expectation that we do so. Where the real difference and ultimate distinction lies is in HOW we make them better, in the acknowledgement that in caring for the human in front of us and those who serve around us we are realizing the true potential healthcare has to offer.
Yes, to care is human, the evidence bears out its impact and value. And in giving ourselves the permission to hold that idea as central to all we do in healthcare we can and will reframe a system with a potential for care, wellness and healing we have only dreamed could be possible. Experience is not something else we must or should do, it is all one does in healthcare, it is time we acknowledge this and move forward with this new sense of possibility. What will be your first step?
Jason A. Wolf, PhD, CPXP
The Beryl Institute