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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 

Why Your Hospital is Competing with the Apple Store

Posted By Julian Hutton , Monday, January 9, 2017

At a recent patient experience leadership forum, the question was posed “Who is your competition?” Predictably the initial discussion revolved around the merits and reputations of other local or specialist hospitals and how their patient experience was judged to compare. But who else is the patient comparing your hospital to when they give a verdict on the service they have received? What other experiences form the benchmark when evaluating how highly they should rate their hospital experience?

The United States is now a service economy in which we are spoilt for choice on which stores, malls, restaurants, supermarkets, automobiles, hotels and electronics to spend our time and money. As products and services, at all levels of cost and quality, have proliferated, one of the major differentiators has become the customer service experience both at point of sale and for as long as we own the product. Although it is an investment, training staff in the skills to make customers feel valued and respected is a great deal more cost effective than slashing prices. It also has swift return with minimal impact to the bottom line and, if you get it right, earns you enduring customer loyalty. When you buy a $4 Big Mac, you can be fairly certain that somebody will greet you (occasionally with a smile), ask what they can do for you, take your order and deliver the right product. From that standard, the bar for customer service keeps getting higher – for less than $100 a night, a limited service hotel receptionist will welcome you warmly, inquire as to how your journey was, efficiently check you in and show you to a room with clean sheets and small, tastefully designed, bottles of gold, frankincense, and myrrh in the bathroom. (Coming soon to a chain hotel near you.)

When you go into an Apple store, you’ll be greeted by somebody who seems genuinely pleased to see you. They are friendly and professional. They give every impression of being sincerely interested in helping you. They listen attentively, they make sure they have understood what you have told them, and they then tell you who is going to be helping you. They introduce that person and hand off to them by repeating what you have said to them and inquiring if, before they go, there is anything else that they can do for you. During your whole experience with Apple, whether you are buying something, or getting help with an existing Apple product you already own, you are kept informed of the process, how long it is estimated to take, what is going on behind the scenes that you may not know about and when the person helping you will be back. At every stage, there is a handover from one person to the next. If the person helping you needs to go somewhere and you are by yourself, it is only a matter of minutes before an Apple employee asks you if you are being helped and if there is anything they can do for you. You are never left wondering if anyone has forgotten you or what is going on. And however intractable your issue is, you are never made to feel you are being a burden.

Can hospitals ever operate as smoothly as an Apple store? No. But can hospitals learn from the kind of customer service culture that companies like Apple have trained their staff on? That has set them apart from their competition, earned the loyalty of their customers and set a standard of customer experience that other services are judged by? Fairly or unfairly, hospitals are being judged by patients on the constantly improving standards set by the service culture they experience in their everyday lives.

Julian Hutton studied leadership at Britain’s Royal Military Academy Sandhurst and was an officer in the Scots Guards. From there he went into the hotel and hospitality industry, working all over the world for some of the industry’s best known names. For the last 10 years, he has been increasingly involved in developing leadership and hospitality service training programs providing the highest standards of guest and patient experience.

Tags:  competition  customer experience  Customer Service  Hospitality  Leadership  service excellence 

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How Did Dr. Dean Edell Save My Life?

Posted By Lee Tomlinson, Wednesday, July 23, 2014
Updated: Monday, July 21, 2014

"Life begins on the other side of despair.” - Jean-Paul Sartre

Did you know that hopelessness is the leading risk factor for suicide in cancer patients? Did you know that doctors have the highest suicide rate and nurses are the second most unhappy professionals in America?

Why so much despair?

Imagine being a cancer patient and feeling so dehumanized by your hospital care that you plan to commit suicide; no sense that you are in the hands of people who see you as a person, acknowledge your suffering or treat you with simple dignity.

I’m a C-level executive, author and internationally recognized speaker on customer service and the bottom line. Until my battle with Stage 3+ throat cancer, I assumed that customer service in healthcare (a patient’s experience) had some impact on profitability.

What I discovered, however, is that customer "compassion” can be a matter of life and death for patients, as well as caregivers and the institutions in which they serve. At my lowest point, hospitalized in a top-tier hospital with a life-threatening infection, my care was insensitive, unkind and totally lacking in human compassion.

Once, while waiting for a doctor to remove my infected PICC line, I heard him berating a nurse outside my door. When they came in, she appeared humiliated and I was terrified he’d treat me as insensitively. Sure enough, as he began, the pain was excruciating and I begged him to stop. He shrugged me off. "This will only take a minute.” It took far more than a minute and was among the worst physical and emotional pain I’d ever experienced.

When a dead gecko lay next to my toilet for three days, all I could think about was filth and infection. When my fever spiked and my room was sweltering, I was told to "call maintenance.” Frustrated, I rasped into the phone it was "so damn hot” in my room. The maintenance guy said, "Calm down and call back later” and hung up. Humiliated, I called back and he said he’d "get to it tomorrow.”

I have wonderful friends, but oddly, none came to see me. When I received a "Thank You” note from the hospital, I understood why. Over the whiteout on a used envelope was my name, but it began "Mrs.” (I’m a Mr.), was spelled wrong and had the wrong room number. My friends had been told I wasn’t there. I didn’t exist. Dozens of experiences like these pushed me from depression to despair and thoughts of suicide.

