Organizational Culture: A Critical Choice at the Heart of an Exceptional Patient Experience

By Jason A. Wolf Ph.D. CPXP

The Beryl Institute defines patient experience as the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care. While healthcare organizations may not be able to directly control the perceptions of patients and families, the opportunity to influence these perceptions is grounded in their very culture. I suggest that culture is fundamentally based on the choices an organization makes.

When I first explored the characteristics of high performing organizations in healthcare, “seven simple truths” emerged that were tied to positive outcomes. They represented committed choices of action in the organizations studied. These truths included:

• Visionary leadership
• Consistent and effective communication
• Selecting for fit and ongoing development of staff
• Agile and open culture
• Central focus on service
• Constant recognition and broad community outreach
• Solid physician/clinical relationships

It was this combination of efforts that helped organizations drive exceptional outcomes in experience, engagement, quality and the bottom-line. These characteristics have continued to emerge during my exploration of what is driving patient experience success in healthcare organizations around the world.

As recently as my last two On the Road visits, with St. David’s Healthcare and Scripps Health, the central role of culture in patient experience efforts was reinforced. In the St. David’s system, at the core of the process for reinforcing system-wide values and focus on exceptional experience are three questions. They ask daily how staff will define, live and manage the culture. The recognition at St. David’s is that the experience tactics you implement are only as effective as the foundation of culture on which they are built.

This was also the case at Scripps Health, where they recognized the very nature of the organization has a significant impact on overall experience. Vic Buzachero, Scripps Health’s Corporate Senior Vice President for Innovation, Human Resources and Performance Management shared, “It is important that we build a culture that drives consistency in our effort. We must have the infrastructure to show the genuine nature of our organization, reinforce our focus on the patient and shape the balance of systems, processes and behaviors that will help us realize our goals.”

This is not just a U.S.-based phenomenon. My visit to the NHS in the United Kingdom reinforced the importance of culture to experience. They created an opportunity for patients, family and community members to interact directly with senior leadership and initiated processes that improved communication and understanding of patient’s needs. They also focused on creating happy and engaged staff to ensure happy patients.

This idea is reinforced by recent research conducted by Britt Berrett and Paul Spiegelman. They suggest in any business, and especially healthcare, you can’t take care of customers if you don’t take care of employees. The realization, as we saw exemplified in the cases above, is that to ensure the best experience and focus on patients and families, there must also be an intentional focus and effort to create employee engagement and loyalty. Again, this is driven by the culture of an organization. (They offer a complimentary survey in which you can gauge your own organization’s culture of engagement).

Through all our explorations at The Beryl Institute into what drives the best in experience there has always been an element of those simple organizational truths above, all which represent a commitment to creating a culture of service. Simply putting tactics in place has you run the risk of turning your patient experience efforts into the latest flavor of the month activity. Patients and their families and, yes, your colleagues and employees deserve much more. To truly drive an exceptional patient experience, you can only influence perceptions through the choices you make. One of the most critical of those being the type of organizational culture you choose to create.

Jason A. Wolf, Ph.D.
Executive Director
The Beryl Institute