Customer delight is not just customer satisfaction. It is to consistently exceed the expectations of your customer. We, CustomersFirst Now (CFN) are in the business of being the source for end-to-end customer delight. We offer a roadmap, CFN Solution Framework for our clients to increasingly delight their customers. CFN Solution Framework is agnostic to the industry or geography.

When we are working with our health care customer, we encounter a dramatically unique industry. This brings out unique flavor when we offer the CFN solution framework. Indeed, health care is a unique industry. This is primarily because of the diversities and complications that exists in this industry across various dimensions: care delivery models, stakeholders, geography, regulations, payment models and many more. Moreover, it is unique by how you define success in this industry, which should be very obvious. Needless to say, health care industry is challenging.

This article talks about customer delight in US health care industry. And more specifically how US health care industry is addressing customer delight, more specifically patient delight, in the wake of changes brought in by 2010 Affordable Care Act (ACA). We also prescribe a CX solution on how you could move forward to ride this wave of change.

What has happened post ACA?

First, let us start with asking the question. Who is the end customer here? Is it the patient? The physician? The hospital? The payor? I have heard this in several major conferences and discussed numerous times with my colleagues and medical professionals. With the exception of the past few years, post ACA, the end customer was not the patient. We don’t think this should be a surprise. Who decides which policy patient can buy and from which payor? Who decides which drug will be administered? It was insurance companies kowtowing the employers or pharmaceutical companies with the physicians. However, post ACA there has been a disruptive change in US healthcare industry. The wake-up call was when reimbursement and payment model (Value based purchasing model) has become patient outcome driven; 70% of which are clinical outcome drivers and 30% are patient satisfaction drivers. What is patient’s perception of quality of healthcare has thus become a major driver now? And the government has mandated the health care providers to evaluate this through an industry wide standardized patient survey called Hospital Consumer Assessment of Health Care Provider and System, HCAHPS. Thus the major change: health care industry has become increasingly patient-centric and moved from an overtly B2B mapping model to a dominantly B2C mapping model.

The Challenge

Well the change is here to stay, whether we like it or not. The question is whether health care industry is ready for this change. Reality is 50% of hospitals will be receiving less reimbursement based on this new payment model, Value Purchasing Model. With the growing focus on HCAHPS survey, some of the patient centric questions you may ask: What drives my patient experience? Where do I stand in patient delight? Where are the pain points in my interactions with my patients? Which pain points I can address immediately? These are all really interesting questions and must be addressed, but there is a bigger question.

We find this quote from the visionary, Hunter Patch Adams from the movie very apt, “You treat a disease, you win, you lose. You treat a person, I guarantee you, you’ll win, no matter what the outcome”. Very patient centric! The big question… where the industry is when it comes to this mindset.

The Beryl Institute, a global think tank in patient experience defines patient experience as the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care. In its annual survey, The State of Patient Experience 2015, they have identified the following top 3 roadblocks or I will call opportunities for the health care industry in executing a successful customer experience: #1-Other organizational priorities reduce emphasis on PX, #2-General cultural resistance to doing things di­fferently and #3-PX leaders are pulled in too many other directions. All these roadblocks point to a certain mindset, patient centricity for the sake of patient.

Value based purchasing model is definitely a carrot stick that motivates all health care providers. As ratings under HCAHPS driving reimbursement has exposed to the harsh realities, patient experience has become a huge focus. However, it is exposing the key stakeholders to the impacts made by stories of successful patient experience initiatives that creates Patient Experience that sticks. This is about you to Inspire and to be Inspired. The other side of the coin which should be equally addressed is tying customer delight with financial outcome. This is about you to Act.

You to Inspire and to be Inspired

How do we inspire a patient centric culture? A good story inspires. It is these value-in-action stories and vision-stories which motivates and help overcome change resistance.

