Swimming with Alligators: More Misconceptions in Patient Experience


I was recently asked “How long should healthcare organizations allow to effectively integrate a strong patient experience program across the organization? Where is the common denominator (if there is one) regarding expectations about the timeline?”

Recently I was in a meeting discussing patient experience goals and performance improvement, and someone described their challenges achieving their goals and focusing on improvement by exclaiming, “We’re swimming in alligators here!”

I thought that comment was such a vivid picture of the pressure and fear that some leaders feel when facing their goals and the expectations of their board, staff, and community regarding patient experience. I was so taken with this image and the panic that I’d have if I was truly swimming with alligators, that I did a bit of research on what to do if you find yourself in such a situation. Here’s what I learned:

“If you fall into water where crocodilians [alligators and crocodiles] live, remain calm. Splashing around and shouting attracts attention from crocodilians and may incite them to attack. Swim or wade to the shore as quickly, quietly and calmly as you can, preferably staying below the water’s surface to avoid splashing.”

It’s exactly the opposite of what our natural reaction would be in this situation, right? Well, I think the same thing is true of our work in patient experience. When leadership is panicked, pressured, and reactive, it leads to communication and direction to the physicians and staff that is frantic, fragmented, and shotgun. Rarely do those types of leaders sustain the improvement in patient experience that they are striving to achieve. On the other hand, when those leading this journey can take the time to step back and truly define where they want to go (and why), and articulate that to the organization, then the improvement strategies can be aligned with the vision and transformational success can be achieved.

So, back to my answer to the original question: how long does it take? Well, in working with various health systems across the country, I have seen many struggle to get their patient experience efforts going in less than 18 months. That’s not something that executives like to hear when they want the data to improve yesterday!  But, realistically, to get the right people in place, to set up an effective steering structure, and to adequately communicate throughout the organization to ensure buy-in, it takes time.

Often, there is training or coaching component to make this happen, that can influence this timeline as well. Our team helps organizations to reduce this timeline by extending the internal team in getting things going.

Plus, I believe it takes time to get beyond the “this too shall pass” or “this is just the flavor of the month” attitudes among some staff and physicians that often surface in response to a new patient experience effort.

Now, if there is already a structure in place and only a few refinements are needed to current strategies, the timeline is usually compressed. For example, we recently completed a rapid-fire assessment for an organization in about 6 to 8 weeks. This produced for them a comprehensive road map with immediate (“just do it” 1-3 months), short term (3-6 months), and long-term (6-18 month) recommendations.

No one likes the “go slow to go fast” mentality but in patient experience that can definitely hold true. Organizations who have succeeded in this work ultimately take the time to be thoughtful and plan out their strategy such that they can realize long-term gains.

Stay tuned next time when we’ll look at another misconception in patient experience related to …. Data!





Janiece Gray

I began my career as a social worker and later, with my Master of Health Administration (MHA), directed operations at Allina Health in Minnesota. I later directed patient experience at Allina. My background and experience give me strengths in approaching healthcare opportunities and challenges through a systems lens – with unique strengths, challenges and activation points. My experience is also informed by leadership roles leading performance improvement in patient-centered care and patient experience departments. Working in the client role with healthcare consulting firms inspired me to address some unmet needs in the industry, and to co-found DTA Healthcare Solutions. I have a Lean Six Sigma Black Belt, and find that the discipline of practice translates to healthcare work very well.

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