So I’m making dinner the other night and I’m reminded of a story I heard a while back on NPR. The narrator and his wife were talking about their 50 year marriage, some of the funny memories they shared which helped keep them together. One of the stories the husband related was about his wife’s meatloaf. Their recipe for meatloaf was one they had learned from his wife’s mother. Over the years they had been served meatloaf at the home of his in-laws on several occasions, and on most of those occasions his wife would help her mom prepare the meatloaf.

She’d mix the ingredients in a large wooden bowl; one pound each of ground beef and ground pork, breadcrumbs, two eggs, some milk, salt, pepper, oregano, and a small can of tomato paste. She’d knead the mixture together, shape into loaves, and place the loaves into the one-and-a-half pound pan, discarding the leftover mixture. She would then pour a mixture of tomato paste and water, along with diced carrots and onions on top of the two loaf, and then garnish it with strips of bacon.

He went on to say that meatloaf night at home was one of his favorite dinners. His wife always prepared the dish exactly as her mother. One day he asked her why she threw away the extra meatloaf instead of cooking it all. She replied that she was simply following her mother’s recipe.  The husband said, “The reason your mom throws away part of the meatloaf is because she doesn’t own a two-pound baking pan. We have a two pound pan. You’ve been throwing it away all of these years and I’ve never known why until now.”

Therein lays the dilemma. We get so used to doing things one way that we forget to question whether there may a better way to do the same thing. Several of you have inquired as to how to incorporate some of the patient experience strategy ideas in your organization, how to get out of the trap of continuing to do something the same way it’s been done, simply because that’s the way things are done. It’s difficult to be the iconoclast, someone who attacks the cherished beliefs of the organization. It is especially difficult without a methodology and an approach. Without a decent methodology, and some experience to shake things up, we’re no better off than a kitchen table amateur (KTA). A KTA, no matter how well-intentioned, won’t be able to affect change. Without them the end results would be no more effective than sacrificing three goats and a chicken.

So, here we discuss how to disrupt patient experience, how to find a champion, and how to put together a plan to enable you to move the focus to developing a proper strategy, one that will be flexible enough to adapt to the changing requirements. But keep the goats and the chicken handy just in case this doesn’t work.

I’m sure you have seen the dance when someone in your organization expresses an idea about how to change something that most people do not think needs changing. It looks a lot like two dogs sniffing around each other to see whose top dog.  People like being on the solid ground that comes with maintaining the status quo, afraid that if they step off they will be on a greased slope, or even worse that they will be sent to the penalty box to listen to old ABBA songs.

A gentleman in my meeting was pointing at something in my presentation with all of the trepidation of a new geography teacher trying to locate Burma on an outdated map. I knew how he felt. Sometimes l like to leave a trail of breadcrumbs for my audience to follow as I try to make my point. 

But we have all had times where we would have been served better had we left a trail of croutons instead of breadcrumbs. (Croutons are larger, making it easier for people to follow them.) Those are the times when you feel it would be easier to slip a hippo through a clarinet than to slide a fresh idea between two synapses, like trying to explain cholesterol to a Big Mac.

So there I was in the meeting laying out my vision for the hospital of the future, one in which patients would carry their hospital around on their iPad the way people carry around Amazon today. One member of the audience asked me if I had ever seen such a hospital. I replied that I had never seen such a thing, but then again I had never seen my pancreas, yet I knew I had one.

There is no technical reason why someone cannot interact with their hospital online to accomplish all of their business needs. There is no technical reason why someone cannot register, schedule, admit, manage their discharge, educate themselves, monitor their health, set up a payment plan, refill a script, or file a claim.

The only thing preventing this is that nobody has stood up and said “Let’s do it.”