CXO Dr. Linda Lombardi on why best practice doesn't always make perfect patient experience

Linda C. Lombardi, PhD, chief experience and strategy officer at NYC Health + Hospitals/Bellevue in New York City, discusses the broadening scope of patient experience, the importance of learning from the frontlines and why relying only on best practices from other facilities is a mistake.

Editor's Note: Responses have been lightly edited for clarity and length.

Question: What is the most important lesson you have learned about delivering excellent patient experience?

Dr. Linda Lombardi: We have learned a lot about delivering excellent patient experience over the last few years and we are still learning. Perhaps the most important lesson is that building an excellent patient experience results from a team effort that engages staff and patients in creating a responsive and caring environment. We have learned that those who deliver the care and service, our physicians and nurses, our registrars and environmental services staff, together with those who receive care and service, our patients and their families, know the challenges and have the solutions.

Our CEO, Bill Hicks, launched leadership rounds with staff three years ago. These weekly rounds by executive leadership have strengthened staff engagement, improved the overall experience and allowed us to learn from those on the frontlines, whether in our clinics or office operations.

Q: What are some common missteps hospitals make in their patient experience initiatives?

LL: There are so many terrific efforts underway to improve the patient experience in hospitals and clinics. [But] a misstep that is apparent is the overreliance on best practices and external voices about how to create the best patient experience. To be sure, best practices and external voices can provide important insights into how other facilities have improved their patient experience. These insights are rich in ideas and valuable. But each facility is unique; unique in staff composition, patient population and culture.

The size, scope, location, demography and so many other features of each facility must be understood on its own and must be honored in order to achieve the best patient and staff experience. Our system and facility rely on our staff and patients to lead us to change. Trusting in those who 'live' in the facility each day and relying on their suggestions paves the road to success.

Q: What has been the most successful patient experience initiative at your organization?

LL: That's a challenging question, as we have several successful patient experience initiatives. To be sure, the [following] twin and complementary programs led by our system, New York City-based NYC Health + Hospitals, have been very successful in standardizing and aligning our efforts to improve both the patient and staff experience. The ICARE Program, emphasizing the values of Integrity, Compassion, Accountability, Respect and Excellence, is the foundational underpinning for our work.

The Joy in Work program, aiming to build a positive, caring and learning environment for our staff, aims to restore joy in the workplace.

At the facility level, our most successful efforts have been those led by team-based programs such as using Lean and Scrum tools. These programs rely on teams to identify challenges and trust the teams to develop experiments and make change. Through these initiatives, we have learned that teams are the accelerants of change and improvement. Empowering many, small and focused projects creates energy and innovation, broadens staff participation, improves the employee and patient experience and shows respect for those doing the work and using our services. Our Lean work chartered 21 team-based events with over 500 staff members participating over a five-year period. Much of the work completed by these teams has been sustained for several years.

Q: What excites you most about the future of your role?

LL: We are just beginning to understand the importance and the impact of the service experience on the delivery of care in the 21st century healthcare delivery system. The quality of the care we deliver is of the utmost importance, and there is a broad agreement that delivering high-quality care is not just a moral imperative but a financial one as well. The service experience of how and where that care is delivered will be a companion goal in the next five to 10 years.

Emphasis on the environment in which care is delivered, on the 'soft skills' of communication, team-building, negotiation, will be the focus for improving the employee and patient experience. We will move to a true partnership model in working with both staff and patients, using artificial intelligence, digital technology and the power of face-to-face interaction to create true healing environments of high-quality and compassionate and responsive service. The role of the chief experience officer will broaden in this emerging healthcare delivery system.

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