Seeking the “Perfect Patient Experience”

I hear lots of negativity in my discussions with friends, relatives, and clients regarding their respective healthcare experiences. That’s understandable; our healthcare system can be complicated and overwhelming. But it makes me sad, because I know that the individuals who work in healthcare do so in order to help others.

Fortunately, many individuals and organizations are working diligently to make positive changes. For example, last week, I attended an event about “Lean Thinking Principles.” It reminded me of a recent “perfect patient experience” of one my clients — an experience that was the result of a particular hospital’s commitment to this type of improvement process.

Lean Thinking Principles

Lean Thinking Principles encourage the practice of continuous improvement and are based on the fundamental idea of respect for people. 

That’s the opposite of disrespect for people — allowing them to work in broken/dysfunctional processes time and again, yet still expecting outstanding results.

The five principles of Lean Thinking include:

  1. Defining value from the standpoint of the end customer
  2. Mapping the “value stream”
  3. Creating flow that removes barriers from delivering value
  4. Using a “pull system” to remove barriers that get in the way of helping the next customer
  5. Pursuing perfection

The first four steps are focused on removing waste from the system and are all important. But to me, it’s the fifth step — pursuing perfection — that is most vital. This is about imbedding the practice of ongoing improvement into the organization’s culture in a way that is felt by consumers, regardless of who they encounter within the organization.

Continuous Improvement in Practice

Six years ago, I wrote about my dad’s perfect patient experience when he had knee replacement surgery at a local hospital. Recently, I guided a patient through a total hip replacement at the same location. Once again, we could not have been more pleased. 

The fact that there were six years between encounters with this organization and that the second experience was as positive as the first, reinforced the notion that this organization’s culture is one of continuous improvement. Here are just a few things I observed:

Fabulous pre-surgery communication. Where to go, how to prepare, what to expect on the days of surgery and discharge, how to be prepared when back home. (As an aside, the surgeon mentioned that despite multiple other job offers, he chose to work in this setting specifically because of the culture and commitment to improvement.)

Pleasant and informed staff. Every person we encountered, from the pre-op experience through discharge, was agreeable and helpful. For example, as I was leaving the hospital unit late the night of surgery, I must have looked a bit lost. An employee asked if I needed help and, instead of just directing me, escorted me to the exit. He said, “we always help visitors this way.”

Proactive, real-time communication. There was an electronic communication board in the waiting room that allowed me to “follow” where my client was. Additionally, the woman overseeing the waiting room frequently checked in verbally — just to be sure I didn’t need anything.

In-person and private communication with the surgeon to review status. This happened consistently with every waiting family member.

Well-coordinated teamwork. The patient unit team consisted of nurses, aides, physical therapists, dietary personnel, and housekeepers, all of whom were competent and fully engaged. They seemed to really enjoy interacting with us!

Short wait times. We waited just three minutes for the wheelchair transporter to take us downstairs and help us into the car. Such short waits are not the norm! This reflects the quality of the hospital’s internal processes and its respect for patients.

What You Can Do

Of course, not every healthcare institution is as well run as the one described above. And so while I counsel clients to start each healthcare encounter expecting the perfect patient experience, if things do not go as expected, we must participate in the process to improve it.

Some suggestions…

Research

Visit your physician or healthcare setting’s web sites and look for information regarding process improvement efforts. As you prepare your agenda for physician appointments, place this topic on the agenda so you can discuss how quality is measured and improved. Clinical protocols are derived from data, so ask about how that data led to protocol development and how it continues to be measured.

Feedback

Participate in surveys and offer specific comments and examples. Ask for a phone call if something did not go well. I always start by thanking them for soliciting feedback and may respond like this: “I felt _________ encounter could have gone better. Please help me understand what factors may have contributed to a non-perfect experience.” This helps to create a dialogue and facilitates being heard. Be prepared with specific suggestions about how the experience would have had greater value for you.

Participate

If you have the time and inclination, join a Patient Family Advisory Council (PFAC) and participate in formal process improvement events. When I was a member of a Patient Advisory Council for a large physician practice, I represented the patient’s voice by participating in a full-day Kaizen Event that entails assembling a cross-functional team to address specific problems in a short period of time.

Summary

In life, we are often faced with the choice of looking at challenging systems, like the delivery of healthcare, from an optimistic or a pessimistic perspective. I choose the glass-half-full approach and try, however I can, to become part of a culture of improvement rather than one of negativity. 

It is my hope you will join me in this pursuit, so that we may all enjoy more perfect patient experiences!