An overnight stay at an average hospital costs more than a Presidential Suite at the Four Seasons. But you're rarely in for a night of luxury. You'll be lucky to get a private room with a bath, and the phone will cost extra. Don't count on a mint on your pillow.
But times they are a changin'. There's a movement in the hospital industry to treat patients with the same finesse that hotels offer their guests. Hospitals are borrowing the fundamentals from the hospitality industry to improve patient experience, honing in on customer service and using patient feedback to improve. It's part of the new emphasis in health care on putting the patient at the center of everything--something that's been talked about forever, but is starting to actually happen. Why now? In part it's because people are covered with higher and higher deductible health plans, paying more of the bills themselves, and--as a result--are transforming from passive patients to picky customers.
But hospitals have a steep hill to climb to achieve the kind of customer experience bestowed at the Four Seasons. In a recently released Medicare survey, 60 percent of responding hospitals received three or fewer out of five stars in patient satisfaction rankings. Only seven percent of hospitals received top marks.
Even states with nationally-renowned hospitals, like New York with Memorial Sloan Kettering and Mount Sinai, lagged on the ratings. Indeed, the Empire State was among the lowest performing in the country, averaging a score of only 2.5 stars-just above Nevada's 2.4.
The Real Patient Experience
One of my family members - let's call him Hal - recently stayed in a hospital and reminded me of just how bad it can be. Hal's hospital didn't get the memo about trying to emulate the hospitality industry.
Hal is an athlete with a successful career, whose health profile is as near-perfect as you can get. Other than the day he was born, he has spent a total of one night in the hospital in his life. That is, until about a month ago when he cut his leg in a parking lot, and the wound failed to heal. An ER doctor admitted him to the hospital.
Hal was treated with strong antibiotics, and discharged after about a week. Despite the happy ending, this was not a success story. What Hal learned:
- Nobody lets you sleep: "They woke me up and took my vitals at 4:30 a.m., then woke me up again at 6:00 a.m. to change the trash can. And then the trash guy stood outside the door having a conversation for another five minutes."
- Nobody listens to you: "I got online access to my records and in the report he completely screwed up the description of what I had explained had happened when I got hurt."
- Nobody listens to anyone else: "My doc had ordered a referral but no one put it in the computer..."
- Nobody is watching over you: "I have to manage everything myself. I cannot imagine truly having to need a hospital to rely on."
- Your needs don't come first; the doctors' do: "No one has any idea where the doctors are, when and who they are planning to see. They just drop in out of nowhere (or they don't). It seems like it wouldn't be hard for people to know that a certain doctor is planning to see you that day and there's a ballpark window of time he's coming. Even the cable companies do that."
Hal's experience is the definition of bad customer service, but it could have been much worse for him--at least he came out of it alive. The Keystone-Cops culture Hal endured at his hospital can lead to deadly hospital errors. New estimates suggest upwards of 1,000 patients die every day from preventable errors, accidents, and infections in hospitals. One in six patients suffers an adverse event.
But are hospitals prioritizing luxury finishes over a solid safety track record? In Elisabeth Rosenthal's popular series, "Paying Till it Hurts," she notes, "hospitals can improve their bottom line and their reputation by focusing more on hospitality than health care -- offering organic food by a celebrity chef rather than lowering medication errors, for example."
To truly be patient-centered, hospitals need to focus on customer service and delivering safe, high quality care at the same time. That does not require a degree in hospitality or a concierge desk. Rather, it requires a new set of priorities that put patients first, from the moment they enter the hospital.
To get a truer picture of provider performance, we need to match safety ratings and accessible outcome measures to satisfaction scores. Safety, patient satisfaction, and outcomes data together can indicate whether a provider is truly delivering high-quality, patient-focused care. But as I explain in a forthcoming essay in a book to be published by the Manhattan Institute, we'll have to do far more than just gathering the data.
While employers, insurers, and governments will play a role, much of the burden--and opportunity--will fall on hospitals. Successful hospitals will need to retool to meet the new, patient-focused reality, and win in the marketplace. Smaller community hospitals will have every opportunity to out-compete bigger name competitors when they focus on their patients' well-being.
At the heart of the patient-centered care movement is dignity and respect--for a patient to feel heard, safe, and informed. We can't do it with pillow mints alone.