The ObGyn wife tells her side
When my husband was appointed chief experience officer, I naturally was happy for his accomplishment but admitted that I was not sure exactly what it meant. What was he going to be doing? Would he give up surgery, which he loved?
The experience “thing” always had been fuzzy to me. I equated experience with satisfaction, and I saw my primary role as taking care of patients, not making them happy. I believed that I had great patient relationships, so what else did I need to know to contribute to this work? The connection to safety and quality did resonate with me, though, and it made talking about patient experience more tangible.
When Jim started teasing apart what steps needed to be taken, improving the culture seemed like an obvious focus. One thing was clear: He would need to get the physicians on board by helping them to see the practical importance of this work. It could not be gimmicky or too touchy-feely. The work had to be relevant and tangible to their everyday practice. One thing he said struck a chord: “Everyone comes to health care to help people, and we all believe we are the best we can be, but clearly there are opportunities to improve, and evolve our skills.” I started to consider specific circumstances in which that made sense.
Practice to be a better communicator
Improving physician communication was a top priority. I believed that I was a very good communicator, so I was not sure I would learn much from participating in a required day-long session designed by the AACH.
For this program we convened in small groups of 8 to 10 physicians, and each person paired with a partner. The course provided an important framework that would help us to better organize the patient encounter, an approach that no one had ever taught me. It showed me how to leverage the patient’s chief complaint to empower her to set the agenda. This would avoid unnecessary and inefficient conversational tangents, such as the doorknob question—when the patient brings up the real reason for the visit as you are leaving the exam room.
The course also taught me that while I was a good communicator, I was not efficient. I learned how to listen more effectively. Notably, how we manage patients and how we communicate are learned skills, just like mastering a new surgical procedure. High performance requires thoughtful review and practice.
Work on relationship skills
I had professional colleagues who were difficult to work with or, as I knew from covering for them, had terrible relationships with patients. These interactions made my job harder and directly influenced patient care. I always found it distasteful to hear, “Dr. X treats people very poorly, but he or she is such a great doctor.” Should not doctors be both excellent at their work and excel at the human relationship side of the business? Maybe we did need to work on certain things.
An early Cleveland Clinic initiative was to immerse every employee, including physicians, in a half-day appreciative-inquiry exercise. This entailed sitting around a table with other randomly selected caregivers—a nurse, valet, environmental service worker, administrator—and discussing various topics, such as our role in the organization, teamwork, and the servant-leader philosophy. Going into this exercise, I was skeptical. But going through it fostered a deeper understanding of how we all need to work better together to drive safe, high-quality patient care. It made me reflect on what patients go through every day and the critical contribution each team member makes. The program made me think about what we do and created greater appreciation and mindfulness of our work.
Think empathy
One of the most impactful efforts was getting people to understand and appreciate being on the other side of health care. The patient experience team crafted an empathy video that showcased people—patients, families, caregivers, physicians—and their thoughts as they experienced the other side of health care. The video frames what they are thinking about in the moment and is a powerful reminder that each person has something happening in their life that affects their daily experiences. The empathy video has been viewed by millions around the world. (See “Empathy: The human connection to patient care,” at https://www.youtube.com/watch?v=cDDWvj_q-o8.)
Together we embraced the work
Amy and I shared a unique perspective on this work as the leader of the experience improvement initiative, married to a person experiencing it. We both came to realize that we did not know all there is to know about how to deliver high-quality patient care. Improving experience is both complex and highly nuanced, and it is a vital component of what we do as physicians. The Clinic’s efforts moved the organization to high performance, and everyone played a role. However, we would not have succeeded without the engagement of physician leaders.
Making patients and families happy was never part of the equation. It is about reducing patient suffering and delivering safe, high-quality care in an environment where people feel cared for. That is what the people we serve desire, and it is what we want for ourselves. Although there will always be doubters, especially among physicians, of the importance of patient experience, we must never lose sight that this is the right thing to do for our patients, our families, and ourselves.
Share your thoughts! Send your Letter to the Editor to rbarbieri@mdedge.com. Please include your name and the city and state in which you practice.