Our personal brick walls

No doubt there are obstacles to eating well, exercising regularly and, for tobacco users, escaping its grip. As the 42^nd unhealthiest state in the nation, Tennesseans are clearly not immune to these obstacles.  In our newly-released 2013 Awareness & Engagement Study Among Tennesseans, we heard people give their reasons, in their own words. In essence, they cited their personal “brick walls.”

Time was the most widely cited obstacle for not exercising regularly or enough. Residents consider themselves too busy with work, children, school and/or extracurricular responsibilities to put in the recommended 30 minutes a day of vigorous physical activity, five days a week.

A surprising number of respondents, 12%, were brutally honest with us and said that they are “lazy” and lack the motivation to get active.  We heard other reasons, as well, including the cost/location of a gym and not wanting to exercise outdoors in weather that’s either too hot or too cold.

When we asked about the barriers to eating better, respondents reported that the cost of a healthy diet was just too high. Fresh fruits, vegetables, and meats, particularly organic ones, are more expensive than canned or frozen options. They also can take more time to prepare.  As we all recognize, more time and effort is required to go to the grocery, buy healthy food and then cook it than it is to just cruise through a drive-thru. Other citizens simply said that they don’t have the motivation or desire to eat better.

Whether people’s individual brick walls are time, motivation, or cost, they inhibit the chances of living a healthier and often longer life.  One where the chances of getting heart disease, diabetes, and depression are reduced, according to sources I read.

What do you think? Is improving your overall well-being worth getting off the couch and going for a 30-minute walk? Is it worth spending a couple extra dollars on fresh salad ingredients, and putting the cookies back on the shelf? Is it worth staying up 10 minutes later at night to make your lunch for the next day so you don’t end up eating a fast food lunch?

Obstacles are what we’re up against.  We all have them. As the recent group of Olympians showed us over and over, obstacles can be overcome.  Let’s take a cue from them. Start small, stay consistently focused, and overcome the obstacles that hold us back.

To download a free copy of the 2013 Awareness and Engagement Study among Tennesseans, click here.

Do people know what to do to stay healthy?

Yes.

Recent statewide research we conducted for The Governor’s Foundation for Health and Wellness showed us that Tennessee residents do, for the most part, understand and recognize healthy habits.

Of the 1,200 people that we surveyed, 93% knew that exercising regularly is important for health, and 92% agreed that the kinds and quantities of foods you eat affects health. Overall, 77% of citizens know that they should be getting five servings of fruits and vegetables daily, exercising regularly and staying away from tobacco. The results made it apparent that education about the right things to do is not a big issue.

But while Tennesseans may know what to do to stay healthy, a staggering percentage are not taking the steps necessary to lead a balanced life. 43% of Tennesseans are exercising two days a week or less, and more than half (62%) are eating two or fewer servings of fruits and vegetables daily. Almost 20% are using tobacco, which is too high by any measure. What does all that add up to?

Only 3% of respondents are eating correctly, exercising and refraining from tobacco usage. The major disconnect is between knowing and doing. Just because someone knows the right things to do, doesn’t necessarily mean that they are doing them.

The results of the study revealed perhaps a more difficult challenge than education: motivation. Encouraging and inspiring residents to make healthier food choices, exercise, and quit using tobacco are now the obstacles that The Governor’s Foundation for Health and Wellness is addressing.

The results of the study don’t just apply to Tennessee. They don’t just apply to a particular region of the country. Nationally, we fail at eating correctly and exercising the recommended amount. To read our newest white paper about the 2013 Awareness and Engagement Study Among Tennesseans, and see how it could be applied in your state, click here to download.

Where do CXO’s come from?

What do you think of when you hear the word “hospitality”? A great hotel experience complete with decadent room service? Staying with friends for a weekend and seeing them fuss over making sure you have enough clean towels, sheets, and blankets?  Feeling good about the experience you just had in a hospital?

While today’s patient experience professionals come from a variety of backgrounds, it’s not surprising that some health systems are hiring experience leaders right out of the hospitality/hotel industry.*

Genevieve Conroy, Chief Marketing and Patient Experience Officer at Broward Health Medical Center in Fort Lauderdale, Florida is one such individual. Before joining Broward Health, Genevieve worked for The Ritz-Carlton for six years. Most recently, she served as their project director of service, marketing and sales, and one of her responsibilities was implementing programs to increase customer satisfaction.