This is a powerful patient experience story, which happened in Mayo Clinic. It also shows the power of storytelling. Storytelling continues in the workplace because, once people are away from the classroom, the idea of putting the patient first can seem distant and sometimes even unrealistic, given the stress and unpredictability of day-to-day work. Consider, for instance, one story featured at several orientation sessions and widely disseminated throughout the organization. A critically ill patient was admitted to the Scottsdale hospital shortly before her daughter was to be married, and she was unlikely to live to see the wedding. The bride told the hospital chaplain how much she wanted her mother to participate in the ceremony, and he conveyed this to the critical care manager. Within hours, the hospital atrium was transformed for the wedding service, complete with flowers, balloons, and confetti. Staff members provided a cake, and nurses arranged the patient’s hair and makeup, dressed her, and wheeled her bed to the atrium. A volunteer played the piano and the chaplain performed the service. On every floor, hospital staff and visiting family and friends ringed the atrium balconies, ‘like angels from above’, to quote the bride. The wedding scene provided not only evidence of caring to the patient and her family but also a strong reminder to the staff that the patient’s needs come first. They got the message: We heard the story again and again in our interviews with employees.

Lilly Diabetes launched new Disney book called ‘Go, Team Coco’ for families affected by Type 1 diabetes, which is about a fun-loving monkey who has type 1 diabetes. The readers will learn about how Coco and her family cope with her diagnosis at the hospital, the new routines they establish at home, and her first follow-up visit to the doctor. Coco, along with other Disney characters, helps readers understand that with proper planning and management, children with diabetes and their families can still have fun and do things that children without the condition can do.

You to Act

Now, inspiration needs direction. What do we do? CFN recommends 20 best practices that ties patient delight to financial outcome. This has been sure recipe of success for creating a customer experience that sticks. In this article, we have selected some of the best practices and summarized as below. A detailed narrative can be saved for future.

  1. Define who our customers were and then listen to them is highly critical. In a healthcare provider setting, there can be multiple personas: inpatient, outpatient and emergency department patients, family members, referral doctors etc. and defining the customer can be more challenging. The most widely used platform for listening to customers in hospitals is HCAHPS. The Chief Patient Experience Officer at John Hopkins says, “We use different versions of the CAHPS survey. We do lots of measurement. We also use patient letters, patient comments to advisory committees – if we have grievances we learn from grievances – and we learn from observation. How you hear the voice of the patient has to be many-faceted.”
  2. Act to make improvements in products, processes, and systems that mattered to our customers.
    For instance, quietness of the hospital environment has been consistently scoring very low in Cleveland Clinic and triggered numerous initiatives across the hospital network. Cleveland Clinic implemented enterprise-wide “Quiet at Night” improvement team created guidelines, including H.U.S.H. (Help Us Support Healing) protocol, to reduce nighttime noise, which has been very successful and took the hospital on par with the industry standards.
  3. Communicate those improvements to both customers and colleagues ensured that we received value for our actions.
  4. Reward the colleagues who delivered the improvements, actively listened and responded to customers, and lived the company’s values. For instance, Mayo Clinic in its 7-prong approach to deliver quality patient experience has implemented recognition and reward of service achievement through programs like Star ratings, Thank you grams, etc. In addition, positive patient comments were shared via group emails, and employees identified by patients were recognized for providing excellent service.

To summarize, this is time to respond as the change in the US health care industry is here to stay. To begin with, bringing a radical change in the culture… a patient centric culture. We recommend you to be inspired and to keep inspiring your colleagues and this may require you to become great story tellers. This has to be complemented by acting and adopting best practices in customer experience.

Would you like to know where you stand on par with your competitors in customer experience?

Try our best practices assessment which takes about 10 minutes. We will come back with your CFN Rating, the customer delight rating which will show you how your organization ranks by industry, company size and by our overall database. It will give you a perspective of how you are doing against some of these elements.

HCAHPS 2015 score

Note: Indicated scores next to states represent overall hospital rating by state on 1-100 scale. While average US rating stands at 71, you will be able to realize which states are performing above average and below average.


CustomersFirst Now (CFN) has been refining our CX solutions for more than 40 years – working with and for many Fortune 100 companies. We provide the only proven, predictive process that links Customer Delight to financial performance by incorporating and measuring CX Best Practices across all key business disciplines. For more information contact Amit Garg, Data Science Leader, at

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