The woman in front of me at the checkout line in the grocery store had two full shopping carts filled to their rims with food.  She began placing her items on the belt, one item at a time, sorting them into neat categories; perishables, organic, canned goods.  I tried using my ventriloquism, repeating the phrase “get out of the line…get out of the line.”  I could see her looking around trying to place the voice, but she remained fixated on her sorting…place the frozen Salisbury steak next to the TV dinners.

A felt a bead of sweat start to trickle down between my shoulder blades and a slight shiver overtook me. I pictured her in front of me at a salad bar, inspecting individual chickpeas prior to placing them on her plate.  The only other thing that could have made the situation more untenable is if the grocer decided to play Celine Dion’s Christmas CD over the loud speakers.

After about twenty minutes the last of her items had been scanned, and the clerk announced the amount. The woman fumbled about in her purse, pulled out a large white envelope, and withdrew a fistful of coupons.  The voice in my head whispered to me “I thought we agreed there would be no killing this time.”  Ten more long minutes passed.

The store manager and I simultaneously saw her reach back into her purse.  Even before we saw it, we both knew she was reaching for her checkbook.  The manager knew he only had a couple of seconds to try to stop me from exploding.  He leapt the service counter, pushed aside the boy bagging the groceries and flung me to the floor.  A Good Samaritan in the next aisle straddled my legs while the manager hooked me up to an IV of Benadryl, and shielded my view from the woman as she was escorted from the store by security personnel.

That was my day.

If experience teaches us anything it teaches that if we represented the people who think they understand business strategy and planning on a Venn diagram, and also represented the people who actuallyunderstand business strategy and planning on the same diagram, the number of those who actually understand it would be like comparing the circumference of the donut hole to the circumference of the donut.

About one hospital in seven actually has a defined patient experience strategy, and of those that do almost all of those strategies focus exclusively on what occurs within the hospital, and almost all of them rely exclusively on improving HCAHP scores.

That said, we can make a few observations about why it is difficult for any hospital to make any significant improvements regarding patient experience:

• 85% of hospitals do not have a system-wide patient experience strategy even though ninety percent of hospital executives rank improving patient experience as their first or second priority over the next three to five years.
• Of the fifteen percent with a strategy the vast majority of those strategies are constrained by what occurs to the patient in the hospital.
• Most hospitals do not measure the experiences or levels of satisfaction of their outpatients or discharged patients.
• It is possible that no hospitals measure the experiences or levels of satisfaction of prospective patients.
• A strategy to improve HCAHP scores is not the same as an enterprise-wide strategy to improve access and patient experience

Where is the hospital’s definition of patient experience?  Where is the plan?  Where is the strategy? What is the retention goal?  The referral goal?  Everyone who tries to do business with your hospital by calling it or by going online to schedule an appointment or pay a bill has an experience. Having an experience is far different from having a remarkable experience.

While data and coaching may add a percent or two here and there, to patients and prospective patients the experience your hospital offers will appear the same a year from now as it does today.  Unless you reinvent patient access and experience, a you will never know how many people have decided to take their healthcare somewhere else.