Another important background is professional experience in quality, service, and performance improvement. Amy Lisenby, Patient Experience Officer at Baptist Health in Jacksonville, Florida, is familiar with all of these. Before becoming the Patient Experience Officer, she served as the Vice President of Quality and Safety for Baptist Health and as the Director of Operational Performance Improvement for Baptist Health Care in Pensacola.  Many quality/safety people are assuming the roles associated with a Chief Experience Office (CXO), even if they don’t take on that title.

The Chief Nursing Officer is another position with strong potential to become an effective Chief Experience Officer. A CNO has overall responsibility for patient care so they are a natural fit for a position that revolves around the experience of that care. In addition, they are already a member of the C-suite and presumably know how to think and execute at a strategic as well as a tactical level.  Rhonda Scott, CNO at Grady Health in Atlanta, exemplifies this pattern.

Our research so far suggests that few hospitals or health systems have moved physicians into the CXO role.  Yet an MD, if motivated and skilled, can make a great and extremely influential CXO.  Doctors are very aware of the challenges of delivering care, coordinating care, and communicating with patients and their loved ones. An MD as a CXO can be an effective advocate for change because doctors pay attention to other doctors.  Dr. James Merlino, Chief Experience Officer at The Cleveland Clinic, is one of the best-known examples of an MD turned CXO.  In his case, a background that included statistics was an added plus, particularly when it comes to measuring, interpreting, and sharing data such as patient survey and quality results.

Does a CXO need to have grey hair?  Many do come into this level of responsibility only after many years of professional experience, whatever their specific background and previous jobs.

However, it seems to me that a younger healthcare manager could make excellent CXO, assuming they have been immersed in and shaped by a hospital system with a true patient-centric culture.  A younger person who has grown up in the digital age and who understands the generational differences could make a great CXO.

This isn’t to say that a former CEO or COO wouldn’t also make an excellent Chief Experience Officer. In fact, the former CEO of Community Heart and Vascular Hospital, Tom Malasto, was just named the Chief Patient Experience Officer of Community Health Network.

Each of the backgrounds I’ve talked about here do bring certain very important elements to a CXO position, elements that can make or break the patient experience in a hospital.  But the real test is can the person “round out” their skill set in order to fulfill all the stated and unstated duties of a CXO? That usually depends on the person, their personality, flexibility, and passion.

Do you have a CXO? What is his or her background? Was measurement a part of their skill set coming into the job?

As measurement professionals who can offer customized programs and reporting, we offer an approach that saves hospitals money for measuring HCAHPS and CG-CAHPS.  Learn more with CAHPS PLUS.

*http://www.beckershospitalreview.com/hospital-management-administration/new-seat-in-the-hospital-c-suite-the-rise-of-the-chief-experience-officer.html

Who has a CXO?

The “Chief Experience Officer” title is still relatively new in healthcare. Our best current guess is that there may be less than 100 individuals with that specific title and level of authority in U.S. hospitals and systems. There are also others actually performing the functions of the CXO, without having that title.

Larger hospitals and many multi-unit systems seem to be embracing the concept, even if they don’t always use the words “CXO” to describe the function. It seems like every week I hear about a system that either has just hired a CXO, or is actively looking for one. For example, I was told that HCA, the nation’s largest for-profit health system, is currently seeking a professional to fill this role at the corporate level.

Our own database of hospitals and health systems in 11 Southeastern states includes a total of 29 that have a person with “patient experience” as part of their title. That’s 29 out of a total of 642 100+ bed hospitals and health systems operating in an 11-state region, or 5%.

It’s also hard to get a firm count on how many CXO equivalents there are in the U.S. This is because, while the person may have the “experience” function and responsibility, and sometimes the authority and accountability of being a C-level executive, their current title is something other than CXO.

An example is someone who is the “Vice President of Patient Experience.” Plus there are many service excellence, service quality, and quality improvement titles where the person holding that job is essentially the key leader responsible for patient experience in their organizations.

In addition, in my conversations with hospital leaders, it’s clear that some individuals carry the “CXO” responsibility, but do it under the banner of another C-level function. An example is Rhonda Scott, the Chief Nursing Officer at Grady Memorial Hospital in Atlanta.

Our own international study for The Beryl Institute found that the most frequent answer to the question of who in the organization has the prime responsibility and accountability for the Patient Experience was “a committee” or work group. So there are still plenty of health organizations that have not decided to make the investment in a senior-level position, leaving the task to several different departments or individuals.

Still, with reimbursements now at risk, I predict we’ll see a further increase in the use of the CXO title and its equivalents in this country.

For more information on the CXO and the role they play in the patient experience, click here to see the 2013 State of Patient Experience Study.