The impact of the consumer on healthcare delivery.

THE ARTICLES BY Quint Studer and Julie Morath deal with an issue at the heart of healthcare delivery: the experience of the consumer. These two authors address what consumers want and need beyond what is typically measured in healthcare organizations. Both articles stress the importance of trust and patient beliefs about safety. The authors direct leadership attention to an organization's purpose and values, solidly connecting these with consumers' wants and needs. MEASURING CONSUMER SATISFACTION Classic measures of consumer satisfaction can too easily objectify the patient to an age/sex diagnosis-related group or a resource-based relative value scale factor. Truly understanding the consumer's experience, charting the connection to an organization's success, and realizing an impact on healthcare delivery go beyond traditional quality-of-care and service measures. Success in these efforts requires understanding the fundamentals of a business strategy and appreciating the complex challenges of our current healthcare system. It requires, as both lead articles suggest, a willingness to see beyond statistics to understand the stories and the intangible benefits of a positive experience. REDEFINING PATIENT SAFETY We have an opportunity to recast the current conversations about control, demands, and patient safety in this deeper understanding of the consumer experience. Morath speaks to issues of control and the power of true partnership in healthcare with reference to "nothing about me without me" (Delbanco et al. 2001) and Dr. Don Berwick's theory of abundance (Batalden 2002). We see ourselves as being responsible for creating patient partnerships in every element of healthcare, and we are challenged daily with new ways of doing this at a time when technologies and access to information continue to expand. Our role as healthcare leaders is not simply to perform better, but to do so while being increasingly accountable to our consumers. The Morath article is especially helpful in redefining patient safety as an issue of consumer experience-one that promotes trust, protection, and well-being. This approach offers much promise for the healthcare organization traditionally focused on safety and quality issues. Since the release of the Institute of Medicine (2000) report, To Err Is Human, the quantity of patient safety literature has increased, but it is still too narrowly defined. My congratulations to Morath for taking this key concept deeper into a comprehensive review of how and why it matters to patients. UNDERSTANDING THE POWER OF INTANGIBLES Both authors discuss the importance of intangibles-the small actions and interactions that matter to consumers and staff in seemingly disproportionate measure. Studer notes the impact of such efforts as nurse leader rounding to recognize staff performance, hear patients' concerns, and facilitate solutions. Morath describes focus groups with families to construct "promises" for safety efforts that clinicians will commit to. Both authors stress the importance of working with staff to build commitment and ownership for an environment that is focused on improvement and service. Understanding the power of these connections between patients and providers is key to changing and sustaining an environment focused on the consumer experience. CONSUMERS AS PARTNERS IN HEALTHCARE We are at a unique point in time. Today's consumers are savvy and vocal. They have easy access to huge quantities of web-based medical and quasi-medical information, advocacy groups, and other resources. Consumers want more control, and they want more choice. They increasingly want to be partners in their healthcare and are looking for physicians who can help them navigate the confusing elements of our system. I have the privilege of commenting on the consumer experience from the best possible vantage point-as president and chief executive officer of an organization that has this consumer experience as part of its "DNA. …