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      Brief

      It’s a Love Story: The Power of Patient and Employee Experiences in Healthcare

      It’s a Love Story: The Power of Patient and Employee Experiences in Healthcare

      The US healthcare system is falling short on patient and clinician experiences. Fostering a culture of love can spur a virtuous cycle that benefits everyone.

      By Adrienne Boissy, MD, MA, and Erin Ney, MD

      • min read
      }

      Brief

      It’s a Love Story: The Power of Patient and Employee Experiences in Healthcare
      en
      Executive Summary
      • Patients want the convenience and personalization of everyday retail and service experiences, but the US healthcare system often fails to meet their expectations.
      • In parallel, Bain research shows that clinicians are increasingly overwhelmed and burned out by excessive workloads and administrative burdens.
      • A culture of care and love for employees can create a virtuous cycle, improving patient and clinician satisfaction and loyalty.
      • Along with employee advocacy, providers can implement new operations and processes to markedly improve clinical, operational, and financial outcomes.

      What’s love got to do with healthcare? Well before Tina Turner’s famous song, a 1955 piece in the New England Journal of Medicine posed the question: How do we clinically define “love?” Later, a concept analysis of love in nursing described it as “the combination of nursing care with a sense of responsibility, benevolence, attention and concern, respect, and understanding of others as a human being.”

      Written in collaboration with

      Written in collaboration with

      qxm-logo-50.png


      Some have found that this “companionate” love—defined as “feelings of affection, compassion, caring, and tenderness for others”—not only positively influences employees’ experiences but also patient outcomes and satisfaction.

      No matter how you define love, companies in nearly every other industry are making progress in deeply understanding and creating emotional connections with their customers. Nonetheless, healthcare has been slower to embrace customer love to this extent.

      Yet love holds tremendous potential for provider organizations’ clinical and operational success. Our experience suggests that customers and employees who feel loved are more satisfied and loyal, and loyal customers and employees reinforce one another, creating a virtuous cycle that benefits everyone.

      The healthcare challenge

      In the US healthcare system, that virtuous cycle is broken. Clinicians work long hours under significant pressure. At the same time, they often face cumbersome systems that add high administrative burden, with the dehumanizing effect of stealing time and energy from caregiving, contributing to fatigue and burnout.

      In parallel, patients have come to expect the convenience, ease, and personalization of everyday retail and service experiences. Yet to get the healthcare they need, they often face long wait times, unanswered questions, charges for portal messages, and overly complex, redundant processes. They also encounter burned-out clinicians and frontline staff who often feel unequipped or unempowered to fulfill their mission of delivering high-quality care and experiences.

      What’s more, patients’ pain points regularly go unaddressed. A Bain survey found that 78% of nurses report that their organizations solicit patients’ feedback throughout their care journey, yet only 53% say that the feedback system in place helps solve recurring pain points for patients. And in the US, return rates for regulated satisfaction surveys are, on average, around 30%, leaving innumerable voices unheard.

      Under these conditions, no one feels loved at all.

      Most healthcare system leaders appreciate the importance of the patient experience. Similarly, they want to do right by their employees. But given industry complexities, they’ve struggled to make meaningful progress. And few have deeply examined the instrumental correlation between the employee and patient experiences in order to recognize that they can’t attain the full potential of patient love without consistently addressing employee love as well.

      The employee love imperative

      The consequences of missing the mark on the employee experience are serious. Research shows that, on average, hospitals with higher nurse burnout scores have higher odds of patient mortality and failure to rescue, as well as prolonged lengths of stay.

      Conversely, the benefits of preventing and treating burnout are huge. For one, improving the employee experience can reduce the costs of absenteeism and attrition, saving on recruitment, training, lost productivity, and more.

      But more importantly, a systematic review of the effects of physician well-being on patient care found that a positive employee experience contributes to improvements in patient satisfaction, adherence to treatment, the physician-patient relationship, and the overall quality of care. A recent meta-analysis also found that staff engagement has a positive correlation to patient safety outcomes. Similarly, according to a recent Bain study, 90% of nurses report that when they have a positive experience as an employee, they feel as though they provide a better patient experience.

      Furthermore, across industries, we’ve found that higher employee satisfaction is correlated with higher customer satisfaction. In healthcare, the value of patients with a high Net Promoter Score℠ (a measure of how likely customers are to recommend a company to friends and family) is too significant to ignore. These patients are up to 4.7 times more likely to use other services from the same provider and 6.6 times less likely to switch providers.

      How can providers enrich employee and patient lives with love?


      The first half of the story: A culture of care

      Given the importance of patient satisfaction, what does a better employee experience aligned to a mission of a better patient experience look like? All employees need a physically and emotionally safe work environment, proper processes and tools to do their jobs, and fair compensation. Beyond these basics, healthcare systems can take a page from customer-centric pioneers in other industries by focusing on four critical areas of employee advocacy. In leading the wave of employee love in healthcare, providers can create a halo effect that extends to patients.

      Congruence with values. Clinicians who are proud of their organization’s mission of enriching patient lives and who see how their work fits into that mission are far more satisfied with their employers and jobs. Today, around a quarter of US clinicians are considering switching careers, primarily because of burnout. But of those who aren’t, around 55% feel that practicing medicine is their calling. They report their positive impact as the biggest reason for staying in the profession. But they want employers to show that they care, too, with actions aligned to the values and purposes they profess.

      Consider customer experience leader Disney, which has successfully embedded its purpose in its culture. At every touchpoint of the customer journey, employees are committed to fulfilling its purpose of “entertaining, informing, and inspiring people … through the power of unparalleled storytelling.” The effect is tangible: For customers, interacting with employees whose job is to “create magic” feels different than interacting with employees whose job is to “operate a business” or “park cars.”

