People, client-people, expect that if you are going to question their best efforts about something of theirs that you exercise a bit of decorum.  I am that way around the house.  I often tell my family you can tell me what to do, or you can tell me how to do it but you cannot do both.

Take dusting as an example in principle.  I was asked to do the dusting.  The person asking me to dust is five feet one-and-a-quarter inches tall.  I asked myself do I need to dust any furniture whose height exceeds that of the person who will be inspecting my work.  I concluded that no furniture higher than five feet tall needed to be dusted.

Later in the day my wife asked my son what he was doing.  He replied that he was writing his name in the film of dust on the top of her dresser.  Apparently there are times when I need to be told what to do and how to do it.  Apparently it is not sufficient only to do the portion of the task that is being inspected by others.

The current approach to the task of improving patient experience is not unlike the approach I took to dusting.  CMS only measures hospitals against a five-foot tall ruler.  HCAHPs.  Hospitals focus their patient experience improvement efforts on those patient touchpoints that are being measured.  That is how the game is played, for the way CMS defined the rules of the game hospitals will be penalized for failure and will not be rewarded for doing anything more.

What many hospitals have failed to discover is that by doing only what is asked of them they are only hurting themselves.

How are hospitals hurting themselves?  Let me illustrate it with a single business process—Access. 

1. Hospitals are not measuring and addressing the experiences of people who Access the hospital on the web and on the phone.
2. Hospitals do not assess the Access experiences of prospective patients, outpatients, or inpatients.
3. One hundred percent of the people accessing the hospital online and by phone are prospective patients.
4. Patients Access the hospital before they are admitted and after they are discharged, sometimes for months and years after they are discharged.

It is worth imagining how much better everyone’s experiences would be if they could Access the hospital at a time and on a device of their choosing.  A remarkable experience for every person every time on every device.

The story about me and the dusting is fictional, although the idea did cross my mind.