Patient Experience: I may not be right, but I doubt it.

I just fell out of the stupid tree and hit every branch on the way down. But lest I get ahead of myself, let us begin at the beginning. It started with homework–not mine–theirs. Among the three children of which I had oversight my parenting responsibilities include coloring, spelling, reading, and exponents. How do parents without a math degree help their children with sixth-grade math?

“My mind is a raging torrent, flooded with rivulets of thought cascading into a waterfall of creative alternatives.” Hedley Lamar (Blazing Saddles). Unfortunately, mine, as I was soon to learn was merely flooded. Homework, answering the phone, running baths, drying hair, stories, prayers. The quality of my efforts seemed to be inversely proportional to the number of efforts undertaken. Eight-thirty—all three children tucked into bed.

Eight-thirty-one. The eleven-year-old enters the room complaining about his skinned knee. Without a moment’s hesitation, Super Dad springs into action, returning moments later with a band aid and a tube of salve. Thirty seconds later I was beaming–problem solved. At which point he asked me why I put Orajel on his cut. My wife gave me one of her patented “I told you so” smiles, and from the corner of my eye I happened to see my last viable neuron scamper across the floor.

One must tread carefully as one toys with the upper limits of the Peter Principle. There seems to be another postulate overlooked in the Principia Mathematica, which states that the number of spectators will grow exponentially as one approaches their limit of ineptitude.

Another frequently missed postulate is that committees are capable of accelerating the time required to reach their individual ineptitude limit. They circumvent the planning process to move quickly to the doing stage, forgetting to ask if what they are doing will work. They then compound the problem by ignoring questions of feasibility, questions for which the committee is even less interested in answering. If we were discussing particle theory we would be describing a cataclysmic chain reaction, the breakdown of all matter. Here we are merely describing the inability of most hospitals to connect with the experiences of their patients.

What is your point?  Fair question.  How do we get hospitals and patients to connect?  It appears patients have decided that the current approach (HCAHPS)—will not work.  Thanks for riding along with us, now return your seat back and tray table to their upright and most uncomfortable position.

Putting all of your chips on HCAHPS is a failed plan.  It can’t be tweaked.  We can’t simply add a few more questions to the survey.  We have reached the do-over moment for improving patient experience, or at least the moment when we must acknowledge that while HCAHPS may pass the test of being necessary, HCAHPS are from passing the test of being both necessary and sufficient.  Having reached that moment, let us agree to do something. 

Today’s patient experience efforts rely on an amalgamation of patient experience data.  We have no data about a single patient. We don’t even have data about how a single patient compares to the amalgam. We also have firms that will charge you a lot of money, based on the blended results of your hypothetical patient, to help make the experience of the non-existent patient better.

Need proof? Take blueberries, a mango, two kiwis, and your favorite cheese, pop them into the blender, and hit puree.  Hand the mixture to someone and ask them to describe how a single blueberry relates to the blended drink.  The blueberry and its attributes no longer exists.

Patients, people, and customers want you to know about and improve their individual experience. One way to do this is to ask them, and then to actually design the experience. Design it beginning with the experiences they have before they enter the hospital and include the experiences they have after they leave the hospital. Design it for outpatients, discharged patients, former patients and prospective patients.

By the way, don’t put the cheese in the blender. It will ruin the drink.

I may not be right, but I doubt it.

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