As we continue to explore the conversation on patient experience excellence, one truth that is continually reinforced is that health care at its core is about human beings caring for human beings. This makes the management of patient experience an incredibly exciting, boundless and somewhat unpredictable venture. I have yet to find two human beings exactly alike and, while we can generalize for efficiency, the core tenets of patient experience excellence stress the very value that we personalize encounters. This requires a focus on the individuals engaged in any health care process outside of an unwavering commitment to the broader collective issues of quality, safety, service, cost and outcomes.

Grounded in this belief, I have offered the concept of the “Patient Experience Centrality of Needs.” The centrality of needs provides a visual layering of efforts to consider, from an inner ring of interactions, subsequently to process and then services. It is through this layered approach that you can build an effective experience effort. The greatest potential for impact lies at the core in mastering interactions, but organizations must start where they are comfortable, have traction and are willing to commit.

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Employee turnover is rising steadily across the nation. In health care specifically, turnover has increased from an average of 11.2 percent in 2011 to 16.4 percent in 2015, and the average hospital spends an additional $379,500 for every percentage point increase in turnover (NSI Nursing Solutions, Inc. 2015). This means the average hospital has nearly spent an extra two million dollars over the past four years. Bottom line – turnover is expensive and is getting worse!

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What sets apart great from good physicians? What kind of physician is she? Will she get along with the nursing staff? Will patients like her and trust her judgment? Would she be a good fit for our hospital?

Health care recruiters, headhunters, chief medical officers and other key decision makers wrestle with these questions on a continual basis – and, to an often surprising degree, they rely on the wrong information to answer them. For example, recruiters are more frequently relying on social networking (e.g., LinkedIn) to identify candidates with very specific skills, years of experience and who are located within certain geographic regions. If I were a recruiter, I would find 26 oncologists with 6-10 years of experience located within 50 miles of Los Angeles, based on my LinkedIn search. Certainly, my search provides a list of potential candidates, but it does not help me identify the best, talented physicians. Education, job experience, references and biographical data are a good start – basically what can be gathered from a LinkedIn profile – but they provide substantially less useful information when making a hiring decision as compared to more scientific and rigorous methods, such as structured interviews. When comparing validity coefficients of these assessment tools – that is, how well they predict job performance – structured interviews provide between 3 and 40 times more relevant information than education, job experience, references and biographical data. In fact, research has consistently found that structured interviews have the strongest validity of all assessment methods (Schmidt & Hunter, 1998; Wiesner & Cronshaw, 1988).

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Between my ‘big surgery’ in 2009 and today, I had two more surgeries. In 2011 I broke my foot and required surgery to repair it. In 2012 my gallbladder nearly exploded so I had to have emergency surgery to have that removed. All things considered, they were relatively minor procedures and I was only down for the count for a few days.

Recently, though, I had a medical scare. My stomach was not emptying properly – what takes normal people one hour was taking my stomach four to five hours. I decided to return to my surgeon for a consultation and see if I needed another surgery.

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In health care, so often the focus is on the physical healing…and it has to be. Without the physical ability to breathe, eat, process thoughts and have true functionality in your body, there are great obstacles to overcome. Daily obstacles, often visible to the entire world. But that is only half of the battle…if that. The emotional obstacles you have to overcome in a difficult medical situation are equally, if not more so, traumatic, often more difficult to diagnose and certainly can leave lasting scars far deeper than any surgical knife. This is where inherent talent in a person either shines or explodes. And depending on your own natural talent you will potentially travel a very different path down the road to recovery.

Physically, I had healed and recovered from my surgery. When I left the hospital I came home with a feeding tube, was still not able to eat any solids and had a long road of physical therapy ahead of me. By the time August rolled around I was able to return to college for my junior year feeding tube free, eating completely on my own and making great progress on my physical therapy – it would ultimately be a little over a year before I was physically healthy again, able to walk long distances and lift or carry anything heavy. The surgery was a success, for which I was infinitely grateful. However, mentally, I had a long road ahead. The first night home brought about a new struggle that I was certainly not prepared for.

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