The Patient Experience: How You Can Know – Measures

By Kent McAllister

PART 1 of 4

Recently, Vyne Medical's Kent McAllister was featured in MultiBriefs sharing his thoughts on the patient experience and how you can know what is actually happening from the patient’s perspective in your health system. In part one, Kent sets the landscape with some history about measuring or monitoring business processes.

Measures

How you can know. This is not a question; it is a statement. Albeit, it is the appropriate question to ask in most industries where any management discipline is applied.

 

Let’s examine patient experience and how you can know what is actually happening from the patient’s perspective in your health system.

 

There are serious challenges to measuring patient experience, and these challenges have recently taken on increased significance as the industry tide shifts.

The “patient as consumer” is seen in headlines time and time again, and discussed by providers, executives and boards of directors at meeting after meeting. This shift may have more than one cause, but the general focus is increased financial burden of patients for a growing portion of the cost of their care.

Also at stake are federal dollars that are, in part, tied to patient satisfaction. Thus, hospitals across our nation are taking new interest in measuring, and then attempting to improve, the patient experience.

 

Let’s set up the landscape for our discussion with some history about measuring or monitoring business processes.

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Back in the 1920s, what is commonly known as the "Hawthorne effect" was discovered in a Western Electric plant on the outskirts of Chicago. The Hawthorne effect, now accepted in all contemporary management circles, is that the observation (measurement) of something influences the outcome.

 

The Hawthorne plant experience taught us that people’s performance generally improves when they are being monitored or measured. The result: a readily accessible and powerful management lever to improve performance — simply start measuring.

 

It stands to reason that merely measuring the people (employees) who are interacting with the patient will influence their activity and related outcomes in a positive manner.

 

In a moment we will talk about the practical impact of measurement in one small, but important, sliver of healthcare. But first, let’s provide a comparison with which we are all familiar.

 

We all recognize the small, dark semi-globes that protrude from the ceilings of department stores, casinos and other public venues. We recognize them as security cameras or, as they are sometimes referred to, the “all-seeing-eyes.” Most of us appropriately assume that there is a room somewhere with a dozen flat-screens being monitored by security personnel.

 

The behavior of all rational people is influenced by the mere presence of those security cameras. Their presence has been proven to decrease shoplifting, and this is true even when the cameras are broken, fake or when there are no humans actually viewing the video. Just the potential for measurement, if the subjects are aware of it, has a demonstrable impact on behavior.

 

This teaches us something important as an adjunct to the Hawthorne effect: it is not the measurement of the subjects that influences behavior as much as it is the perception and the potential of being monitored.

 

Let’s jump forward a few decades from the discovery of the Hawthorne fffect to a loosely related management principle often attributed to both Edward Deming and Peter Drucker.

 

There is some debate about who first postulated or promoted this principle, but the simplest rendition of it is: you can’t manage what you don’t measure. This is not strictly true, but there is a lot of practical value in it.

 

What is true is that the better the data you have about a process, the better equipped you are to manage that process. In short, relevant measurement data does help you manage better.

 

In contrast to Hawthorne, this principle requires that you actually collect data, as opposed to individuals’ perception that they might be measured or monitored.

So in combining our Hawthorne effect discussion with the principle of measurements being necessary to effectively manage as promoted by Deming and Drucker, we will offer this conclusion: The patient experience in healthcare can only be optimized after we accomplish a thorough, end-to-end measurement of the people, processes and systems that interact with the patient.

 

Behaviors will improve and become more compliant as measurement systems are implemented, and the hard data that is actually collected enables management to analyze that data as a foundation for changes that drive operational improvements.