      Healthcare systems can likewise strengthen employees’ sense of pride by prioritizing and staying true to the mission of enriching patient lives through the quality of care and the experiences they provide.

      Empowerment. Clinicians need latitude to make decisions that best serve their patients. At top providers, they feel equipped and empowered to improve their patients’ experiences and that they have a voice to encourage ongoing organizational improvements. This culture of empowerment isn’t limited to clinicians: Across these organizations, individuals have the necessary autonomy, tools, and processes to do right by patients.

      Customer-love champion Warby Parker, a digital disrupter of the US eyewear industry, not only uses customer feedback to fuel product and experience innovation but it also empowers employees to take part by asking them to submit a weekly “innovation idea.” The retailer has also established the Warby Parker Academy, which offers free workshops on everything from frame design to public speaking, giving employees tools to promote and implement change. In a similar manner, healthcare providers can proactively seek employee input on innovative ways to improve patient experiences based on what they’re seeing in their own wards and clinics.

      Recognition and gratitude. Recognition and gratitude go a long way in making employees feel valued and reinforcing efforts to provide an exceptional experience. For instance, Lumen Technologies, a global enterprise technology solution, found that when frontline technicians felt recognized for great service, they were nine times more likely to resolve a customer issue at the first touchpoint, bolstering operational efficiency.

      The healthcare industry has significant room for improvement in recognizing employees’ efforts: Only 52% of nurses say that their organization recognizes them when they go the extra mile for patients.

      Recognition on a large scale can be tough, but technology can help. For instance, UPS uses a bespoke system to route customer comments directly to individual employees and hands out awards for jobs well done. Healthcare organizations can similarly distribute patient feedback so that clinicians and other frontline staff can directly hear stories of their own impact and receive recognition accordingly.

      Professional and personal growth. Today, almost 60% of clinicians say they don’t get the coaching and mentorship they need. Strong coaching and mentorship are directly correlated with employee satisfaction: For each 1-point increase in a supervisor’s leadership score, researchers saw a 3.3% decrease in the likelihood of employee burnout and a 9% increase in the likelihood of employee satisfaction, according to a Mayo Clinic study.

      In addition to coaching, it's vital that employees have other formal opportunities to grow and thrive. Chipotle provides employees with the ability to earn debt-free degrees, access to grants for financial support in the event of an emergency, and transparent career paths—it promotes more than 90% of restaurant managers from within.

      Some healthcare companies are already making strides: At Cleveland Clinic, formal communication skills training reduced clinician burnout rates and improved clinician empathy and patient satisfaction.

      The other half of the story: Operations and processes that support loving care

      As organizations build a culture of care, how can they ensure that they are making progress in improving both employee and patient experiences?

      Listen to and assess emotions, efforts, and experiences. Many healthcare organizations still deploy long surveys assessing patients’ overall satisfaction and likelihood to recommend. But the field is changing. Today, pioneering organizations are using unstructured and unsolicited data—no survey required. Artificial intelligence tools such as ambient listening can collect, codify, and understand emotions, efforts, and experiences in real time, in multiple languages, across channels. There’s widespread opportunity to implement these more advanced systems to better understand patients and their experiences.

      Explore relationships in the data. Loving organizations don’t look at the employee experience and the patient experience as distinct data sets. Instead, they establish an understanding of the relationship between the two and the influential forces on each. They also explore the links between this data and important clinical, operational, and financial metrics.

      Move from measurement to actions that demonstrate love. Organizations committed to loving care have systems in place to ensure that feedback quickly makes its way to clinicians and frontline staff. Practically, this can involve automation that flags negative comments and routes all feedback to the appropriate team members. Organizations can also utilize existing processes such as daily huddles and executive rounding.

      In addition, leading providers establish processes that empower employees to act on feedback and improve patients’ experiences, making employees feel good and reinforcing the virtuous cycle of patient-employee love.

      It’s important to recognize, though, that it doesn’t feel loving to constantly ask depleted employees to do more. Inherent to this work is delineating which feedback needs to be directly addressed at the human level and which requires deeper change. To help differentiate, providers can apply a qualitative scoring of emotional intensity or harm. It’s also crucial to create workflows to elevate recurrent pain points that need to be addressed in a systemic way.

      Intermountain Health is at the forefront of improving the patient-employee experience through listening and action. The company started by reducing the total number of patient surveys from 96 to 14 and listening to feedback across websites, apps, its contact center, and other digital channels. When Intermountain receives negative feedback, it notifies the relevant team so that they can course correct.

      Similarly, Intermountain has expanded listening across the employee experience—including hiring, onboarding, training, monthly check-ins, and exiting—through technology and town halls. By enhancing the company’s understanding of its people at scale, leadership can proactively target moments of improvement, gratitude, recognition, and coaching.

      Improving the patient and employee experience is a complex and challenging endeavor. The organization-wide gains for doing so, however, are undeniable. When healthcare providers do better by their employees, they do better by their patients. Some may call that a good business strategy; we call it love.

      About Qualtrics

      Qualtrics empowers nearly 20,000 organizations around the world to deliver exceptional experiences and build deep relationships with their customers and employees. With insights from Qualtrics, organizations can identify and resolve the greatest friction points in their business, retain and engage top talent, and bring the right products and services to market. To learn more, visit qualtrics.com.

      Authors
      • Headshot of FIRST LAST
        Adrienne Boissy, MD, MA
        Chief Medical Officer at Qualtrics
      • Headshot of Erin Ney, MD
        Erin Morrissette, MD
        Partner, Boston
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