The patient's experience is key, but ... what about the professionals?

Anna Sant

Undoubtedly today we notice the relationship between the patient's experience and that of the professional. Although we often pay more attention to the former, both are equally important, and their improvement is essential to achieve satisfactory results.

This reflection is more pertinent because we work in healthcare organizations that aim to improve and/or reorganize the way they relate to their patients. Although we have long talked about the evolution of the Triple Aim concept of healthcare (better health outcomes, lower costs, better patient care) to that of the Quadruple Aim, adding the fourth dimension of the professional experience, we continue in operating patient experience and professional experience programs independently. Normally, the first led by the patient care area and the second by human resources or medical and nursing management.

A patient will not be involved in her treatment and in her health if the professionals who take care of her are not also involved in it. Likewise, a professional will not be committed to her work if she doesn’t have the possibility of providing safe, quality and humane medicine to her patients.

In a healthcare context such as the current one, with limited resources, excessive bureaucracy and clinical data recording to feed the needs of big data - besides the growing trend towards over-specialization - the human dimension of care has the most staying power. Paradoxically, it’s precisely this human dimension that faster connects doctors with patients and with the vocation that guided them towards the medical profession.

Coordination of projects to improve the experience of patients and professionals

It’s difficult to tackle two major transformation projects and even less if they occur in a complex organizational environment such as a hospital. However, it’s imperative to coordinate patient experience and professional experience programs to ensure that there is no duplication of work, that frustration among professionals is not generated and that we don’t miss opportunities to create synergies.

As an example, and returning to the beginning of this reflection, the realization of multi-disciplinary creative workshops, designed to detect opportunities for improvement in the experience of our patients, has a much more direct effect, in the short term, on professionals than it does on patients. In these sessions, professionals obtain key information for their day-to-day (people that did not know about the team, protocols or indicators they had overlooked, projects they had never heard of, other visions of the same incidence) and so on. They realize that "I am not the only one in the organization that has problems." Giving voice, method and defining joint workspaces for different professional profiles dedicated to the same cause is to offer a solution generator for everyone.

Hospital organizations continue to be, due to their size and type of activity, organized structures that are excessively hierarchical and fragmented, so decision-making is very separate from daily clinical actions.

It’s essential to grant more autonomy to the teams that directly relate to the patient, reinforce cross-sectional communication and promote area managers in the daily activity of services and care areas.

The seven factors that most determine the professionals' experience

The key drivers of engagement and burnout at the Mayo Clinic Proceedings* are very inspiring in this field. The recipe for avoiding exhaustion, cynicism, inefficiency (burnout) of clinical professionals, and promoting energy, dedication and involvement (engagement), goes through seven key items.

*Mayo Clinic Proceedings, Vol. 92 Issue 1, Shanafelt, T., Noseworthy, J.H., Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout, Pages No. 129-146, Copyright (2017), with permission from Elsevier.

• Efficiency and resources: the inefficiency of the processes or the lack of organizational instruments to work with a guarantee on the quality and safety of the patient (little integration of computer systems, excessive demand for clinical data, administrative bureaucracy, saturated agendas, underfed plants, spaces dead in operating rooms, among others, without forgetting the lack of time with patients).
• Workload: the "feeling" of excessive workload, which may be because of saturation of demand caused by free access to services, but also because of poor standardization of processes, causing inefficient activity flows.
• Culture and values of the organization: on paper, organizations seem to have a clear idea of what they want to achieve and where to go - mission, vision and values, strategic plans, aim tables - but on occasions, they lack the methodology to implement it in a way efficient.
• Sense of the profession (in the centre of the graph): professionals have their vocation and are aware of the personal motivations that led them to it, but they need to 'refresh' them with projects that motivate them and leaders who support them in their development.
• Social and community support: professionals need to work more as team, more humane treatment between professionals and patients and more connection with the actual needs of patients.
• Control and flexibility: professionals cry out for more management autonomy to lead projects that connect with their day-to-day needs and need their leaders to support them to counter immobile professionals and generate favourable contexts for change.
• And work-life balance: easier to balance profession and personal life.

In short, we must approach the patient experience and the employee experience from a joint global perspective, so that patients, clinical, technical and administrative professionals interact positively to improve their well-being. And also so that health organizations can modernize their processes and flatten their structures.