Story by Joseph A. Michelli, PhD., Illustration by Sandra Dionisi
> “OUR LEVEL OF SERVICE CAN'T LET THIS BUILDING DOWN.”
Those words rang through an otherwise quiet hallway prior to the opening of Ronald Reagan UCLA Medical Center in June 2008. David T. Feinberg, M.D., M.B.A., and CEO of UCLA Hospital System, not only made that proclamation but he and leaders throughout the system have been on an unrelenting mission ever since to elevate the satisfaction levels of patients.
While stories of revolutionary medical breakthroughs and extraordinary clinical outcomes are common at UCLA, the health system’s leadership did not always hear that patients were impressed with their treatment journey. In fact, when Dr. Feinberg was promoted to CEO, in 2007, he took the reins of an organization that was rich with strengths in medical education, research and healthcare delivery but decidedly deficient in leaving its patients and their families with a warm feeling about their experience. UCLA’s overall patient-satisfaction scores were in the 30th-to-40th-percentile range and in need of considerable improvement.
Rather than looking at the miserly numbers and feeling discouraged, Dr. Feinberg saw in this a significant opportunity. “To be honest, being chosen for this job was rather daunting,” he says. “This is a place where miracles are performed every day, however, when I talked to patients I heard some disconcerting things. I’d gone to business school and they taught me that you should know your customer. But how much were we talking to our customers at UCLA, and why were our satisfaction scores so low?” Even more disconcerting was the fact that few patients indicated they would refer their family or friends to UCLA, in spite of the excellent medical care they had received.
“Some people [within the system] told me that our scores were inevitable given the complexity of the cases we treated and the training nature of our facilities,” Dr. Feinberg says. “I just couldn’t accept that.”
From that point forward, Dr. Feinberg’s overarching goal was to boost those scores by giving patients and their families the level of care, both medical and personal, that any member of his own leadership team would expect for themselves or their families. To that end, Dr. Feinberg inserted the “face of the patient” into every business discussion at UCLA by starting each meeting with a patient story. He also asked leaders in the organization to get out of their offices and go up to the floors to talk with patients.
> “OUR SENIOR-MOST LEADERS ASKED ME IF I SAW PATIENTS, and I realized at that point that my contact with patients was merely incidental and not the focus of what I did as a leader,” recalls Mark Speare, senior associate director for patient relations and human resources. “It was a significant ‘aha!’ moment for me. The first patient visits were a little awkward and angst producing. Initially, the staff members were perplexed, if not suspicious, of hospital administrators when we visited the patient floors.”
But it soon became evident, Speare says, “that listening to the patients was the only way anyone could truly learn how to serve them, and patients wanted us to listen. Now, some years later, visits with patients and families come naturally. All of our directors and managers participate in patient rounds, and our staff members enjoy seeing us and getting feedback on what we are doing to make the patient experience better.”
Informal processes of listening like those described by Speare have evolved at UCLA into systems that increase the consistency of service delivery and ardently solicit the voice of the patient. “To turn our patient-satisfaction numbers around, we had to go back to the basics,” Dr. Feinberg notes. “We took our mission statement, ‘Delivering leading-edge patient care, research and education,’ and personalized it for staff with a strong emphasis on care delivery. Specifically, we redesigned our vision statement to say ‘Healing humankind, one patient at a time, by improving health, alleviating suffering and delivering acts of kindness.’” By linking that vision to UCLA’s underlying values of integrity, compassion, respect, teamwork, excellence and discovery, “we built a framework to solicit staff’s commitment to caring.”
Providing excellent medical care was never the issue. “We knew we delivered great clinical outcomes and that we are one of the finest healthcare facilities in the world but we needed to be challenged to be, first and foremost, known for our compassion and our relationships with patients and their families,” says Tony Padilla, director of patient affairs and volunteer services. “We have faced and met that challenge by demonstrating unprecedented increases in our satisfaction levels from the 30s to greater-than-95th percentile systemwide.” Those systemwide improvements have led to UCLA being recognized as one of the nation’s top-rated academic medical centers from a patient-satisfaction standpoint. More importantly, they have caused those receiving care, like Rachel Vollmer, to say, “Hospitals are not exactly the most fun place to be … but I actually look forward to going to UCLA when we have post-operative appointments … and I don’t want to think of a world without UCLA Health System.”
UCLA’s turnaround of the patient experience, elevating it to the forefront of the system’s thinking about how it delivers care, is just part of the story that I learned while researching my book about UCLA Health System. The lessons revealed have relevance beyond healthcare. For anyone interested in “serving well” – whether personally or professionally – the experience of UCLA Health System offers an opportunity for insight, renewal and transformation.
Author, public speaker and organizational consultant Joseph A. Michelli, Ph.D., has written extensively about transformative corporate cultures, including Starbucks, Ritz-Carlton Hotel Company and the online retailer Zappos. His book about UCLA Health System, Prescription for Excellence (McGraw-Hill, 320 pages), has just been released. Dr. Michelli is donating proceeds from the book to benefit UCLA’s Operation Mend.