CXO

This post by John H. Schumann, FACP, originally appeared at GlassHospital.


A classmate of mine was recently given a job title I'd never heard of: CXO. He's been made the Chief Experience Officer at a large Midwestern medical center--one of the ones that's been touted in the health care reform debate as a paragon of effective care delivered in an efficient and [somewhat] cost-conscious manner.

I'd seen the announcement about his promotion, and didn't really understand what it meant. So I contacted him, and this is what he emailed back: "I was appointed to this role in July. I report to the CEO. We have the highest level commitment to patient experience. I get all of the resources I need. [The CEO] has made employee satisfaction/engagement, and patient experience the two highest institutional priorities. These two issues are linked completely. Can't have satisfied patients without satisfied employees!

"I am partnered with the Executive Chief Nursing Officer and together we run the office of patient experience. ~65 employees. We realized that it is really about the docs and nurses. [She] and I have adopted our Chief Human Resources person as the third wheel of patient experience, because of the engagement / satisfaction component. Our department includes a variety of programs. We have an executive director who runs the operations. As CXO I sit on the executive team and too many committees to name."

Hang on a second. Let me pick up my jaw.

My old classmate has sixty-five employees in an "office of patient experience." This tells you a couple of things:

1. The medical center that he works at is sizable and has ample resources.

2. They take customer (patient) satisfaction very seriously (and couple it with employee happiness, interestingly). Hmmm ...

Being the CXO means that my friend has become the face of his organization for all patients and their experiences at his medical center. Since in his role the buck stops with him, he's fully empowered to make change. No doubt it helps to have direct access to the CEO, whose vision helped my friend attain his position.

This CXO role got me wondering: How can I get sixty-five employees to do my bidding?

Actually, what I'm really wondering is what the consequences of such an office are. What if wewere fully empowered to serve our patients the best way we knew how? Or still yet, in ways we've not yet even conceived of?

Here's what I came up with; I'd love to hear your ideas:

1. Scheduling that works.

When patients call to see their doctor, being told that my next available appointment is in 8 weeks is not helpful. Patients should be able to see the template online and pick a spot, just like a seat on an airplane.

2. Transparency.

Instead of being told, "The doctor will be right with you," which could mean anything from now until 30 minutes, let's have some honesty or at least give patients more accurate information. Restaurants can do this.

3. Prices.

This is an easy whipping-boy for lots of health reformers and pundits. But what other industry would survive where the service providers (doctors) have no clue about the real world prices of the tests and products they're recommending? Believe me, I've asked, and the runaround I get on this one is amazing. So it's not my fault, entirely.

4. Products and services.

Why do we treat the medical record like some ancient biblical text? "You want a copy of your records? That'll be 20 cents/page, take 5 business days and require you to stand on a stack of holy bibles to prove your identity."

I understand the need for patient confidentiality, but our system is corrupted: I'm as guilty of this as any doc. Our records are to please the dictates of billing/coding and quality assurance. They're usually at least somewhat in gibberish, and we almost never give the patient a copy of what we just did with them.

Wouldn't it be nice to have a printout of our consult? Results of your tests? Doctors have gotten better about giving out lab results, to be sure, but shouldn't you be able to somehow get online and check your own results and then contact us with your questions? Or at least be able to access them once the doctor has 'reviewed' them?

I'd like to look at this post as the start of a wish list for 21st century medicine. From your keyboard to my ears. Or screen. Or eyes. I have a lot more ideas, but I hope this gets the ball rolling.

John Henning Schumann is a general internist in Chicago's south side, and an educator at the University of Chicago, where he trains residents and medical students in both internal medicine and medical ethics. He is also faculty co-chair of the university's human rights program. His blog, GlassHospital, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people that inhabit them.

Labels: Glass Hospital, guest post, hospital leadership, patient care, patient satisfaction

posted by John Schumann, M.D. at 8:00 AM