CEO LOREN HAMEL, M.D., was certain something was amiss with Lakeland Health’s overall patient satisfaction scores. They were nowhere near the high marks the St. Joseph, Mich., health system attained on individual HCAHPS metrics. So, in the winter of 2013, he decided to show patients that he and his staff really do have heart.
How did you come up with a “Bring Your Heart To Work” effort to change the patient experience across the board?
Hamel: The focus on patient satisfaction is one part of what brought us to where we are today. We also had to live up to our brand promise to the community, which was to always provide medical excellence and compassionate care.
However, we knew that the compassion that we felt for our patients did not appear to be coming through. Overall patient satisfaction lagged behind measures like staff response, effective communications and even the quality of the food. That told us it wasn’t that we needed to do new things to improve patient satisfaction. Instead, we needed to better demonstrate how much we cared.
What’s the difference between taking care of patients’ needs and showing how much you care?
Hamel: How well we care is the clinical stuff. It’s efficiency measures, response times and other performance indicators that are quantitative. How much we care is the emotional side. All of us are trying to build a healing institution, but we have to understand that the patient experience will always be largely traumatic and dramatic.
We play a significant part in the drama that is health care. For the patient, it is something that’s frightening, painful and always memorable. They will remember, decades later in 3-D, many details of their experience. A certain smell, a sound, a taste will bring back very specific memories of the patient’s time with us. It’s routine for us health care providers; but it’s never routine for the patient.
It wasn’t that your staff were unfeeling?
Hamel: In general, staff had compassion. But there are better ways to communicate compassion, and we set out to learn them. For one thing, you communicate why you’re doing what you are doing. You say, ‘Hello, I’m Dr. Hamel and I’d like to check your vital signs because we want you to be able to leave us and get back to your home just as soon as possible.’
Or even, ‘I’m Dr. Hamel and I’m here so that we can get to the bottom of what’s going on with your condition so that we can alleviate this pain you are having.’
We call it the ‘Who, What and Heartfelt Why.’ Also, almost always smile broadly. There are times when tears are appropriate, but it’s all about body language.
The goal was to hit scores in the 90th percentile.
Hamel: That goal, in all three of Lakeland Health system’s facilities, was met in three months, and exceeded! Of course, it’s hard to keep it up, going well beyond 90 percent ratings. But, by and large, the numbers are staying positive and our other methods of measurement are staying high as well.
Aside from improving scores, how did you know it was working?
Hamel: We gave everyone a simple way to measure the way it works. How do you know you’ve touched a heart? You put a smile on the patient’s face. It’s immediate feedback. Clinically, there are immediate benefits. That smile translates into less need for pain medication, normalization of blood pressure, modulation of heartbeat, reduction of stress and more. And, it’s bidirectional: When a health care provider gets a smile from the patient, he or she puts on a bigger smile, reaping the same well-being benefits.
What else encouraged all employees to embrace the benefits of compassionate care?
Hamel: The whole leadership team did rounds, specifically focused on compassionate care. We found that our associates were empowered by our presence. This needs to occur through inspiration, not by requirements.
The key is reinforcing successes as quickly as possible. We told those stories that we heard or encountered in survey results, patient letters and what each of us saw personally. So, we have simple, fast recognition briefly during a staff meeting or a hallway huddle.
We retell the story and give the employee an additional heart on a badge backer. It creates more conversation about bringing your heart to work and gives immediate recognition.
For me, it’s the most fun, engaging thing that leadership gets to do. The whole senior leadership team is involved and we have told thousands of stories now. The trick is, you do it as soon as you can. It connects you with your purpose. We all do safety rounds on a regular basis, and you get energy from doing that. But leaders have found that they get all that and much, much more from rounding the halls looking for and talking about compassionate care.
Is this kind of thing sustainable?
Hamel: There is such a thing as compassion fatigue. There’s process improvement stress, financial stress, regulatory stresses, change management stress. With all those stressors, other things, not compassionate care, often seem more urgent, top of mind.
But there’s a different sort of calculation to do. You can be a good employee, be competent, do the things you’re supposed to do and be fine. Or, when you come into work inspired to show your heart every time, you’ll actually be more productive, more competent, more efficient. The difference between competent and inspired is a competitive advantage. People are not willing to sacrifice for any cause when the end game is merely competence. But they are absolutely willing to sacrifice when the end game is a much greater human value.
What advice can you give to other health systems about heartfelt care?
Hamel: Don’t start it unless you are willing to continue forever. One, it’s not a program or an initiative; it must be an organizational value. Two, the leadership team must be 100 percent engaged. And three, you’ll need to weave it through the organization. Include it in hiring, orientation, exit interviews and day-to-day routines. It needs to be pervasive.