Who owns the patient experience?
By Brian Wynne, Vice President and General Manager, NRC Health. This article can also be found here on Becker’s Hospital Review website.
For evidence that definitions of patient experience are shifting, consider the variety in the backgrounds of today’s Chief Experience Officers. There are nurse and physician CXOs. Administrators, too, from in and outside of the industry. More recently, another class of professional has entered the mix: marketers.
That marketing professionals have begun to assume this all-important responsibility is a sign of the times. The trend encapsulates how organizations are adopting a more expansive view of patient experience.
Experiences are no longer confined to traditional clinical encounters. Today’s organizations consider every touchpoint a consumer has with their brand, whether it occurs within or outside the four walls of the hospital.
This broader understanding is crucial for retaining patient loyalty. But it also raises some questions about organizational accountability.
With such a wide range of consumer touchpoints to consider, yesterday’s delineation of roles is no longer sensible. Patient experience is too broad to be siloed in any single department.
Instead, the question of responsibility, of who owns the patient experience, must be answered with reference to a robust partnership between everyone involved—including clinicians, experience departments and marketers.
Experience as a clinical question
Historically, considerations of the patient experience began as a clinical concern.
Though concerns about patients’ experiences obviously predate CAHPS, the Center for Medicare and Medicaid Services’s surveys ushered in a new rigor in pursuing patient satisfaction. CAHPS’s answer to the question of ownership was simple: the patient experience belongs to the clinician.
With its 1995 nationwide rollout, CAHPS centered its investigations on the clinical encounter. Quantitative benchmarking largely focused on the behavior of doctors and nurses. CAHPS questions prompted patients to remember whether or not their doctors listened to them, showed compassion or answered their questions.
By measuring satisfaction through clinician performance, CAHPS pushed patient experience under the administrative umbrella of Quality and Safety. Experience was a clinical measure, like any other—so questions about patients’ experiences were raised in the same meetings that discussed fall prevention and infection control.
And the ideal “owners” of that experience were considered to be the staff best equipped to answer those sorts of questions: physicians or nurse leaders, who knew firsthand how to direct clinicians in making patient experiences great.
Outside the exam room—the patient-experience department
But though CAHPS surveys rightly pushed clinician empathy and compassion into the foreground, they inadvertently reinforced a narrow conception of the patient experience. Clinician behaviors improved, while ancillary parts of the patient experience received considerably less institutional attention.
This oversight ultimately proved to be costly for health systems, as frustrations about appointment booking, wait-times and billing prompted patients to migrate en masse to retail clinics. It’s a phenomenon that health systems are still trying to contain, and it proves decisively that the patient experience does not belong to clinicians alone.
Enter the patient-experience department. By championing skills outside the ordinary purview of clinical training—like hospitality and customer service—experience departments help health systems perfect their administrative and ancillary functions. This minimizes patient friction, leaving them happier with their healthcare experiences and more loyal to the organizations that provide them.
Which, in turn, has shown us that the patient experience belongs as much to specialized experience departments as it does to doctors and nurses.
The experience outside the hospital
However, even this designation of ownership does not go far enough. Experience departments capture and optimize patients’ contacts within facilities. But what about those healthcare encounters that happen outside a hospital’s walls?
Research has found that direct care only accounts for about 20% of patient wellbeing. The rest is attributable to broader social determinants in the community. More and more, the public expects hospitals to address these determinants directly, taking an active role in shaping the health of the patient population.
Digital healthcare has similarly expanded the hospital’s mandate. Innovations like telehealth and social media have enabled health systems to be present for their patients in ways that were never possible before.
In turn, consumers have grown more comfortable inviting organizations into their lives, sharing data and establishing connections to further their own wellbeing. At least 87% of Americans use at least one digital health tool.
These expansions indicate that consumers now expect hospitals to show a commitment to keeping them well, even if they’re never admitted as patients. The care experience, in other words, is not so much a discrete episode of receiving a health service, as it is a constant and enduring bond between patient and institution.
Demonstrating this kind of commitment requires the careful management of every touchpoint between a patient and their health institution. Whether these touchpoints happen via social media, through a community wellness initiative, or even through a hospital’s advertising and public-information announcements, they must be properly understood as part of the patient’s experience with a health brand.
This means treating them with all the seriousness that implies. Those leaders who craft these messages and design these programs—the marketers, the community relations staff, even the social-media managers—own the patient experience, too.
Not a department—a partnership
The patient experience is broader than anyone might initially have supposed. It resists easy compartmentalization. As our understanding of it grows, so should our sense of who’s responsible for it.
No single department can own all the interactions that add up to a wonderful patient experience. Delighting patients requires an impossibly wide variety of staff members of different roles, working in concert to put consumer needs in the foreground.
And perhaps this suggests that the question of who owns the patient experience is a flawed one to begin with. Because the patient experience is not owned—it’s shared. More than a department, patient experience is a commitment: a commitment best fulfilled when clinical, experience and marketing departments pursue it in partnership—together.