Cleveland Clinic’s Approach to Patient Experience

Hospitals are in the business of making patients well, but there are times when patients feel overlooked—for example, when complaints about inedible food go unheard or interactions occur with brusque doctors and nurses. This is a dichotomy that James Merlino, M.D., addresses in his book Service Fanatics: How to Build the Superior Patient Experience (McGraw-Hill Education, 2014). Dr. Merlino, now president and chief medical officer of Press Ganey Associates’ strategic consulting division, is the former chief experience officer of Cleveland Clinic Health System who helped implement the hospital’s “Patients First” philosophy in an effort to improve patient satisfaction.

“No one really believed that one simple motto, Patients First, would transform Cleveland Clinic,” he says. “But that motto did something I’m not sure anyone recognized at the time: it started a cultural alignment of the workforce around the patient and began to define the organization’s purpose.” This revolution paid off: the hospital’s overall ranking in the Centers for Medicare & Medicaid Services (CMS) survey of approximately 4,600 hospitals on patient satisfaction jumped from about average to among the top 8%.

Patients First

The Cleveland Clinic looked at patient satisfaction surveys and complaints to decipher what matters most to patients. One of the first things they addressed was timeliness. When patients realize they need to see a doctor, they expect immediate care. The Cleveland Clinic reorganized itself to make sure any patient calling before 4 pm was able to see a doctor the same day. This is a radical change for healthcare since it requires a sophisticated triage process to make sure they have the capacity to handle these requests. Yet focusing on this one patient need took patient satisfaction to a whole new level.

Patients also expect to communicate with doctors in the same ways they communicate with everyone else: mobile, chat, and email. Accommodating this kind of request was tricky with HIPAA, but with waivers the Cleveland Clinic now accommodates patients who wish to make appointments and receive information on their mobile devices, chat with doctors online, and send and receive email communications with clinicians.

Another breakthrough was to consider patient concerns as important as clinical outcomes. The patient’s response to care, while often emotional, has bearing on how well the patient will recover, and getting patient buy-in improves the compliance with treatment. The Cleveland Clinic determined that addressing patient fears and concerns during doctor visits and hospital stays is just as important as focusing on the complaint and clinical issue.

Patients expect to leave hospitals in a better condition than when they arrived. They need to feel confident they will able to care for themselves and no longer need the hospital’s intervention. Providing clear discharge instructions that allay any remaining concerns is therefore also crucial.

Patient Experience Is More Than a Motto

Despite all the talk about putting patients first, there is no evidence of that philosophy being put into place at many hospitals. As Dr. Merlino puts it, “[T]here is no accountability or management, and if you evaluate these hospitals’ operations, there is no evidence of alignment around the patient.” In true job engagement, Dr. Merlino says, “All employees would go out of their way to think one step beyond what they do to what is important to the customer.”

For hospitals, producing a better patient experience has to go beyond the focus on making them well. Ultimately, if Dr. Merlino’s advice is taken, hospitals can offer a true “hospitality” experience. Learn more about how to put your patients first with our white paper Patients First: Superior Patient Experience the Cleveland Clinic Way.

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