# Patient Experience: Why not turn it upside down?

I was about halfway through my run and had just strained my hamstring running up a long hill so I began walking. A few minutes later I was greeted with a perky “Good morning!”

I turned my head just in time to see a buoyant, twenty-something running and pushing a double pram up the hill. “That’s not fair,” I replied, and she laughed.

I wanted to tell her that when I was her age I held a world-record for a twenty-four hour run. I wanted to do a lot of things, but the only noise coming from my lips was a death-rattle. I considered my options and the only one that had any chance of restoring my dignity was to take her out, and to take her out hard. After applying the foot brake to the stroller—I had nothing against her children, I hip-checked her into the culvert. I hip-checked her so hard that I almost swallowed my dentures, knocked out my hearing aid, and dislocated my artificial hip.

“Good morning,” I told her as I began to limp away.

Segue.

Sometimes you need to take the initiative, and sometimes you need to look at a problem from a different perspective.  Take a look at the following problem.

XI + I = X

The numbers are written in Roman numerals using match sticks or toothpicks.  The problem is for you to determine the least number of toothpicks you can move to make the equation true.

Most people will probably think that the correct solution is to remove one toothpick from the plus sign which yields the following equation:

XI – I = X

Most people would be wrong.  The correct answer is that the least number of toothpicks that can be moved to make the equation correct is none.  The only thing you need to do to arrive at this answer is to change your perspective. Place your left hand on the left side of your screen, and your right hand on the right side, and turn your screen upside down. Now the equation reads:

X = I + IX

What if every business problem was that easy to solve?  Some of them are.  I think improving patient access and patient experience is one of those problems. Five thousand hospitals are trying to improve patient experience, and all five thousand of them are approaching the problem in more or less the same way.  That approach only focuses on the experiences of a percentage of inpatients, experience that they encounter inside the hospital and that are related to HCAHPS.

That approach requires people to believe that either nobody has any experiences outside of the hospital, or that those experiences do not matter.  That approach requires people to believe that either outpatients, discharged patients, or prospective patients do not have any experiences outside of the hospital, or that those experiences do not matter.

That approach is wrong.  That approach ignores the experiences of most of a hospital’s stakeholders.  That approach ignores where the majority of people have experiences with the hospital—on the phone and on the web.

If most people experience the hospital every day on the phone and on the web, shouldn’t hospitals make a very deliberate effort to design those experiences?  If the number of outpatients and discharged patients and prospective patients greatly exceeds the number of surveyed inpatients, shouldn’t hospitals make a very deliberate effort to design those experiences?