By Sally Grady
Health care organizations across the country are realizing that the focus on improving the patient experience is here to stay, and many are creating new executive level positions that focus on leading their organization through this uncharted territory. There are now chief experience officers (sometimes called the CXO) in many facilities who are responsible for improving the patient satisfaction scores as reported by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), Press Ganey, and Gallup. It can be somewhat confusing to the traditional health care team who has typically believed that taking care of the patient’s physical needs and delivering high level medical care is the basis of patient satisfaction. Although this is important to the patient as well as their family, it is often not the true measure of their overall satisfaction. The environment in which service is experienced is one of the key components to achieving patient satisfaction. It is time to step back and realize that we must reinvent ourselves and focus as much on the “high touch” as we do on the “high tech.” This is vitally important in imaging departments where the focus on high tech equipment often takes priority over meeting the patient’s emotional needs.
Defining the Patient Experience
According to The Beryl Institute, the definition of patient experience is “The sum of all interactions shaped by an organization’s culture that influences patient perceptions across the continuum of care.” Business Wire reports that in 2012 the majority of hospital administrators surveyed ranked patient experience ahead of cost reduction and efficiency and second to quality and safety when asked what was important for the success of their facility. As the competitive health care landscape continues to change, hospitals must seek new ways to differentiate, grow market share, foster patient loyalty, and lower the cost of patient acquisition. The creation of a healing environment is one way to achieve this. Environment provides a first impression of the health care experience and may influence the patient’s expectations even before the service is experienced.
Rethinking Imaging
In today’s competitive imaging market, it is challenging to determine how to take an existing product and reinvent it to be more appealing to our existing customers while gaining the interest of new ones. We sometimes lose sight that our main goal is to help our patients get better and not just reduce costs and increase efficiency. In imaging in particular, there is a tremendous focus on having the most up-to-date, high tech equipment available. While high tech equipment certainly is important, we have to realize that high tech will only take us so far. Technology allows us to maintain a competitive edge only as long as it takes for the hospital across the street to obtain the same technology.
Patients expect the best equipment and don’t believe their doctor would send them to a facility that didn’t have great equipment. They want more than great equipment. They want a healing experience. In my 33 years in health care, I have never received a comment card from a patient that said the MRI was not a high enough Tesla or the CT scanner didn’t have enough slices. All of the comments were about the patient’s experience and what had happened to them while they were in our care. That is what patients remember and talk to their friends about or describe on Facebook and other social media. We need to make sure we provide an experience that is memorable for all the right reasons.
Changing the patient experience requires a clever merging of the world of high tech equipment and imaginative design. High tech equipment takes care of the medical aspect of the patient’s needs and assists in diagnosis. The creation of a high touch, healing environment promotes harmony of the mind, body, and spirit, and some studies suggest that this may promote faster healing. A patient is much more than the illness or medical exam they are experiencing at the moment. There is no technology that can take the place of human interaction. A high touch environment tells a positive story about your facility and strengthens your mission in the community. Today’s patients are not willing to compromise high touch for high tech—they expect both. Patients want an optimal healing environment.
Key Components of a Healing Environment
According to the Institute for Healthcare Improvement, there are many positive distractions facilities can install to reduce patient stress and anxiety. These include:
•Art and interactive art
•Music
•Themed design
•Architectural features
•Natural light and open spaces
•Warm colors
•Noise reduction
•Patient attire
•Scents
•Cleanliness
•Appropriate way-finding/signage
Creating a Healing Environment
Well-known health care futurist Leland Kaiser once said, “If a hospital is to be a healing place as well as a curing place, health care architects must design for the spiritual, mental and emotional dimensions of patients as well as for their bodies.” This is certainly true for imaging. Imaging no longer needs to be a cold, white, sterile, scary, and unpleasant environment for patients and their families. We can help reduce anxiety and stress and create a relaxing, safe, and soothing environment through the use of pleasing sights, sounds, and smells that touch all the senses. The creation of calming surroundings that replace traditional settings is key to helping patients overcome their anxiety and discomfort when undergoing imaging tests. Environments that touch all the senses give patients the ability to better tolerate medical testing and allow the entire process to go more smoothly. Innovative design can reduce patient stress levels, which can directly relate to recovery time and overall satisfaction.
