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The Journey of Two CEO’s to Drive Patient Experience Scores Via a “Next-Gen” Approach that Capitalizes on Accountability & Throughput


Understanding What Patient Experience Is

Patient satisfaction is not a cut and dry determinant. It’s often based on a patient’s expectations as well as the customer experience they’ve received in other aspects of their life. While healthcare organizations are comparing themselves to their peers, patients have no idea what the hospital in the next county is doing. Instead, they are comparing the experience they receive from a healthcare provider to other businesses.

Thanks to companies like Nordstrom, CostCo and Amazon, healthcare organizations need to keep in mind that patients and their families are consumers when they walk through the door. And more importantly, they are Facebook posting, tweeting consumers comparing everything in their path to other experiences they, their family and their friends have had with other businesses.

So how do you convince patients that assuming there should be more jelly on their PB and J does not warrant a poor satisfaction rating on their survey for the care they received?

You must engage your organization from top to bottom in the goal of delivering a great patient experience by focusing on key strategic areas that drive the improvement of patient experience scores. This next-gen focus on patient experience goes beyond attitudinal changes alone, to creating an environment that focuses on responsiveness to patients and their families.

The Impact of the Affordable Care Act on the Business of Healthcare

A key action of the Affordable Care Act is the use of HCAHPS, which introduces additional outcome measures that are based on a variety of performance factors. These factors are scored and weighted to come up with a Total Performance Score (TPS):

  • Clinical process: 20 percent
  • Patient experience: 30 percent
  • Outcomes: 30 percent
  • Effi ciency: 20 percent

With every hospital in the country now focused on patient experience, even high scores might be in danger from the competition. What if you could improve patient experience while affecting the other three domains? The reality is you can if you use Caldwell Butler’s 100 Day Workouts.


CBA has been infl uencing the patient experience scores for over 15 years by ensuring continuity and sustainable work through leadership coaching and driving accountability. Today we’ll focus on three healthcare organizations who teamed up with CBA to design a system that included proven methods for increasing focus, accountability, speed and inter-departmental collaboration while producing tangible customer satisfaction scores and heightened patient experience.

Henry Ford Hospital West Bloomfi eld

West Bloomfi eld is part of the larger Henry Ford healthcare system located in a very competitive market. The new CEO was faced with a new facility that had a $7M loss the fi rst year. They needed tremendous turnaround to close the budget gaps and to move at a faster pace to impact the change they were not receiving from internal PI structures.

Hill Country Memorial

Hill Country Memorial had won the Baldrige award for the highest patient satisfaction scores in the country. However, they lacked consistent processes for hard-wiring changes. They needed to build on the effi ciency skillsets and accountability of their middle management team to be a continued, top performer in all categories and expand their profi t margins. There were also concerns that a brand new hospital built on the edge of their service area would overcome patient satisfaction and be deemed better because it was new.

Solution Applied

To boost patient experience, the focus is on throughput and engaging everyone in the organization to facilitate change. With CBA’s 100 Day Workouts, any organization has the structure to move metrics forward. Added to that, CBA’s expert team is there to help along the way, providing custom-tailored guidance to solve specifi c challenges that come up for each organization.

Patient Experience is still a waste workout!

  • Redefi ning quality with LEAN concepts targets all areas that do not meet “customer” expectations
  • Any patient experience that does not “always” meet expectations is an opportunity for improvement
  • All 100 Day Workouts require each leader to drive at least two (2) changes per month that address each of those opportunities


While specifi c fi nancial metrics may not always be directly tied to patient experience, the results can be measured in other ways, including in patient satisfaction scores. Everyone can infl uence patient or customer experience regardless of their department.

Hill Country Memorial won the Baldrige Award for the highest patient experience scores in the country. Henry Ford at West Bloomfi eld had also won the Baldrige Award for creating a model in which a new hospital was built from scratch with the active involvement of the community.

There’s a transformational, cultural shift after 1-2 workouts - a signifi cant improvement in how department leaders work together to accomplish goals.

A 100 Day Workout structure boosts collaboration – gets directors working with people they might not have ever worked with – as they focus on broader goals of the organization.

Key Learnings:

  • Must focus on care through the patient’s eyes
  • Doing something is almost always better than doing nothing
  • Front-line staff often know the answer, don’t forget to ask
  • Care experience improvements take more than attitudinal adjustments
  • Keep looking, you will fi nd an opportunity
  • Change is the only constant

Key Results for Henry Ford West Bloomfi eld Hospital:

100-Day Workout 1: Quality Waste Recovery – Directors and Physician Leaders

Henry Ford West Bloomfi eld has completed four 100 Day Workouts to date. These include Patient Experience, Waste, IQS and LEAP Quality Management which focuses on leadership development. Despite changing their CFO and fi nance, they were still able to accomplish $1.62M in validated savings from these workouts.

Plans Completed for Patient Experience338
Targeted Plans400
Average Plans Per Manager6.76
Plans Completed for All Workouts1,204
Targeted Plans1,600 (that’s a lot!)
Average Plans Per Manager6
Completed changes$6.5M
Validated & budgetized by CFO$1.62M

Key Results for Hill Country Memorial

Hill Country has completed three 100 Day Workouts to date. These include Waste and IQS focused on patient experience, plus a formal patient experience workout.

  • Patient Willingness to Recommend scores have consistently been above 95%for three year’s running for Inpatient, ED, AS and Home Care divisions
  • Workforce Willingness to Recommend Physicians has been at nearly 100% for three year’s running.
Plans Completed for Patient Experience337 (36% above target!)
Targeted Plans248
Average Plans Per Manager10.87 (well above average)
Plans Completed for All Workouts943 (27% above target!)
Targeted Plans744
Average Plans Per Manager10.14 (well above average)
Completed changes$2.5M
Validated & budgetized by CFO$1.8M

Caldwell Butler, LLC

Caldwell Butler is an innovative fi rm specializing in strategic deployment of Lean-Six Sigma resulting in cost position improvement, fi nancial turnarounds, and patient throughput optimization. Caldwell Butler has assisted hundreds of clients increase productivity, maximize patient throughput, and improve patient satisfaction. Our team is exclusively dedicated to healthcare and brings extensive practical experience in hospital operations to each project. Our knowledge of the healthcare environment allows us to implement effective performance improvement programs tailored to the specifi c needs of your organization. Caldwell Butler is the trainer of choice for both the American College of Healthcare Executives and the American Society of Quality. During the past decade, Caldwell Butler has personally trained thousands of senior hospital executives in the effective healthcare application of Lean-Six Sigma.

Unlike traditional consulting fi rms, Caldwell Butler believes on-site mentoring and apprenticing are the most effective methods for achieving sustainable gains in performance. Our on-site programs empower your employees by providing them with the tools to attain new levels of performance. We offer proven techniques and methods for enhancing personal accountability, monitoring progress of initiatives and tracking your ROI on each project. Where most consulting fi rms are satisfi ed with fi nding “identifi ed savings,” Caldwell Butler works along side your team throughout implementation thus providing you with a sustainable process for managing the entire productivity improvement cycle.