Focusing on Hospitality in Hospitals
A BHR Interview with Greg F. Burke, MD, FACP,
Chief Patient Experience Officer, Geisinger Health System
What is the role of Chief Patient Experience Officer all about?
The role of Chief Patient Experience Officer operates on two critical levels. First is working with clinicians, frontline staff, and all our new hires and educating them on our mission and purpose. We closely monitor our adherence to and compliance with standards of hospitality. This is reflected in everything we do from our messaging to curricula to our ever-evolving culture. We are continually looking for any pain points throughout our health system so we can fix them and make for the best patient (and employee) experience.
The second level is the real human part. It’s directly engaging with any patient or family who has had an experience that is below our own standards and expectations. Forms of resolution may include sincere apologies, finding process changes based on what we’ve learned, and managing service recovery.
At both levels, it’s about uniting people around a common purpose. Authenticity is essential. And doing the right thing is essential.
Part of my role as a clinician is to reawaken the aspirations of medicine and how deep medicine’s relationship with patients and families can be. We also must remember the word hospital is in the word hospitality. We need to get back to our roots. Healthcare is all about relationships, compassion, and care. Functionally, hospitality becomes a series of actions, habits, and expectations. But it’s all part of caring for your patients and doing the right thing.
From a healthcare practitioner perspective, how do you define hospitality?
To me, hospitality extends beyond service-mindedness. Hospitality is about building relationships and communicating in a way that is supportive and caring. In the hospital setting, hospitality is about making sure patients and families feel recognized, and that their dignity is appreciated. They need to be made to feel special and not just another case in room 302.
I believe, like so many hierarchical systems, healthcare has experienced a diminishment of trust. Part of my goal is to restore trust and reestablish confidence. To me, practicing medicine with hospitality is paramount to achieving that objective. We need to appreciate everyone’s humanity in all we do. We work to reposition our health system so patients and families know we are dedicated to reducing their pain and suffering, on a medical level and on an emotional level too. Our responsibility is to demonstrate that we genuinely care.
It’s important to note in healthcare, the stakes could not be higher. When it’s your health on the line, when there’s a life-or-death situation, when a loved one is ill, I believe the level of hospitality that’s required must meet the moment. It may sound radical, but I feel hospitals should be more hospitable than a Ritz-Carlton. If we really believe in our goal, hospitals should be reducing suffering and making people feel loved. That’s true hospitality. It’s a higher calling because the stakes are so high.
Given the healthcare system is under significant financial pressure, how does patient-centricity make sound economic sense?
It starts by understanding today, more than ever before, the healthcare marketplace is highly competitive. No longer are patients limited to seeking medical care in their immediate community. With access to travel, telehealth, urgent care centers and so much more, patients have choices and that means if we are going to succeed as a health system financially, we need to earn loyalty. We need to treat them in a manner that, in addition to the medical care they are provided, they feel cared for, and their humanity has been recognized. Those repetitive experiences of being satisfied, or even better, having expectations exceeded help build trust. The greater the amount of earned trust and loyalty based on positive experiences, the greater the amount of forgiveness if something ever does disappoint.
At Geisinger, we understand a negative patient experience diminishes trust. We feel this is such a crucial factor, we pioneered a patient refund promise. If patients feel disappointed with us, we take a hard look at that. Did they feel disrespected? Did they not feel genuinely cared for? Were they experiencing repetitive scheduling cancellations? If they did, they do not incur related costs. This is separate from healthcare decisions, diagnosis, and treatment, but focused instead on the basics of how we treat people – our hospitality. Fundamentally, it shows we have some skin in the game. No one ever thought a health system would accept financial risk based on patient experience. Ultimately, we implemented this policy for one reason. It is the right thing to do.
There’s almost an anthropomorphic component to our health system. If it lets you down in some way, it’s almost like you were let down by a person. If that relationship fails the patient, the hurt, anger, and loss of trust can be intense. This is what we strive to avoid by being patient-centric and fully committed to the promises we make.
How do you define a positive patient experience?
To me, a positive patient experience is rooted in emotional connection. It comes down to how well did we make you feel?
There are two things patients are most afraid of. The first is that their human dignity is not going to be recognized, and they will be made to feel like a number or characterized as a medical condition. The second is they are going to be embarrassed or humiliated in some way by their interaction with us. So, if we work to deliberately avoid those issues, the gestalt they’ll have is a good experience and, if someone asks them, they would recommend us.
How do you cultivate hospitality and positive patient experiences?
Fostering positive experiences starts from within. Everyone on our team must understand our purpose and the commitment we are making to patients and families. They must understand that regardless of their specific contribution, they play an essential role. We take a two-pronged approach to making sure this happens. We inspire our team members, and we hold them accountable. We recognize and reward positive performance (from big ideas to the smallest of meaningful gestures). And we are unafraid to address team members who need improvement – by providing coaching and supportive resources. Ultimately, if performance doesn’t get better, we may part ways.
Healthcare professionals are making critical decisions, frequently working long hours, and bombarded with emotionally charged people and issues. How is it realistic to expect them to practice hospitality?
The reality is that there are times you might have to emotionally detach to survive. William Osler, who founded internal medicine over one hundred years ago said that sometimes you just have to put your emotions on ice. Sometimes you must distract yourself. I’ll share with residents that even if they don’t feel emotion at the time, they have developed the habit of compassion and still do the right thing even if emotion is not at the forefront. And that’s perfectly okay. It’s important to know there may be times they have to emotionally detach to survive the onslaught of sad stories and stress. But they must always act with compassion and hospitality. The compassion and hospitality are 100% authentic. The care is authentic, and the effect on the patient cannot be underestimated – even if practitioners are purposefully dulling their personal, emotional response.
How do you incorporate the concept of experience innovation in the healthcare setting?
One of the most fundamental starting points is asking our patients what they think. What’s working and what’s not? What would they think of this change or that. We need to avoid assumptions about their experience and simply ask. If we are going to innovate positive experiences, it needs to be done with patient input and guidance. In fact, assumption can be a foil to meaningful innovation. And innovation is not always technology-dependent. Listening and learning are key. Clear and reliable communication is key.
One of the innovative things we did at Geisinger was senior leadership rounding. We told leaders who were not clinically oriented they also had to engage with patients and families. They needed to talk with them and learn from them. Among others, this included people from finance, environmental services, and food services. We had our CEO, Chief Legal Officer, and Chief Medical Officer, all walking the halls in different shifts. And we’re not a 9-5 organization so that meant some people were doing this at 4:00 am.
We asked them to visit families in the ICU and ask how things were going. It was uncomfortable for some. But we all have accountability as leaders in our health system. After their visits, we would get together and talk about patient experiences. What were the pain points they could address? The result was a leadership team that was profoundly more connected to their organization and its reason to be.
How do you provide positive patient experiences when your audience is so diverse, as are their expectations?
We need to meet each patient where they are. Medically, culturally, educationally, and emotionally. That means we must operate with a tremendous amount of flexibility in how we provide care, and with an uncompromised commitment to providing care. This is something we emphasize with all our team members and a criterion we look closely at when hiring. Even with a diverse patient population, there is a common denominator. Everyone deserves the very best care. Everyone deserves to be seen and heard. Everyone deserves to be treated with dignity. And that means a hospital is a place where everyone deserves to be treated with hospitality.