Leveraging Competency as A Cultural Transformation, Sustainment & Accountability Method

By The SHSMD Team posted 07-25-2017 11:43 AM

When we think of human connection, not many people think about our doctors, but we should. The stereotype of the doctor is of someone with a stoic expression wearing a white coat and reading our information off a clipboard – not exactly an image that invites intimacy. Likewise, nurses and CNA’s can be overworked, making them short with patients as they try to complete all their tasks before the end of their shift. It’s no wonder people say they hate hospitals and continue to lie to their doctors about what they’re really doing, eating, and experiencing.

But if people aren’t honest with their doctors, they can’t get the care they need. Northwell Health identified this problem with their patient experiences and they decided change needed to start with them.

But that’s easier said than done. As a large, integrated organization of more than 61,000 caregivers, 21 hospitals and more than 550 physician practices, creating a unified patient experience throughout the healthcare company was not going to be easy.

“Every single interaction that you have with a person who comes to us for some kind of care is a moment of truth,” said Michael Dowling, President and Chief Executive Officer, Northwell Health.

Where To Begin
They started by creating a new role: Chief Experience Officer. They hired Sven Gierlinger, who had worked for The Ritz-Carlton Hotel Company and had also had his own patient experience when battling Guillain-Barre Syndrome.

The solution Gierlinger came up with was based on four main components: culture, care delivery, hospitality, and accountability. He also co-led the Leadership Rally at Madison Square Garden Theatre in New York, where more than 4,500 Northwell leaders gathered to discuss the organization’s commitment to improving the patient experience.

C.A.R.E. and The OPCE
It was also at the Leadership Rally that Gierlinger unveiled the framework of the organization-wide cultural transformation: C.A.R.E. © The acronym stands for Connectedness, Awareness, Respect, and Empathy.

The newly-formed Office of Patient and Customer Experience (OPCE) led an initial discovery phase, which revealed inconsistencies throughout Northwell Health regarding resources, ownership, scope, and accountability related to the patient experience. In order to address these inconsistencies, the OPCE created a new role: Culture Leader. Today there are 55 Culture Leaders, all of whom are responsible for executing the overarching patient and customer experience strategy by collaborating with local stakeholders. Culture Leaders all report to their site or service line’s executive director.

Creating Objective Measurements
The challenge is the patient experience is almost entirely subjective. Everyone has a different idea of what constitutes a good interaction based on past experiences, assumptions, relationships, and cultural influences. The OPCE collaborated with colleagues in behavioral health, human resources, and nursing to create competency tools to measure how their communication and service recovery models are embedded into care delivery.

Once their new policies had been designed, the next step was to educate the staff. The OPCE spent more than a year rolling out their educational program, consisting of class sizes of 20-25 students, in which interdisciplinary teams shared their personal stories and experiences and related the Northwell Health unique communication model, practiced service recovery techniques, and focused on selfcare and appreciation. It was a two-hour class that used a cascade approach across leadership, physicians, staff, and volunteers. To date, more than 55,000 Northwell employees have participated in this program and the feedback has been overwhelmingly positive.

Maintain Momentum
That leaves one question: How do they maintain these initiatives after the initial educational roll-out? The answer has been a holistic approach consisting of new policy, focus on competency, new employee orientation, continual development of Culture Leaders, patient experience strategic planning, patient story libraries and weekly huddle messages.

The new roles of Chief Experience Officer and Culture Leaders will become part of the future based on the need to offer a better patient experience.

Since its implementation, employee engagement at Northwell Health has gone from the 45th percentile in 2014, to the 68th percentile in 2016, before increasing still further to the 85th percentile in 2017. Physician engagement saw a similar improvement, going from the 27th percentile in 2014 to 59th percentile in 2017. Likewise, the HCAHPS nurse communication domain has gone up 23 percentile ranks. In 2016, 91 of Northwell’s 550+ physician practice sites scored in the 90th percentile for patient experience. These rising percentiles demonstrate the marked difference in Northwell Health’s transformation.
It’s not a destination or protocol only. We are always striving to exceed patient expectations.

For more information on leveraging your skills to stay ahead, visit

By Sven Gierlinger | Posted July 25
Chief Experience Officer
Northwell Health