My will to live was restored by Dr. Dean Edell, America’s original "Media Doctor” and dear friend. I asked him, "If I use all these pain killers, will I die?” He said yes, but strongly proposed an alternative. He said, "Why not fight to live and combine your customer service knowledge, business acumen and patient experiences to become part of the solution?” Instantly I took his advice and am convinced I am alive today to do just that.

I have come to understand that:

  • Compassion has a measurable impact on healing and the will to live.
  • Healthcare providers are under enormous stress, and they deserve our compassion and gratitude.
  • All I care about now is that ALL patients receive the compassionate care they so desperately need and deserve.

So I ask, "What will it take for all institutions, physicians, and every person who touches us to see us not only as individuals and valued customers, but also see that every minor miracle of compassion alleviates our mutual suffering, reaffirms our shared humanity, and, over time, makes its way to the bottom line?"

Lee Tomlinson is a C-level executive, author and internationally recognized speaker on customer service whose life is devoted to improving the patient experience to benefit patients, healthcare professionals and the bottom line in hospitals in which they serve. Lee combines spellbinding speaking skills with in-depth business skills to reconnect, re-inspire and re-engage healthcare professionals to "up their games” when it comes to patient-centered care.

Tags:  compassion  Customer Service  despair  hope  Patient Experience  physician 

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Understanding the Totality of the Patient Experience through Total Quality Encounters

Posted By Paul Roemer, Monday, January 27, 2014
Updated: Saturday, January 25, 2014

Point One. New College, Oxford, was founded in 1379, hundreds of years prior to the invention of the I-Beam. As a result, the roof of the main dining hall is supported by big oak beams, two feet square and forty-five feet long.

About 100 years ago, entomologists were studying the beams and noted that they were infested with beetles, a problem which had eroded the integrity of the roof. Unfortunately for the college it was believed that all of the large trees from the old-growth forests had long since fallen.

As luck would have it, the college owned a great deal of land and actually employed its own forester. When the college asked their Forester about whether he knew of any large trees, the Forester replied, "I was wondering when you’d come asking.” It was discovered that when the college was founded, a grove of oaks had been planted to replace the beams in the dining hall when they became beetle-infested. This information had been passed down from forester to forester for more than 500 years.

Long term planning: Planning that involved the exact solution, not a series of ad-hoc fixes year-in and year-out.

Point Two. Heliocentric versus geocentric. Heliocentric—the planets revolved around the sun. Geocentric—the earth was the center of the universe and everything revolved around it. Copernicus. Early astronomer, pretty smart guy—he got it right.

Point Three. Patient experience. The hospital is the center of the universe and the patients revolve around it. Where is Copernicus when we need him? What about a patient-centric model?

Four out of five hospitals do not have a patient experience strategy. Of those 20 percent that do, most, if not all of them, do not include anything outside of HCAHPS.

There are several fatal flaws with the hospital-centric model of patient experience. Improving HCAHPS scores is not the same thing as improving patient experience. One strategy involves improving a set of numbers, the other involves improving experiences.

Here are the flaws around what most hospitals are doing:

The experiences of outpatients are ignored—surveying them doesn’t count; we already established that with HCAHPS.
The experiences of all prospective patients - the largest group of stakeholders - are ignored. Definition of Prospective Patients—everyone who has ever been to your web site, called the hospital, parked in the garage, eaten in the cafeteria and driven past the billboard advertising the hospital’s urology practice.

The hospital-centric patient experience model requires hospitals to try to apply a fix for every patient experience, patient by patient, day after day. One hospital fixing thousands of patients’ experiences. Shampoo, rinse, repeat. Since the patient is no longer classified as a patient when the fix is applied, whose experience is the hospital attempting to fix?

The patient-centric model of patient experience centers around one patient, one person. It is designed, planned and thought through. A patient, like a customer, should be able to carry the hospital around on their iPad. That person should be able to accomplish everything they need to with the hospital, with the possible exception of a hip replacement, the same way they can accomplish everything they need to with Amazon.

The following graphic shows the lifecycle of someone’s experience with a hospital. The most noteworthy aspect of the graphic is that only the green circle represents a person’s time in the hospital. The blue circles represent all of the other interactions someone has with the hospital.

Patients only spend a small fraction of their time in the hospital. Hospitals only spend a fraction of their time understanding the totality of someone’s experience.

Since most hospitals do not have a working definition of patient experience, I like to use this definition: TQE—the Total Quality of a person’s Encounter with the hospital is equal to the sum of their HCAHPS scores plus all of the nonclinical patient touch points. This definition parallels The Beryl Institute’s definition of the patient experience – the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care. Using these definitions as guides in their own organizations enables healthcare leaders to truly keep the patient at the center of their universe.

A remarkable experience happens for every person, every time, on every device.

Paul Roemer
Vice President
Tower Strategies

Tags:  Customer Service  defining patient experience  HCAHPS  healthcare  Hospitals  Patient Experience  patients 

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