The X-Factor that can kill your hospital or make it thrive

As a follow-up to our previous post about "What keeps hospital CEOs awake at night" we are focusing on quality, and what some people think-of as the "X-Factor" in healthcare delivery today.

Let’s pose several questions:

-Do patients really determine the level of quality?  (What is meant by “quality?”)

-Is there a link between patient experience, their perception of quality, and the level of your care team’s engagement?  

We’re talking about the two-headed animal called “quality.”  And this leads to the dominant revenue driver called “Brand.”

Yes, it’s marketing.  And yet it’s much more than that.  Brand is what matters most when “selecting” a healthcare organization.  This applies to both patients and care teams.   The best teams of physicians, nurses and administration leaders want to be affiliated with top “brands.”

The slick TV ads don’t matter to patients once they are inside of your organization.  What matters is their own personal perception, imperfect as it may be.  Every patient touch-point is an opportunity and a risk.  And the best part of this?  It’s all delivered by your people, and they have the power to make those touch-points all winning experiences.

Because when the brand slips, the entire healthcare enterprise starts to unwind and spiral. It’s not pretty. As one CEO said “if the care teams stop favoring my hospitals and clinics, and move their procedures and patients away to competitors, as a CEO, I’m cooked.”

CEOs do stay awake at night worrying about clinical care and containing unnecessary expenses and reducing variability in the way care is delivered.  In many ways those objective measures of operational performance are “easier” to box, than the “unstructured” perceptions of service quality of patients.  It can be very frustrating.
But it’s intertwined by that X-Factor that joins the clinical quality stats with the patient perception of quality measures.  That X-factor is the care team.

Brand warfare today is happening all around us.  Just turn on the radio or TV and see dueling healthcare advertisements.  Expensive super-slick agency productions, they all talk about “we are more friendly” and “we know your name” and “we speak your language” and “we are in your local neighborhood.”  What’s missing?  “We deliver better medicine.”  Because that’s not what Brand warfare is getting at.   What drives the quality that is underlying this brand warfare?  It’s our X-Factor— great care teams.

Getting back to the interdependence of great care teams to great medicine, it’s also essential to go back to the objective clinical stats and remember that highly engaged care teams tend to make fewer mistakes, and tend to do a better job of providing instructions at discharge, better follow-up post treatment and the whole list of best practices that make patients “feel” more quality and love, and also drive better medical outcomes.  This is a known correlation, and we are working to assist leaders measure and manage these connections.
But there is more.

Engaged care teams impact perception of quality from the moment patients come into contact with their healthcare provider at reception, to the last interaction with the billing department.  Think of the billing department as the poster-child for your brand’s great quality.

Yes, billing is often the “last impression” a patient has with your healthcare organization.  Now that’ alone is enough to keep many CEOs awake at night.  Imagine this— a spectacular patient experience in both their objective clinical outcome to their true collaboration and participation in their ongoing care.  But the last contact is with a cranky, ill-tempered billing department that is working on antiquated systems that make billing a nightmare for everyone.   Result?  Brand damage, and game-over.   That patient will walk away with a huge negative and your brand is “cooked” - to paraphrase that CEO.

An interesting study was conducted by BJC Healthcare and published in the Journal of Healthcare Management.  Over 14,400 patients were interviewed and three areas were explored that relate to Brand (and revenue):
-Overall Quality of Care
-Willingness to Recommend
-Willingness to Return

For quality of care (a major determinant of healthcare reimbursements), the highest influencing factor according to the study is nursing care, followed by staff responsiveness. The impact of the admissions process, physician care, and the treatment room experience was less than 20%. Message: If you are losing sleep over reimbursements take better care of your nursing team and staff.

In the study, staff responsiveness dominates the willingness to recommend and willingness to return followed by nursing care (which has big role to play in staff responsiveness as well). 

Next - if you losing sleep about the size of your patient population focus less on marketing and more on creating experiences that will drive patients to recommend and return.  Word of mouth has always been the most powerful marketing tool. One Hospital CEO said that every poor patient experience loses the hospital five new customers. 

These seem like questions one would receive in a retail establishment or likely at a restaurant:  “how is your meal?  “Please recommend us on Yelp” and “here is a 10% off coupon for your next visit.”  In Healthcare, brand is retail, because it is “consumer.”  Patients are very sophisticated consumers, and as they gain more control over their healthcare dollars, they are moving quickly to measure value in terms of cost, quality of service and “brand” reputation as criteria, as they do in all other important areas of their lives.

What does this have to do with our X-Factor?  Everything!  Healthcare CEOs are staying awake at night because they recognize the interdependence of having the top care teams and of providing the best working environment and best engagement.  It can be a matter of life and death for the patients and now it’s a matter of economic survival for the healthcare institutions. More than ever, it is the patients that are “defining” the quality as “customers” in a consumer model.

Yes the world has changed.  We think for the better.  The top leaders we meet have long been advocates of patients as full participants and “engaged” in their treatment as well as arbiters of the “quality” of their experience, both clinically and overall.

Top leaders focus on this X-Factor of the care teams because it drives all of these operational statistics and patient quality perception measures.   

What is your experience at your healthcare organization?

if you want to join the discussion on healthcare employee engagement and how to improve it, please join us at our LinkedIn group.

4 responses
Great Article! i think it is concerning especially in healthcare how we fight for market share. Organizations must do so much to get and keep peoples attention. Yet, really we dont want to confuse patients
Our company refers to our team of nurses as "Team X Factor" and they are correct! Our X factor is treating each patient as if they are our ONLY patient!
The reason we manage quality, marketing, satisfaction etc, is; "the patient". We do it so we can pay the bill to turn the lights on, but we also do it because the patients deserve it and it is the right thing to do. At every nexus point we have an opportunity to engage our patients and experience the "Wow-X-Factor." It shows in our patient scores, our community outreach and our local news. The Federal government now assists us with driving our excellence and as a business we must make sure we have the tools and resources to be the best. It starts at the front door and ends with the payment of the bill, however in during this time frame are the staff which we would not be able to accomplish anything without. I enjoyed the article. Thank you for sharing.
It is an interesting topic to read. Thanks