What does 'back to basics' mean?
Co-authored by Dr. Thomas H. Lee, Chief Medical Officer, Press Ganey
In a period of unprecedented duress, leaders of many healthcare organizations are emphasizing the importance of getting “back to basics.” That advice makes sense, because focusing on top priorities is essential when there are so many threats from so many directions. But what are the basics, when healthcare is facing so much pressure for change? The people are changing (the patients, consumers, and the workforce). The payment systems are changing. The information infrastructure is changing.
Getting to the root of Human Experience healthcare
One leader at a New York safety net hospital recently said to us, “We have figured out that getting back to basics means treating people like human beings.” He meant focusing on patients, and understanding how simple things like having a pillow under their heads while they lie on a stretcher, can help them feel confident that the people around them are going to take care of them. He also meant focusing on employees, and understanding what makes them proud, and what makes them feel like they belong where they are.
We think that executive is on the right track—as is almost everyone else who grasps the suffering of patients and of healthcare employees. Getting “back to basics” doesn’t mean performing as many RVUs as efficiently as possible. It doesn’t mean increasing “throughput.” Those are important concerns for management, of course, but they are not the basic focus for healthcare. The basic focus is the Human Experience.
The data behind Human Experience—and the potential outcomes in front of us
Skeptical readers might point out that we work for a company that measures the experience of patients, consumers, and employees. They might say that “patient satisfaction” is a nice-to-have, while healthcare performance is really about the delivery of visits, hospitalizations, tests, and treatments.
Our take, however, is that these very important processes are just that: processes. The actual product that both patients and providers are seeking is an outcome that's both emotional and physical. The product is the reduction of suffering—for patients and for caregivers. The Human Experience is not a condiment: It’s the main course.
In fact, the data are overwhelmingly clear: There are no tradeoffs between the Human Experience and more traditional business “outcomes” and metrics. This point is critical because skeptics sometimes assert that emphasis on patient experience might come at the expense of caregiver experience, or that patient experience cannot be emphasized when organizations are under financial duress.
In fact, the opposite is true. Over and over again, the data demonstrates that patient experience and other clinical outcomes track together1,2. (If you ask ChatGPT “Does patient experience correlate with health outcomes?” you’ll get a very long essay that boils down to “Yes.”) Our data also shows that better patient experience is found at organizations with better employee engagement, and that these track with better safety culture and fewer safety events, as well as better employee retention.
The powerful conclusion that emerges when you look simultaneously at the different types of data on the experience of humans and performance metrics is that these are not a series of different jobs—they are one job. It's about improving the experience of humans and reducing their suffering. There isn't any data to indicate that there's a conflict between reducing suffering for patients and reducing suffering for employees, nor is there conflict between reducing suffering and focusing on other strategic imperatives. It is one job—and it’s a crucial one. It is, in fact, the core of getting back to basics.
References:
- Manary MP, Boulding W, Staelin R, Glickman SW. The patient experience and health outcomes. N Engl J Med. 2013;368:201-203.
- Glickman SW, Boulding W, Manary M, Staelin R, Roe MT, Wolosin RJ, Ohman EM, Peterson ED, Schulman KA. Patient satisfaction and its relationship with clinical quality and inpatient mortality in acute myocardial infarction. Circ Cardiovasc Qual Outcomes. 2010 3:188-95.