A healing environment can range from a lobby with warm and homey furniture to a virtual themed environment that looks like a seaside resort, beach, aquarium, mountains, waterfall, or wherever your imagination takes you. As an imaging director for 25 years, I had the opportunity to create many different healing environments that changed the way patients experienced health care. With the creation of Seaside Imaging at Florida Hospital Celebration Health, a CT and MRI area was turned into a virtual beach environment that immersed the patient in a relaxing atmosphere. This was the perfect area to start as the equipment in CT and MRI is large and can be intimidating to adults as well as children and my hospital imaging center served primarily adult patients. Hallways and flooring were designed to look like beachfront boardwalks. Walls were covered in relaxing, three-dimensional, beach-themed murals. Beach cabanas replaced ordinary changing booths and patients sat in Adirondack chairs. Surfer shorts, a top, and a terrycloth robe replaced hospital gowns. Three-dimensional sand castles covered the CT and MRI gantry and patients were surrounded by the sound of ocean waves and the smell of fresh ocean spray.
Measurable Results, Bottom Line Benefits
Innovative design can create a critical advantage in your market as well as allow you to differentiate yourself from the competition. I had many patients actually return to the imaging department with cameras in hand to ask if they could take a picture of the sand castle CT or MRI. They didn’t think their friends would believe they had their scan inside a sand castle! When a patient drives all the way back to your facility for a photo opportunity, you know you are on the right track.
The creation of Seaside Imaging brought other improvements in the MRI department. The sedation rate for adult patients udergoing an MRI dropped from 6.5% to 2% within 12 months of Seaside Imaging opening. The reduction in sedation in turn improved the overall productivity of the MRI technologists and their outpatient schedule ran on time at an improved rate. The reduction in sedation also allowed the imaging nurses to be more efficient and spend more time talking to patients and caring for them instead of monitoring sedations that took 90 plus minutes of their time. In addition, we reduced the number of patients who had to deal with the inconvenience of undergoing sedation such as arranging for a driver, lost work time, and lost wages. The allocation of space for setup and recovery was reduced as well as the risk for medication reactions. All in all, Seaside Imaging proved to be a win-win for both the imaging department and the patient.
Another benefit realized by the creation of Seaside Imaging was the reduction in MRI cancellations by 50% within 1 year of opening. These were patients that the technologist had spent 30 to 45 minutes trying to convince to undergo the exam. Despite offering to hold their hand or put a cloth over their eyes, not only had imaging lost the revenue from the exam, the patient was unable to complete the test that may have given their physician the diagnosis for their problem. At the time I performed the analysis, the cancellation rate was reduced from 3% to 1.5% and resulted in an additional $143,000 in gross revenue in a 1-year time frame.
Other benefits to creating a healing environment include:
•Improved patient satisfaction—a positive patient experience leads to a loyal and happy patient
•Increased patient referrals/increased market share
•Improve the public’s view of your facility
•Reduce staff turnover and increased staff satisfaction (at my facility the separation rate in imaging was 3%). Creating a pleasant work environment allows staff to concentrate on the task at hand and shows them that management is interested in their well-being as much as the patient.
•Possibility of cost savings
•Possibility of less repeat exams
Captain of the Health Care Team
As imaging moves forward into unknown territory, it is more important than ever to involve the patient and their family in decisions surrounding their care. Patients are no longer satisfied to wait hours in dingy, dreary waiting rooms for procedures and exams they know nothing about. Patients are no longer willing to submit their bodies for exams just because their doctor said they need it. They want to be active decision makers in their own health care. We need to empower patients to become the captain of their own health care team, and imaging providers must be the supporting players.
Patients want and need emotional support as much as they need our expertise in providing a quality imaging exam. Today’s patient assumes the facility they choose will have quality equipment. More than equipment, they want an experience that caters to their individual needs and soothes their anxiety. We are now realizing that the physical environment is a valuable resource that helps meet the patient’s need for safety, security, and physical and psychological comfort. An excellent healing environment will reinforce clinical quality and promote trust and loyalty for your facility.
As imaging professionals, we are charged with doing more than a scan. We are here to provide the best possible experience for a patient and family who may be going through a very difficult time. That is what creating a healing environment is all about.
Although the author is unknown, the following quote can motivate all of us to continue our journey to create exceptional patient experiences for every individual we serve. “Excellence can be obtained if you care more than others think is wise, risk more than others think is safe, dream more than others think is practical, and expect more than others think is possible.”
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Sally Grady is Director of Clinical Innovation for Dream. Think. Imagine, an Asheville, NC-basedcompany that specializes in the creation of unique, thoughtfully inspired environments within the health care setting.
