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Show Us Before-and-After Photos

I’ve always had a fascination with before-and-after photos. In the 70s and 80s, when I was growing up, the only redeeming factor of my dental visits was the waiting-room magazines featuring once-morbidly obese people who now wore a size 6. They were in advertisements for a diet supplement called Ayds - a “delicious” chocolate candy that supposedly worked miracles - and as a child, I was so happy for these people’s success. These days, though, I have a love for room, house, beauty, and wardrobe makeover shows, which produce drastic before-and-after results! To me, there’s something mind-boggling about taking something that may be less than desirable and then transforming it into a thing of beauty. But I can’t be alone in this.

It’s human nature to love a good success story. So, if I were to ask you to show me images of your patients’ experiences before and after the roll-out of HCAHPS, what would they look like? Would there be clear differences in the “after” images, improvements that would wow me? Most improvements in the realm of patient experience, I believe, have been incremental or sporadic. Some of the changes have been embraced and hardwired, while others haven’t quite “stuck.” For hospitals seeking lasting change, before-and-after comparisons of HCAHPS scores can make for defining moments. Hospitals will likely ask something to the effect of: Were there huge improvements within domains, evidencing that behaviors and processes were instituted to address each area of care that contributes to the overall patient experience?

If organizations aren’t able to boast great before-and-after images, then it’s time for them to ask themselves serious questions about their efforts:

  • Do we have in place a comprehensive strategy for behavioral change?

  • Are department leaders held responsible on a weekly basis for survey feedback?

  • Are there action plans in place for every legitimate negative interaction that could be experienced by a patient or a family member?

  • Has every department and specialty identified their patients’ biggest fears and concerns about the services they provide? What resources are available to address those fears and concerns?

  • Has every department created a scenario of what the ideal experience should look like for their patients? Have they designed an experience to address key touch points in the continuum of care?

  • Have we interviewed patients on every unit about how we could improve their experience?

Remarkably successful organizations will tell you that their before-and-after pictures of the patient experience reveal striking differences. They’ll say they blew it up, redesigned it, weathered the pains of change, and now LOVE their new selves. And, more importantly, so do their patients.

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