Healthcare Experience Blog

Hindsight is 20/20: What CXOs wish they had known

In a recent white paper that I co-authored with Jason Wolf, president of The Beryl Institute, we asked patient experience leaders to reflect on what they wish they had known before assuming their current positions.  We thought it might prove valuable to those who may be hiring a Chief Experience Office (or equivalent) and to those who may be considering accepting such a position.

Several patient experience leaders told us that it’s critically important that a new CXO determine to what extent a “culture of experience does or does not exist” in the organization. It’s easy to give lip service to “putting patients first,” but not so easy to actually do so, day in and day out, throughout an organization.  Take some time to talk casually with a cross-section of people who hold a variety of jobs.  Ask them cultural questions like “what’s it like to work in this place?” or “how often do the nurses complain about the doctors?” or “whose responsibility is it to guide visitors?” The answers will provide clues as to the real operating culture of the place, not just what the mission statement says.  Also interviewing various department and functional heads, such as the person handling clinical quality, the person responsible for HR, etc. will provide an early indication of the likely degree of collaboration that may exist to advance the PX improvement agenda.  Going beyond a formal interview with the CEO or COO allows the newly-appointed CXO to more accurately determine how far the organization has yet to travel to foster a patient-centric culture.

Another theme that emerged was patience. Patience is a virtue, and the CXO role requires a lot of it, we were told. Several of the interviewees spoke to the fact that they wish they had changed their mindset before going into their current job.  They came from environments where there were short-term goals, actions, and results.  Now they must mentally prepare themselves for longer-term, more subtle changes, and the results may not be evident for months or even years. Patient experience improvement isn’t so much a single goal as it is “an improvement journey” with performance indicators, like HCAHPS and employee engagement scores.  The CXOs reinforced the idea that it takes not only a herculean amount of effort, but gobs of time to create meaningful change, especially behavioral change, throughout a hospital or an entire health system.  Patience is a neccessity.

By people’s comments, it is also clear that there is a delicate balancing act between instituting certain core values and practices every day and every time versus allowing/encouraging flexibility in how key standards are implemented.  “One size fits all” as a dictum usually generates tremendous resistance.  Health systems are made up of many hospitals that are all different sizes, require different resources, and have their own specific needs. While tactics that work in one unit or one hospital may seem like the obvious choice for others, it’s often difficult to “impose” them from the top.  Involving staff through guided, interactive discussions of how patient experience is delivered today and how this can be improved, within the context of asking them to be mindful of what called them into healthcare in the first place, can create deeper, more meaningful cultural change.  People are then empowered and encouraged to act on the values of the organization, rather than merely repeat a required script.

While the “end game” is cultural change, the bigger picture is moving away from a strictly physician-focused or clinically-focused model to a truly patient/family-focused one.  As such, measurement along the journey is essential.  Several of the patient experience leaders told us that their previous background in using numbers and statistics was extremely helpful in their current jobs.  From the get-go, a new CXO should be prepared to understand, communicate, and utilize HCAHPS scores in their experience efforts. “Data” and “stats” along with “stories” and “quotes” are needed to positively influence the behavior of physicians, department heads, and all other staff. People want to know how they are performing, and how their performance stacks up, over time, and against benchmarks, including internal goals.  So the CXO must learn to use the numbers to his/her advantage.

To learn more about the emerging role of the CXO in healthcare and what our respondents had to say, click here to download this ground-breaking new white paper.  Be sure to enter code CXO_CATALYST at checkout to get this at no charge.

What do you have to be to become a CXO?

What kind of background “qualifies” you to become a Chief Experience Officer (CXO) in a hospital or other healthcare organization? Well, it turns out there is no single answer.

Worked in a non-profit? Worked for NASA? Been a nursing or marketing leader? Almost any background can provide the grounding and dare I say “wisdom” to ascend to a senior leadership role around patient experience.

That’s what we found when Jason Wolf (president of The Beryl Institute) and I interviewed 15 different CXOs or equivalents, some working for a single hospital, others working in a large system.

Jeanette Hodge, Executive Director of Patient Experience at Yale-New Haven Hospital, said that her professional life has been “grounded in relationship building.” Her background includes work as a Patient Advocate and she holds a volunteer administration certification.

Chris Holt feels that her background in marketing and branding is a key asset. She holds a dual role at Mercy Hospital in Meadowbrook, Pennsylvania as the Vice President of Marketing and Chief Experience Officer. She believes and views “patient experience” as a natural extension of the brand.

Even NASA can prepare someone for a patient experience job! Devin Carty (CXO with Cancer Treatment Centers of America) told us that his time at NASA exposed him to rational decision making, while working for Gallup revealed how emotions often govern our decisions and memories. He understands that both are important elements in shaping impressions around one of the most emotional times in a person’s life (when they’re sick or hurt or  receiving care).

