Scott MacStravic, Ph.D.
I first became involved with health care marketing in the 1970s, consulting, writing and speaking about it back then, since my first job involving its use didn’t come until 1981. Back then, my emphasis was on gauging and improving patient satisfaction. It was a relatively simple matter twenty-five years ago, since most health care organizations knew and did little or nothing about “customer” satisfaction, though devoted a lot of attention to keeping physicians happy.
Things have come a long way since then. Almost all hospitals now routinely measure patient satisfaction, along with physician and employee attitudes. Most have adopted “patient-centric” approaches of various kinds, and “patient experience management” is a major focus in hospital capital investments, operational efforts, and balanced scorecard performance evaluation. But sometimes it is far too myopic.
In a recent article, Fred Lee, author of If Disney Ran Your Hospital: 9½ Things You Would Do Differently, noted that patient experience management is much like theater, where “all the world’s a stage”, and staff in hospitals and other HCOs are like characters in a play, acting out and feeling emotions that engage their entire attention and effort, while enabling patient satisfaction to reach new heights. [F. Lee “All the World’s a Stage – Especially in the Hospital” Recruitment and Retention Monthly April 2006 (www.hcpro.com)]
I vividly recall a visit I made to the Celebration Health hospital in Celebration Florida, where this philosophy had been demonstrated. Its diagnostic imaging center included an MRI that had been “disguised” as a sand castle, with patient changing rooms that looked like cabanas in a facility decorated to look like a beach scene, complete with the fragrance of suntan lotion as well as music piped in. Patient satisfaction in that hospital is notoriously high.
But hospitals are more than “stages”, of course, and there is more than patient satisfaction by which to measure the impact that they have. By the same token, hospitals are more than “places” where people are forced to come in order to have “experiences”. They are also “things” that affect the health and lives of patients and consumers in general, often dramatically, and along a wide range of dimensions.
Hospitals may focus on patient experiences, but patients are also influenced in their attitudes and behaviors toward them by the differences hospitals and experiences make in their lives. Focusing on patient satisfaction with their brief encounters, on just what happened in the facility between admission and discharge is a necessary but wholly incomplete and insufficient basis for achieving the kinds of lasting patient loyalty and support most hospitals aspire to.
Already the focus of hospital quality improvement efforts, the clinical side of “experience management”, is extending in two directions beyond the admission-to-discharge period. Patient preparation for admission, including managing their expectations, is a key element in service, along with clinical quality. And the discharge experience is mainly aimed at preparing patients for what will happen after they leave, with follow-up care and monitoring increasingly an element that extends the experience.
But the biggest add-on is the focus on what happens to patients after and as a result of their brief encounter, whether inpatient or outpatient. Hospitals are confronting the same reality that was shown to apply to physicians, when it was learned that providers’ notions of what successful outcomes are do not correspond particularly well to what patients expect and achieve. [“Patients and Doctors Often Differ on What Constitutes Successful Surgery” Strategic Health Care Marketing 20:3 March 2003 p.12]
The more hospitals focus on the “intra-mural” patient experience, by concentrating their satisfaction efforts and measurement on just what happens between admission and discharge, the more they will miss opportunities to learn about and improve patients’ long-term assessment of their total experience and the impact made on their lives. Only by asking about and including such impact in their quality evaluation and improvement efforts can hospitals fully understand and optimize the complete patient experience.
Hospitals and their employees can gain a lot by thinking of themselves as “stages” and “role players”. I have used the “cognitive script” model, including dimensions of “costumes, scenery, props, action and lines” as a foundation for improving the patient experience. But health care involves experiences and effects that go well beyond what happens in the “theater”. Only by evaluating and managing elements of what happens before and after the “play” can hospitals really achieve the patient satisfaction, loyalty, retention, revenue and margin results they desire – only by focusing on patients’ results can they make the most of what they mean to their customers.
