A New Formula for Value at University Hospitals

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Our equation places a premium on patient experience

UH Clinical Update | March 2021

By Cliff Megerian, MD, FACS, UH Chief Executive Officer

We have heard and talked about the importance of value in health care delivery for a number of years. In health care, the equation is the quality of care divided by the ‘per member, per year’ cost.

But to patients, quality contains another variable. For them, the outcomes -- a successful surgery, or the discovery of a condition, followed by appropriate treatment -- is not the only factor when they review their experience.

A patient’s perception of quality is highly influenced by the amount of satisfaction gleaned from his or her interactions with UH -- whether it be surgery or treatment, an office visit, a phone call for an appointment or a visit to the Emergency Department.

Very often, that satisfaction also depends on the kindness and compassion offered not only by their health care provider, but by the health care system as a whole.

So a patient’s surgery can be flawless, the subsequent hospital stay exactly the length expected, all necessary precautions are taken, and the patient goes home to continue a smooth recovery. Yet even if two patients had that identical experience, one will be more positive and satisfied if he or she feels they were treated kindly by everyone they encountered at UH.

That’s why I want our UH value equation to be different from that of any other hospital system. Our equation will be quality times experience (of compassion, for example), divided by cost.

Let’s consider that our new formula.

Compassion is how we have distinguished ourselves over the past decades, and we want it to be part of our UH brand promise. Keeping that promise will fast-forward us to becoming, and remaining, the most trusted health care partner any patient can have.

Now, I have heard, and this is a reasonable point, that some clinicians are concerned that what they do for the patient is the only part of the patient experience within their control. The patient may encounter another UH employee during check-in or registration, for example, who exhibits something less than kindness. And in our post-visit surveys, we do ask about that separately.

According to Jennifer Lorenz, the UH Chief Patient Experience Officer, patients let us know about it specifically, often in the comments section of the survey. It’s not because they want to get anyone in trouble, but as they explain, “I want to share this so other people don’t have to encounter a similar situation.” Such notes are certainly followed up on.

However, when it comes to the physician’s office, I believe we as clinicians have more control than we think, especially as we consider the people at the front desk who check patients in, or who take their phone calls. We need to convey to those who work with us the importance of treating everyone in a courteous, friendly manner – which always includes eye contact. Patients notice this, and good or bad, they let others know about it.

Also, people are influenced by the behaviors they see others demonstrate. A clinician will be watched and observed in terms of how he or she interacts with people. If we take the lead in consistently exhibiting behavior that shows that we treat people the way we’d want our family members treated (even if we weren’t there),  my strong belief is that this positivity causes those around us to do the same.

We have a constant opportunity to teach and lead through our actions; ultimately, that’s what patients and those who work with us, see, feel and remember.

We do want all UH caregivers who are in front of patients – in person or on the phone – to know and remember that they are part of the 1,000-piece puzzle that creates the UH patient experience. Patients value courtesy and respect, and they deserve that from the moment they contact UH or enter any of our facilities.

Examples of how this has worked in our COVID-19 vaccination clinics in recent months have been vivid. Many of those who came to us were not previously UH patients, but at that moment, they were.

Our caregivers in the vaccine clinic met people who had a relative who got vaccinated elsewhere. They shared anecdotes, in person and in letters and emails. “I got the same shot my cousin did, but at UH she was treated with kindness and smiles. I’ve decided to switch to UH, too,” read one.

Yes, the science of health care delivery is crucial and so is the art of delivery.

We demonstrate how well we do this at UH most of the time. I know we can get to ‘all the time.’

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