If our interviewees had one characteristic in common, it was the idea that in previous positions they have been connected , in some way, with consumers. They have the ability to see and sense the world through a consumer’s eyes. In one case, it wasn’t the professional background but the profound personal experience of being a patient that he credits with his ability to to do his job now. Today, he’s the Vice President of Hospitality & Service Culture with Henry Ford Health System.

Some of the CXOs were recruited from within the organization, but just as often they were brought in from elsewhere, including other industries such as hospitality. Paul Westbrook at Inova Health System represents such a case; he spent many years as an executive with Ritz Carlton. It seems that there is no single path to becoming a CXO; the door is open for those with the passion, sensitivity, and proven leadership skills.

To download our newest white paper , “The Chief Experience Officer: An Emerging & Critical Role,” click here and enter code CXO_CATALYST at checkout.

What is the value in having a CXO?

Recently I assisted Jason Wolf, President of The Beryl Institute, in interviewing 14 patient experience leaders from across the country (plus one from across the pond!). We were interested in hearing about their journey in becoming a patient experience leader, their successes, and the struggles that they face in fulfilling their roles. From those interviews, we produced a new white paper entitled “The Chief Experience Officer—An Emerging and Critical Role.”

The most poignant question we asked was about the value of having a CXO in a hospital or other healthcare organization. Not surprisingly, virtually every person told us that having a dedicated role at the senior level reinforces the importance of providing a great patient experience.  If finances are important, then a CFO is important.  If human resources are important, a chief of human resources is needed.  Ergo, when it comes to patient experience.  If the organization says this is truly important (and strategic), shouldn’t there be a CXO (or equivalent)?

A CXO, working in concert with the CEO and other leaders, becomes the sparkplug in shifting the entire organization toward a “patient-centric culture.” As one of our respondents told us, “my job is to make others feel uncomfortable about how we’re doing things today.” A seat at the executive table allows the CXO to share in key resource and policy decisions, ensuring that the customer actually has a voice in such key deliberations. It’s also a way to coordinate and drive change across departments and functions, from parking to IT.

Having a CXO who helps move the organization away from a traditional “clinical” or “physician-centered” culture toward a “patient-centric culture” has another obvious value. Money. Hospitals stand to gain or lose significant CMS reimbursements based on what patients say about their inpatient experiences. In time, the government and potentially other payers will be tracking and reporting patient survey results that reflect the wider experience a patient has, across the continuum of care.

People are paying for more of their own healthcare expenses, while concurrently the federal government is pushing value-based payment and greater transparency.  With these trends, more and more patients will begin to expect an outstanding experience, and tolerance for things like noise at night, poor discharge instructions, and unwieldy business practices will be publicized and will become competitive disadvantages.

Designating (and resourcing) a Chief Experience Officer may be just what’s needed!

To download a free copy of “The Chief Experience Officer—An Emerging and Critical Role,” click here and enter code CXO_CATALYST at checkout.

What is your community doing to promote healthy living?

Tennessee isn’t alone in the battle with a poor health epidemic. Nationally, we fail at eating correctly and exercising the recommended amount. Any bit of tobacco usage is too much.

In Tennessee, we’re fortunate enough to have The Governor’s Foundation for Health and Wellness (Healthier Tennessee) to lead citizens through the process of improving their lifestyles. In the 2013 Awareness and Engagement Study Among Tennesseans that we conducted for Healthier Tennessee, we found out that only 3% of residents are engaging in behaviors that are considered healthy. This means that only 3% of Tennesseans are eating five or more servings of fruits and vegetables per day, exercising five times a week for at least 30 minutes at a time, and refraining from tobacco usage.

To combat residents’ unhealthy lifestyles, Healthier Tennessee launched a campaign that integrates multiple strategies to try and encourage Tennesseans to eat better, start exercising, and quit using tobacco.

“Drastic changes in diet and physical activity are usually overwhelming and hard for people to maintain,” Governor’s Foundation for Health and Wellness CEO Rick Johnson told me. “But making small, simple changes in your daily routine can, over time, add up to a big health difference. Changing your day a little can eventually change your life a lot.”

One initiative that Healthier Tennessee is using is called “Small Starts.” Their website lists more than 50 small things people can do daily, or weekly, to get into healthier habits. Things like walking around while talking on the phone, swapping out one sugary drink a day for a glass of water, or making a list of things you can do to distract yourself when you get a craving for tobacco are all little steps that will hopefully lead to bigger changes. In addition to Small Starts, Healthier Tennessee produced a television commercial

that has run statewide to promote the idea of starting now—not waiting!

The initiative is reaching out to Tennesseans in places where they live, work, worship, and learn – the places where effective tools and support can lead to positive behavior change. Strategies and tools that can be owned and implemented by individuals, workplaces, faith-based organizations and schools are being made available at no charge through the healthierTN.com website.

I encourage you to visit the Healthier Tennessee website to learn more about the cause and how all of us can take discrete steps to lead healthier lives. To download the white paper detailing more results of the study, click here.

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