The Path to Better Care

Setting the Standard for Engaging and Activating Patients

A few months ago, I was named medical director of a brand new patient experience department for a highly regarded hospital system. I’ve worked there for a dozen years and have always been proud of the medical care we deliver. Staff members across all disciplines pour their hearts into their work. Still, like many others, we expect higher CAHPS scores. When patient perception of quality is low, the common denominator always seems to be a missed opportunity for better communication. So, I look at my new role as primarily helping to improve our staff’s ability to engage and educate patients and families.


Striving for Activated Patients

Activating PatientsAs I read more on the topic of patient experience, I learned about patient activation, a central concept in consumer-driven, value-based healthcare. An “activated” patient is one that is well informed, motivated and actively engaged in improving personal health. In fact, this is the basis for our hospital system’s new Healthy Driven focus. Patients require the knowledge and thereby the confidence necessary to do the right thing. Moreover, they must remain motivated despite any setbacks. Research demonstrates that patient activation bridges ideal treatment plans with ideal health outcomes.


Joe’s Story

As an emergency physician, I frequently recommend that patients quit bad habits. Whenever time allows, I explain in detail the typical health trajectory without reformation, which is never good. One day a guy on the street walked up to me and introduced himself as Joe. He reminded me that he was once my patient. Joe had quickly escalated from prescription narcotics to heroin and, minutes before I met him, the paramedics had to administer Narcan to get him breathing. He reminded me that I sat down and explained why opiates are so addictive and what often happens to users. Joe paid attention because I did not judge him for making bad decisions and convincingly explained that he was the only one that could pull himself out of the steep descent. That was the last time he used heroin. That day, the second time I met Joe, my professional inspiration soared.

Transforming the Current Reality

When faced with the challenge of improving patient satisfaction scores, many begin by reviewing the institution’s mission, vision and values. However, no matter how wonderful these statements sound, current culture is reality. To achieve our goals and principles, some degree of cultural transformation is always necessary. Such change management begins with understanding the current state, identifying opportunities and filling gaps, one by one. Change innovators must recruit early adopters who are like-minded and will change the majority over time. The focus is on what seeds are planted, and when and where – not on the harvest.


The Cornerstone of Patient Activation

Communication is the cornerstone of patient activation. It is less about clinching the diagnosis or prescribing the latest medication and much more about establishing trust so that patients become receptive learners. Trust is built upon honesty, respect for patient autonomy and compassion.


Setting a New Standard

Our patient experience department is working hard to develop a set of service standards that we hope will enhance the way patients perceive us. We plan to distill the key components of a communication framework that will work across all service lines – nurses, physicians, technicians, valets, food service staff, housekeeping, registration, public safety … everyone! All of us are care providers and by working well together we become a winning team.


Editor’s Note: Watch for Part II of this blog post in the fall when Dr.Scaletta returns to share details of the communication framework he and his team are creating to improve patient engagement at every touch point.


Tom Scaletta, M.D. Dr. Tom Scaletta is board certified in both emergency medicine and clinical informatics. He is the medical director of patient experience and the emergency department chair at Edward-Elmhurst Healthcare (, past president of the American Academy of Emergency Medicine and a national speaker on emergency department operations and patient satisfaction. Tom designed a computerized patient communication system praised by the Robert Wood Johnson Foundation and Urgent Matters (George Washington University).

Tom Scaletta, M.D. has 6 post(s) at

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