In the corporate world the position of Chief Cultural Officer, or CCO, is not new. Large and successful companies such as Google and Staples have recognized the importance of culture as a strategy. Customers are people and culture is important. It is likely that the importance of culture in the business world relates to building relationships. Relationships with customers and potential customers as well as relationships between employees. These relationships undoubtedly can drive customer acquisition and retention. Relationships provide comfort and make new and repeat purchases easier on the buyer. High quality relationships also allow an organization to get the best work from the employees avoiding the galley-slave mentality.
While there has been no widespread move toward culture as a strategy in health care several successful organizations, such as the Cleveland Clinic Foundation, have appointed Chief Experience Officers, or CXOs. Patients are people and the experience is important. The experience is about human interactions and relationships. Again, it is the culture that builds and defines the relationships. Hospitals currently track the patient experience via the Hospital Consumer Assessment of Health Plans Survey (HCAHPS) and the information is reported on the Department of Health and Human Service’s Hospital Compare website. The survey tool from HCAHPS asks 32 questions of patients recently discharged from the hospital. To date no clear association between the patient experience and patient outcomes has been demonstrated however it has been reported that the early studies suffer from significant methodological shortcomings (New England Journal of Medicine). Prediction: it will be very difficult to associate the output of the current patient experience survey to objective patient outcomes. Bottom line: an association of the patient experience to outcomes doesn’t matter because the patient experience is important as an independent domain of how a health care system is performing!
The patient experience is the most important in a health care system but all of the relationships in the system matter. A November 2012 article in the Gallup Business Journal reports on an initiative at the Cleveland Clinic to initiate a cultural shift. One of the unique aspects of this initiative was the insight to realize that employee engagement was fundamental to the process. Every employee (physician, nurse, housekeeper, gift shop clerk) was considered to be a caregiver. This simple but powerful idea likely created a unifying focus for the entire workforce.
It appears that the health care industry is inching toward embracing culture as a strategy. Culture facilitates both the subjective and objective outputs of this complex system and connects the two. It is the culture that drives the relationships and its the relationships that drive the experience. It is the culture that sets the foundation for the efficient delivery of evidenced based care by engaged and energized professionals. It’s too important to ignore. Someone needs to own the culture initiative.