Getting to Top Box is Heavy Lifting

"The greater danger for most of us lies not in setting our aim too high and falling short; but in setting our aim too low, and achieving our mark.” ~Michelangelo

Truth: There are lots of CAHPS haters out there. Many highly committed caregivers complain that setting patient experience expectations at always is too steep a hill to climb. Without question, the pressure to always deliver on things like courtesy, timely and complete communication, empathy and more requires some heavy lifting. Providers across the continuum are looking to leaders for support, encouragement and solutions. Finding the balance between physician, employee and patient engagement has created a troublesome conundrum within many organizations - one that has risen to the top of things that keep us awake at night.

Truth: the patients' experience and caregiver engagement are organic, interwoven phenomena. Both are driven by culture and culture is driven by leaders (all leaders). You can't get to top box without coming to terms with this causative circumstance in human interaction. What's more, patients and caregivers form judgments and perceptions through remarkably similar filters...

"People start to heal the moment they feel heard." ~Cheryl Richardson

Creating a workplace that prioritizes safety, reliability, and quality shares a common border with building a trusting patient and family relationship. Still, you're going to need square shoulders and a straight back to build bridges between these contiguous areas because people have gotten comfortable in silos. Change is strenuous work. There is no elevator to the top; as a leader, you must walk the distance right alongside your teams. Always demonstrating respect and kindness - whether directed toward patients or coworkers - requires that we exercise heart muscles that may have atrophied from disengagement.

"We rise by lifting others." ~Robert Ingersoll

Truth: Value-based healthcare isn't going away. Designing a delivery system that offers safe, appropriate, and affordable care, is the right thing to do. Asking stakeholders for feedback helps us become better lifters. Fostering a culture that mandates a safe work environment with access to appropriate tools, competitive compensation and meritorious recognition lays a foundation for recruiting and retaining the best talent.

Truth: CAHPS isn't a panacea of insight for the patient experience. The instrument does, however, help us to compartmentalize perceptions into behavioral characteristics aligned with some very important indicators of quality, safety and efficiency. We know the importance of communication about pain management, medications and home care with respect to reducing errors and readmission. Staff responsiveness helps to safeguard patients from events like accidental falls and medical complications. Asking patients to reflect on the frequency of these interactions generates vital improvement data.

"Not everything that counts can be counted and not everything that can be counted counts." ~Einstein (or Cameron)

Truth: We love data. We weigh and rank the boxes; discuss which boxes should be moved first; convene task forces and committees to evaluate our progress in moving the boxes and appoint champions to oversee box-moving activities. Data synthesized into meaningful information is incredibly valuable in revealing variability; optimizing processes; and validating unrecognized trends. So with all this great data, why do only about 3% of hospitals in America achieve a five-star rating? According to Advisory Board (July, 2016), CMS reports that of 3,662 hospitals eligible for a rating, 102 earned 5-star, 934 earned 4-star, 1770 earned 3-star, 723 earned 2-star and 133 earned 1-star.

Truth: The boxes don't move themselves. But if employees and providers - the ones out there doing the heavy lifting day after day, shift after shift, hour after hour - are not feeling the love, we're in trouble. A caregiver's chronic pain radiates to everyone with whom he or she interacts. Patients see, hear and feel the dissatisfaction, low morale and hopelessness. If you want to get to patient experience top box, start by asking your physicians and employees what THEY need in order to provide consistent patient-centered care. If you strive for community loyalty, begin first by earning the trust and commitment of those who must deliver on your organization's lofty values.