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The Beryl Institute invites members to submit posts on patient experience related topics. For guidelines and information on submitting a post for consideration, please contact us at


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Top tags: patient experience  healthcare  communication  culture  patient  HCAHPS  Leadership  patient engagement  empathy  physician  survey  compassion  perception  physicians  technology  caregiver  community  data  employee engagement  family engagement  healing  Hospital  improving patient experience  collaboration  Consumerism  Expectations  interactions  patient and family engagement  pediatric  person-centered care 

"I Need You"

Posted By Dr. Bryan Williams, Monday, July 29, 2013
Updated: Friday, July 26, 2013
Every patient in every hospital is in a rather strange position. They need the services that the hospital and healthcare providers are giving; but they do not want to be in a situation where they need healthcare in the first place. For the most part, people don’t "enjoy” getting sick or injured, but they do. And since this is inevitable, patients reluctantly find themselves fully dependent on people (who they usually don’t know). Every patient is saying, "I need you.” It is critical for every healthcare professional, from physicians to nurses to ER registration clerks, to fully understand the moral and emotional responsibility of their work.

 Allergy season

My family and I live in the Washington, D.C. metro area, and love it. Before moving there in 2004, I never experienced any asthma problems in my life. Since the move, however, I’ve developed asthma-like symptoms every year during allergy season. After a few years, it got really bad, so I found a pulmonologist, who diagnosed me with asthmatic bronchitis. He prescribed the appropriate medications to get rid of the ailment. Over the next few years, the same cycle ensued:

allergy season begins…I get sick…I go to the doctor…the doctor prescribes medication…I feel better…repeat same sequence the following year

Then one year my wife said to me, "Why don’t you just go see the pulmonologist at the very beginning of allergy season to get the medication? Then you can take the medication every day, as a prophylaxis, until the season ends.” Ok, sounds logical, but I immediately thought, "Obviously if that were the case, the doctor would have told me that years ago…right?” So I went to see the doctor and mentioned my wife’s suggestion. To my surprise and disappointment, he said, "Well, yes, taking the medications pre-emptively is the best route for you to take.” What?! Why didn’t he tell me that before?

As a patient, I need you to:

  • Know that I am a whole person, and not just another transaction.
  • Make me feel like you are prepared, and looking forward to seeing me.
  • Tell me what I don’t even know I need to know…after all, you are the subject matter expert.
  • Don’t just comply with my requests, but rather look for suggestions to improve my life.
  • Encourage me to follow through on your prescribed actions (medications, etc).

Most of all, I need you to care about me, and not just my ability to pay or your ability to cure. I need you to care about my well-being and genuinely want me to be healthy overall.

As I’ve written previously, it takes a special person to serve others, and it takes an extra special person to serve in healthcare. Healthcare professionals are, in fact, special people. Besides skills, they have the responsibility and privilege to literally improve the life of someone else. Those who fully embrace that responsibility serve with their hearts, and it’s a beautiful sight to see. They let love pervade everything they do and say with their patients.

Your ability to connect, sympathize and empathize makes you far more valuable than any check that could ever be written. I need you. Inpatients need you. Outpatients need you. Families need you. Communities need you. Serve with your heart and know that your healthcare job is one of THE most relevant ones the world has ever seen. 

Dr. Bryan Williams is a service consultant, trainer and author. He has travelled worldwide to work with more than 100 companies in various industries, and is very passionate about helping companies reach high levels of service and organizational excellence.

Tags:  empathy  healthcare  Patient Experience  Responsibility 

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Understanding the Gap Between Patient Expectations and Reality

Posted By Barbara Lewis, Friday, June 21, 2013

Some events change our lives. They may be small actions that have a substantial impact or they may be traumatic events that forever alter our life. For me that event began to unfold when my younger sister, Joan, called me from the Intensive Care Unit where she had been hospitalized for an unknown infection. She expected to be released within a few days. Nonetheless, as soon as I hung up the phone, I booked a flight across the country to be with her. I spent 15 to 18 hours a day in her room recording and monitoring medications, test results and procedures. During the next few days as she improved, I put on my marketing hat and observed the hospital environment with both awe and surprise. After spending nearly three decades in marketing, much of that around customer or client satisfaction, I was fascinated with how the hospital functioned.

I decided to jot down my observations, which I planned to discuss with the head of the ICU on the day of my sister’s release. Unfortunately, Joan took a turn for the worse and died at the end of the second week. When I returned home, I found my notes. As a looked over the pages, deciding what to do, I thought that the head of the ICU might like to know my thoughts. I set to work on a document I called Joan’s Family Bill of Rights. I marveled at a group of unbelievable people who have dedicated their lives to healing the sick and comforting the dying. Yet, as a family member I felt invisible most of the time – a nuisance in the hospital room, who asked too many questions.

I emailed the document to the head of the ICU, who sent it to the head of the hospital and he, in turn, emailed it to the heads of the health care system. They contacted me to talk and within three months flew me to their facilities to make three presentations, which they videotaped for their training program.  I didn’t feel invisible any longer. Here was a health system that truly listened.

What surprised me was the number of people after each presentation who told me their stories. I realized that my experience was not unique and that patients and family members everywhere shared my own narrative. Joan’s Family Bill of Rights wasn’t just my story; it was universal. As the document was passed around in meetings and on the internet, an increasing number of nurses contacted me.

