Leadership

How Your Board Can Improve the Patient Experience

Article · July 13, 2016

Leadership begins at the top of the organization. Not exactly a profound statement, but many who say it fail to factor in the role of an organization’s board of directors, choosing instead to look at the CEO and executive team at the top of the org chart.

At Virginia Mason, the board has been a partner in leadership. I will never forget the moment early in my tenure as CEO when our board asked our leadership team a pretty straightforward question during a strategic planning session: “Who’s your customer?”

All of us felt pretty confident we provided the correct answer: “It’s the patient.” Then the board asked us to look closer to make sure our actions supported this response. We dove deeply into our processes around the organization and were pretty stunned when we discovered that most of them were designed around physicians, nurses, and other team members — not the patient. For example, what are waiting rooms but places for patients to hurry up, be on time, and then wait for us? And what happens in most hospitals on the weekend? Patients wait for Mondays so things can get done.

We found we weren’t designing our processes around our patients, our true customers.

That revelation was the dawn of a journey we’ve been on for the past 15 years. We work to put the patient at the center of everything we do. Our strategic plan now is illustrated by a pyramid with the patient at the top. This has served as our true north ever since.

For example, we redesigned our medical clinics to eliminate waiting rooms. When patients arrive at our Kirkland Medical Center, they are immediately ushered to an exam room.

Our customer emphasis continues to be a cue for me, as a leader, when faced with myriad decisions every day. “How does this improve the experience for patients in our care?” is a question I am routinely asking myself and others in the medical center.

To further strengthen our focus on patients and the experience they have while in our care, our board requests that a patient or family member attend every meeting and share their stories. In fact, the board prefers that we try to share more negative patient experiences than positive ones as a way to improve. Examples include poorly coordinated care or inadequate follow-up, which, fortunately, are increasingly rare occurrences.

The patient connection is strengthened during leader rounding. The inclusion of executive leaders and board members in patient rounding is a staple of daily management at Virginia Mason. When our patients and frontline team members are visited not only by physicians, but also by the CEO and board, it sends a strong message that our leadership is fully invested in understanding the care experience and how it can be improved.

Within the past few years, we also launched a Patient-Family Partners program. Today, more than 150 patients and family members serve alongside our team members during planning, visioning, and improvement work. Their time, energy, and ideas are truly gifts to our organization and contribute to our goal to create full partnership with patients and families to improve and transform our delivery of care.

I urge all hospital and health system executives, physician leaders, and board members to ensure that the board of directors plays a role in ensuring the best patient experience possible. This is what true leadership in health care is all about.

New Call for Submissions ­to NEJM Catalyst

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

More From Leadership
East London NHS Foundation Trust Non-Clinical Quality Improvement Days Taken to Complete Disciplinary Process

Quality Improvement for Non-Clinical Teams

Administrative QI projects save money, streamline processes, and even improve patient care for the U.K.’s National Health Service.

Physician Clinician Burnout Is Extensive

Leadership Survey: Immunization Against Burnout

Clinician burnout is far from being eliminated at health care organizations, but leaders, frontline physicians, and nurses are joining forces to get to the roots of the crisis.

Fleisher03_pullquote Physicians-in-Training - An Untapped Resource for Health Care Innovation

Physicians-in-Training: An Untapped Resource for Health Care Innovation

Five strategies that can support long-term leadership development and open opportunities for system transformation.

Tait Shanafelt

Beyond Burnout — Redesigning Care to Restore Meaning and Sanity for Physicians

There’s a growing recognition that organizations need to redesign the way that clinical care is delivered to address the national physician burnout epidemic. Measuring rates of physician burnout is the first step.

Sample Testimonials from Fresh Eyes Action Learning Program

Action Learning–Based Leadership Development at an Academic Medical Center

How Mayo Clinic utilized an action learning–based program to foster the leadership skills needed to navigate the changing landscape of health care.

Many Different Definitions of Stakeholder Alignment in a Health Care Organization

Leadership Survey: Why Big Gaps in Organizational Alignment Matter

An NEJM Catalyst Insights Council survey finds that clinicians and leaders do not see eye-to-eye on many aspects of health care delivery.

Physician Coaching Models Interview Large Headshots - Rana Awdish Dale Glenn Ghazala Sharieff Tom Howell Namita Seth Mohta

Physician Coaching Models: Solutions and Impediments

A group of care experience leaders from across the United States discuss innovative physician coaching models at their respective organizations.

University of Utah Family Medicine Residency Program Value Improvement Projects - Practice-Based Learning and Improvement PBLI Milestones Score by Year of Residency

How the University of Utah Prepares Family Medicine Residents to Lead Value Improvement Efforts

A rigorous 3-year program helps physicians focus on improvement through interprofessional collaboration.

Integrating Product Management Education into Health Care - Example of How Curriculum Would Help Physician Tackle Clinical Need in Tandem with Engineer and Business Lead

The Case for Product Management Education in Clinical Training

How can physicians learn to speak the language of innovation and claim a role for themselves within the innovation ecosystem?

Della Lin picture

Lessons in Leadership: Della Lin

How lessons from a concert pianist in timing, audience connection, and intent apply to health care leadership.

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

Physician Burnout

34 Articles

Leadership Survey: Immunization Against Burnout

Clinician burnout is far from being eliminated at health care organizations, but leaders, frontline physicians,…

Leading Transformation

194 Articles

What If We Treated Mental Health…

How would we react if only 1 out of 10 people with cancer saw a…

Leading Teams

130 Articles

Action Learning–Based Leadership Development at an…

How Mayo Clinic utilized an action learning–based program to foster the leadership skills needed to…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now