Why Does Healthcare Miss The Mark When Improving Patient Experience?

A Canadian news program conducted a lengthy (9 month) investigation into the quality of Canadian hospitals.

The investigation's measure of quality was based on a series of performance metrics such as ER wait times, mortality rates, and hospital-contracted infections.

While some of the findings and conclusions were dubious at best, one fact became apparent...in healthcare, nothing affects patient experience and the quality of their care more than the health of employee relationships...both with management and with patients. (*Note, even if you don't work in healthcare, this principle is the same for all industries...just replace "patient" with "customer".)


In healthcare, whether privately or publicly funded, two phrases of choice (one external and one internal) are regularly referred to when justifying the quality of patient care. The phrase provided externally to the public, media, etc., is "resources". The phrase used internally by management and non-management employees is "capacity".

When healthcare representatives are asked why the quality of patient care is as it is, the stock answer provided is "resources"; or "we don't have the resources"; and "lack of resources".

While "resources" can mean any number of things, it is most often used to describe people, equipment, or money (which ultimately translates into people and equipment). 

When discussing employee performance internally as it relates to the quality of patient care, the focus is on "capacity"; or "our department, ward, program, or team lacks sufficient capacity". 

"Capacity" often refers to employee time in their workday. However, it can also include the "resources" previously mentioned.

So, one can only conclude that if the hospital had more employees and more technology, the patient experience would be significantly better...but would it really???

By this definition, the best funded hospitals should also be the ones rated best by patients for quality of care and patient experience...but if the findings of this investigative report are to be believed, this isn't the case.


In fact, when the show revealed its top 10 ranked hospitals in the entire country, almost every single one of them were smaller hospitals.

Not a single one of them were large facilities that had a national reputation for innovation, research, and - ready for this? - funding!

In other words, the theory that patient experience is directly related to availability of employee capacity and resources (both of which the larger hospitals have a larger proportion of) was somewhat discredited.


So, what can explain these results? 

Why are smaller medical centres ranked higher for quality of patient care than the large well-funded centres?

When the evidence presented by the television show is combined with The 2% Factor's experience partnering with healthcare organizations, there is a clear indication that the source of differentiation lies in the health of the workplace relationships.

The strength of the relationships amongst employees, between employees and administrators, and between employees and patients seems to be a primary reason that smaller healthcare providers rank better overall for quality of care.

How can this be?

How can the relationship between front-line workers, support workers, administrators, and patients (including their families) positively affect ER wait times, mortality rates, and the spread of infectious diseases?


Looking at ER wait times first, it should be no surprise that the ability of medical staff to work collaboratively with support workers and management will have a greater impact on wait times than almost any other factor. 

Healthy workplace relationships mean better communication and fewer mistakes being made because of miscommunication.

Things are completed faster as employees are more engaged. When new systems are created and implemented to save time, those responsible for complying do so willingly because they understand, and buy-in to, the reason for the change. 

The positive workplace relationships mean that no employee wants to let their colleagues or their patients down and so they do everything they can every day to be as effective in their role and in the support of their coworkers as possible.  

Positive relationships with patients means that patients feel that staff truly care about them and their well-being and therefore are more tolerant to required wait times.


Believe it or not, the quality of workplace relationships affects the mortality rate, as a measure of quality of patient care, as well.

The reasons for this are very similar to those already mentioned. 

The better employees work together at all levels of the hospital, the faster the response times to emergencies, the more willing staff is to go above and beyond to save lives (no one adopts the "not my job" mentality), the more successful medical staff is in preventing mistakes being made - often from miscommunication, and...when a patient passes away, the more compassionate and caring all staff is to the patient's family (ok - I concede this last point doesn't affect mortality rates but it will play a big part in perceived patient experience).


Lastly, the spread of infectious diseases - or the reduction of this - is also a function of the quality of the relationships between workers and management.

Studies have shown that the number of instances of diseases being spread in a hospital drops significantly when staff's compliance rate to strict hand-washing protocols are adhered to.

To my knowledge, all hospitals have policies in place regarding hand-washing...what is less clear is the number of employees that actually respect these policies each and every moment of the day. 

Excuses such as, "I forgot", or "it wasn't convenient", or "I was in a hurry" no longer come up when the working relationships between management, staff, and patients is completely healthy. 

The reason for this is that employees want to wash their hands. 

A strong relationships implies that employees care a great deal about those around them and therefore will not do anything that could jeopardize or harm others. 

The better the management-staff relationship is, the greater the respect that both groups will have for each other and hospital policies. Simply put, healthy workplace relationships mean that staff will understand the importance of, and be happy to wash their hands to prevent the spread of disease...regardless of inconvenience.  


When hospitals look for solutions to improve the quality of care for patients, the first (and most cost-effective) place they should look is the quality of the relationships between employees of all levels of the organization. 

Patient experience will certainly be affected by more and improved technology, but if the same unpleasant staff are operating that equipment, the patient's perceived level of care will be mediocre at best.

Patients are already scared, worried, and facing uncertainty...and poor relationships between hospital workers will only exasperate that.

Instead, remember the old saying, "no one cares how much you know until they know how much you care" and begin to take note of the smiles on the faces of patients and staff alike.

Often, the first move to improve workplace relationships must be taken by management. However, this can be tough if management can't figure out what it is doing to cause the existing relationship to be as it currently is. To help you figure this out, The 2% Factor is happy to provide you with a complimentary copy of "6 Steps To Blast Past Unhealthy Management Practices".