I asked myself, "How can I help?” I spent over a year researching my observations, such as compassion fatigue, situational awareness and the relationship between quiet and healing. I found that the Healthcare Consumer Awareness Hospital Process and Systems (HCAHPS) surveys were tracking patient satisfaction in hospitals across the country. I was surprised to learn that money was tied to the scores, which reflected certain patterns. For example, the well educated and younger generally score the survey lower, while the poor and less educated score the survey higher. I studied the questions and devised scenarios of high scoring or low scoring.

In my opinion, the discharged patients score the HCAHPS surveys based on the difference between expectation and reality. Patients come into hospitals with certain expectations. Every person has different expectations; however, in many cases those expectations can be generalized. For example, the more educated probably want more information about their condition. (HCAPHPS survey question: Patients Who Reported that Their Doctors {or Nurses} Always Communicated Well.) The gap between the expectation and the reality is where the survey scores reside.

There are at least five HCAHPS survey questions that are directly related to the patient’s journey through the hospital system. Low HCAHPS scores not only affect Medicare payment, but insurance reimbursements; future patients, who opt for other facilities; and donor defections, as well. As businesses have been doing for years, it’s time hospitals understand the patients’ expectations, manage those expectations and shut the gap between the hope that patients have when they come into the hospital and the realization they are stuck with when they leave. Closing that gap means redesigning systems and altering behaviors.  It’s time to exceed patients’ expectations, which will not only boost HCAHPS scores, but have a substantial impact downstream as well.

Barbara Lewis has been a marketing consultant for over two decades. She began her career as a journalist writing for national publications from The Wall Street Journal to Ladies Home Journal. She has an MBA from the UCLA Anderson School of Management where she currently lectures. You can reach her at: 


Tags:  Expectations  HCAHPS  ICU  Patient Experience  reality  survey 

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Celebrating the Individuals Who Enhance the Patient Experience

Posted By Bernadette Brady, Friday, May 24, 2013


Al and Eric

I know that the patient experience is about individuals as much as the organisation. I also know that in some organisations there are individuals who come up with really good ideas to improve the patient experience. Visiting a local hospital some months ago I walked past an enclosure containing birds and lizards. The bird song was piped into the corridor so as you walked along the corridor you could hear the birds chirping. It made me smile. There were individuals standing at the enclosure just having a quiet moment. Each time I visit there are people just enjoying the difference this enclosure brings to the usual hospital helter skelter. Often there are children there who are kept entertained while their parents make phone calls.

This enclosure was the brainchild of the gardener. He roped in the electrician to help. Together they have built the enclosure, lobbied for financial assistance to stock it and feed the occupants and continue to maintain it. They are very proud of their achievements.

Alastair is the gardener at Calvary Health Care in Canberra, Australia. Calvary is a fully accredited 250 bed public hospital. Services on this campus include emergency department, an intensive and coronary care unit, medical and surgical wards, a maternity unity, a voluntary psychiatric ward and ambulatory care and outreach facilities and services.

There are many visitors to this hospital each day, some of whom are fearful for themselves, some of whom are fearful for people they love. Hospitals are not somewhere we chose to go to.

Alastair has, over many years, tried to provide areas within the grounds of the hospital that will allow people to smile, to linger, to revive. His greatest venture to date though is an enclosure that is situated adjacent to one of the hospital’s busy thoroughfares. This enclosure takes up an open air space enclosed by three walls and the glassed corridor. Alastair has turned this area into an aviary with fish and lizards in the undergrowth.

The aviary is evident to all who walk these corridors. It provides a focal point for all who walk along the corridor.

Initially Alastair introduced some lizards, fish and a couple of quail to the enclosure but the crows kept taking the fish. That was when Alastair enlisted Eric’s assistance. Eric is the hospital electrician. He helped Alastair to put a net over the enclosure to keep the crows out. This of course meant they could keep birds in.

The Facilities Manager approved payment for the netting and the social club provided $220 towards buying birds.

About this time Eric saw an ad in all classifieds for finches for sale for $2 each. When he rang to say he would "take the lot” the person selling the birds asked why so many. When he heard where the birds were to go he donated "the lot”. Another man when he heard what they were doing donated quails. One man was overwhelmed by the aviary. He donated lizards.

Alastair and Eric have been impressed by the generosity of local businesses and the community in supporting their project. One woman donated speakers, a microphone and amplifier box so the bird song could be heard in the corridors. She then sent her son to install the equipment.

Alastair gets joy from the number of people who linger at the window. "There are always people standing there I have many thank you notes, We get to know the people who are coming into the hospital regularly. One particular lady who comes to chemo twice a week told me that coming to chemo she has a smile on her face and on her way out she has a triple smile, just listening to the birds.”

For Eric "it is about making it easier for the people who have to come here or the staff who just need somewhere to go and reflect sometimes. We love watching the reactions.”

So from one man’s desire to make a difference to patients a community has been formed with a common goal – to improve the patient experience.


Bernadette Brady, member of The Beryl Institute, has 40 years experience in the Australian health sector as a registered nurse, manager and change agent. She now works with health facilities to improve their knowledge of the patient experience and partnering with patients.

Tags:  Australia  Calvary Health Care  Canberra  Community  Gardening  Hospital  Patient Experience 

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