Right Brain Engineering and the Four Levels of Patient Experience


William Johnson

William Johnson

[Video Podcast] Stewart Gandolf talks with William Johnson, System Director, Patient Experience, Memorial Health System, Springfield, IL at Cleveland Clinic’s Patient Experience Summit

Understanding, monitoring and improving the patient experience is a like a long-distance marathon without a finish line. It’s a process that Memorial Health System uses for continuous improvement. Looking at the entire patient experience spectrum, they consider each the four “layers” that the patient travels through to reach the physician.

In our video podcast today, William Johnson points out that 90 percent of the encounter (the first three of the four layers) all occur before the patient meets with the physician. Throughout the process, particularly at the beginning, there is opportunity to form a positive rapport and to shape patient expectations, and thus to engineer the patient experience along the way.

The Four Layers of Patient Experience…

The Pre-Arrival Layer: Here the experience includes the earliest contact between patient and the hospital. Often it begins by telephone, taking initial information, pre-registration conversation, and booking the appointment.

The Arrival Layer: Here’s where they look at influences that are part of when the patient arrives at the facility or office location; typically including various registration activities.

The Pre-Procedure Layer: Immediately in advance of meeting with the doctor, the patient has various interactions with staff, such as when the nurse takes vitals, makes chart updates and other notes.

The Physician Encounter Layer: The time with the physician is a relatively small part of the complete engagement spectrum, yet it is often regarded as a significant element in how the patient evaluates their experience.

Thus, the Physician Encounter layer deserves particular attention. The challenge—particularly with clinicians—is that doctors tend to be “left-brain” individuals. (Where thoughts and actions are oriented to analysis and facts.) In spending time with physicians, Mr. Johnson’s approach is to help doctors identify ways to interact with patients and, ultimately improve the clinical outcomes.

The “mechanics” versus the “humanics” of health care delivery…

He tries to focus on the “right brain” type of social interaction that patients and families expect in their time with the physician, and thus enrich the patient experience. (Right Brain thoughts and actions involve feelings and creativity.)

“One way that you can gauge acceptance on the part of the physicians is when they reach out to you and ask that you ‘shadow’ them for two or three hours,” he said. “During that time, we are able to closely observe their interaction with the patient, and to provide feedback to them on how they can improve the social interaction time with the patient. And when they reach out to me you know you’re being accepted.”

“We also monitor the HCAHPS data, in particular watching the physician communications scores. And as we do more work with physicians, we like to see the communications domain score steadily improve.”

“That is the ‘right-brain’ or social interaction type of behaviors that physicians have in their time with the patient.”


William Johnson & Stewart Gandolf VIDEO PODCAST

Stewart Gandolf, MBA


About Stewart Gandolf, MBA

Stewart Gandolf, MBA, is both the Publisher of PatientExperience.com and the Co-Founder of Healthcare Success. Stewart has written for dozens of leading healthcare publications and spoken at hundreds of venues on a variety of topics including marketing, reputation management and patient experience. Additionally, he has personally consulted for over 1,500 hospitals and practices. Prior to becoming an entrepreneur, Stewart worked for leading advertising agencies including J. Walter Thompson.

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