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
Kimberlydawn Wisdom

Lessons in Leadership: Kimberlydawn Wisdom

What disturbs you gives you purpose.

Kevin Rooney head shot

Lessons in Leadership: Kevin Rooney

Think big, but start small: change starts with one patient, one nurse or doctor, and one shift.

Amy Compton-Phillips and Tom Lee head shots

The “Give a Darn” Method for Outcomes Measurement

Providence St. Joseph uses the “give a darn” method to deliver value — what makes a difference to patients makes it on the short list.

Leadership and Vision for a Culture of Safety

Leaders must remain committed for the long term, because creating the vision is insufficient; the work to communicate and sustain that vision never really ends.

New HHS Secretary Alex Azar

Infographic: New HHS Secretary Alex Azar

Alex Azar, former head of Eli Lilly and Company, has been tasked by President Trump to reduce the price of prescription drugs, limit health care regulation, and tackle the opioid epidemic.

Izabela Nowosielski head shot

Lessons in Leadership: Izabela Nowosielski

Being a good leader is about knowing who you are as a person.

Health Care Governance Board Quality Committee Johns Hopkins Medicine Governance Structure and Accountability Process with Inpatient Hospital Area Example

Taking Health Care Governance to the Next Level

To take on the underdeveloped state of accountability in health care, directors need to create a board-level quality committee that functions with the same rigor of governance applied by finance committees.

Atrius Health Empathy Forums Employee Participation and Evaluation

How to Integrate Empathy into Daily Care

Atrius Health initiated a practice-wide transformation to integrate empathy into their daily work.

Why Give It Up? My Late-Career Fellowship

Instead of retiring, a physician in his 70s pursued a fellowship in telehealth and found a piece of the future.

A Look in the Mirror: The Role of Medical Training in Physician Burnout

Any rational actor in today’s medical industrial complex wonders, at times, whether the labor is sensible and the effort sustainable.

Connect

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

Learn More »

Topics

Physician Burnout

29 Articles

Lessons in Leadership: Kimberlydawn Wisdom

What disturbs you gives you purpose.

Leading Transformation

177 Articles

Lessons in Leadership: Kimberlydawn Wisdom

What disturbs you gives you purpose.

Quality Management

119 Articles

Lessons in Leadership: Kevin Rooney

Think big, but start small: change starts with one patient, one nurse or doctor, and…

Insights Council

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

Apply Now