The rise of the healthcare Chief Experience Officer
Eight years after the first public reporting of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results in the US, efforts to improve patient and family experience at hospitals and health systems around the country are reaching new heights. Leading organizations have recognized that delivering an exceptional experience of care goes beyond scripting and simple service standards. A new cadre of thought leaders is helping reshape the healthcare landscape, aligning experience efforts with initiatives to improve quality, safety, and performance across the care continuum.
Last year, Vocera’s Experience Innovation Network published the first ever study focused on executives charged with leading healthcare experience transformation, Chief Experience Officers (CXOs). We profiled the priorities, resources, and responsibilities of these mavericks and change agents as they buck the status quo to redefine care delivery. As healthcare experience work matures, leaders face new challenges and priorities. Our 2016 study, The Rise of the Healthcare Chief Experience Officer, includes more than 100 survey responses and 30 in-depth interviews with experience leaders in the U.S. and Canada. We learned that:
- Experience leaders have the ear of the C-suite. Up slightly from 2015, 39 percent of experience leaders surveyed report to their organization’s CEO or their system or hospital president, giving experience a seat at the executive table. Executive visibility and backing is essential to driving the kind of systemic improvement required to achieve differentiation and growth through experience innovation. Further, organizations are recognizing the importance of alignment across clinical and experience excellence disciplines. Twenty-eight percent of experience leaders report to a clinical executive in quality, medicine, or nursing.
- Experience work is catching up with Accountable Care. Patient experience was jump-started after the 2010 Patient Protection and Affordable Care Act introduced value-based purchasing – a practice that began in 2013. With a portion of Medicare payments dependent on clinical and experience measures in the inpatient hospital setting, systems began investing in infrastructure to improve patient experience scores. However, while models designed to reward quality of care across the continuum have expanded, our data suggests that experience responsibilities are still concentrated in the hospital setting. While 60 percent and 54 percent of experience leaders are responsible for primary care and specialty services respectively, we expect these numbers to grow as Accountable Care continues its march.
- Seventy-six percent of executives have their compensation tied to experience. We asked respondents which team members – from the C-suite to the bedside – have their compensation tied to patient experience, staff experience, or physician experience. Not surprisingly, given its link to value-based purchasing, patient experience is most commonly tied to incentive structures (versus staff or physician experience). Non-employed physicians are the least likely to have their compensation tied to experience outcomes. Debates over compensation will continue as 35 percent of respondents cite “driving accountability at all levels” as their biggest challenge with leading experience improvement.
- Patient voice is on the rise. It’s easy to assume that because care teams interact with patients and families on a daily basis, they know what their needs, preferences, and priorities are. But patients and families surprise us every day with their insights and capacities. Monitoring social media for unsolicited feedback (63 percent) and assembling a system-wide patient/family advisory council (54 percent) to provide ready feedback on improvement ideas is a start, but some experience leaders are taking patient voice further. Twenty-eight percent of respondents told us they have patient and family partners dedicated to every major improvement project and involved in even the minor ones. These leaders recognize that patients should be viewed not as reviewers who vet ideas that are already mostly baked but as architects of change, who identify gaps, devise solutions, and have a strong say in the what and how of transformational design.
- Physician and staff well-being and joy is the next frontier. To truly differentiate the human experience, health systems need to address not only the patient and family experience but also the components of physician, nurse, and staff experience that lead to well-being and engagement. Today, 51 percent of experience leaders admit they are not capturing data that reflects well-being and joy. However, those who do are mostly relying on engagement surveys that are often cumbersome to administer, analyze, and tend to focus more on productivity and resources than on the kinds of emotional connection and community that reinforce joy in practice and keep care teams connected to purpose.
As experience evolves to take on a more strategic role in the broader aims of care transformation, our study uncovered several key areas of focus for 2016 and beyond:
- Greater alignment and integration with quality/safety and process improvement efforts – often with experience as the umbrella strategy.
- Broader focus across the continuum of care so that experience improvement ceases to be focused solely on the inpatient hospital environment.
- Deeper engagement of key stakeholders, including physicians, board members, and patients and families. Patients will increasingly be the architects of change.
- A concerted focus on physician, nurse, and staff well-being, joy, and resilience to combat initiative fatigue and drive sustainable change.
Overall, these changes will usher in an era of less focus on patient experience, and more on the human experience of care that serves patients and families while simultaneously supporting care teams in achieving their highest healing potential.
2010 Patient Protection and Affordable Care Act, Chief Experience Officer, CXO, Experience Innovation Network, HCAHPS, Hospital Consumer Assessment of Healthcare Providers and Systems, patient experience, Vocera