'We've always wanted to fix that'

Saint Thomas CXO Dawn Rudolph connects operational decisions with patient experience

As patient experience becomes increasingly important to health systems, many hospitals have added a new position to their C-Suite —that of chief experience officer.

The emergence of the role, abbreviated with the distinctive CXO, comes at a key time within the industry’s evolution.

By focusing on how executive decisions affect patient perception of the hospital, chief experience officers are adding a new dynamic to streamlining care.

Dawn Rudolph knows that dynamic well. The former CEO of what is now known as Saint Thomas West Hospital assumed the more system-wide and strategic role of CXO with Saint Thomas Health in July 2013. A year later, Rudolph realizes a pleasant smile and a nice demeanor won't make up for systems that don't work. So as she enters her second year on the job, Rudolph continues to take a hard look at why Saint Thomas operates the way it does.

"Sometimes the response is 'We've always done it that way,' and the hair would go up on the back of  my neck," she says. "If it's important, we need to know why we're doing it like that. And in this new role, I'm hearing, 'You know, Dawn, we've always wanted to fix that.'"

Rudolph says that as the Affordable Care Act changes health care, it is important to maintain an elevated patient experience, despite the whirlwind of reimbursement, staffing and priority shifts. Hospitals are doing more with less, she says, but executives can't let budget cuts affect the patient's perception of care.

The first things Rudolph evaluated after becoming CXO were accessing and navigating services, the efficacy of discharge orders, reducing wait times and coordinating the continuum of care. From redesigning the patient access strategy to making sure prescription information is clear and easy to follow, Rudolph is attempting to create a sense of flow between the different pieces of the health care puzzle.

"The patient experience arm of the health care system is about augmenting all the other wonderful systems that are already going on," Rudolph says. "We have quality and safety and physician engagement, but is it contributing to the overall patient experience? That's the piece that links all the different interactions."

Being a successful CXO requires approaching every scenario from the patient's perspective, which can be a difficult task for someone who has spent years immersed in a system. From discharge orders to parking directions, hospitals are easy to navigate for those who work in one every day. But for patients who haven't stepped inside one in decades, hospitals can be confusing and intimidating. Patient value, Rudolph says, comes from navigating a health care experience as a partner.

Rudolph seeks to turn patient feedback into action-based initiatives. Her operational background as a hospital administrator and, later, as a CEO is crucial, she says, in giving her a nuanced perspective on the cause-and-effect relationship between executive decisions and patient experience.

"I've always loved hospital operations and the complex environment of different skills and stakeholders," she says. "It's just another way of trying to connect the dots. Everyone is doing good work, and how it all pulls together for the patient is where I try to sit."

Rudolph’s background allows her to look at patient experience decisions through the executive lens — How will we pay for it? How will we make it work? Is it valuable? — and get those assessments to the right executive to make operational shifts.

A main priority is connecting the outpatient experience with the inpatient experience. When patients visit their primary care physician or a specialist, Rudolph wants scheduling additional testing or surgery and transitioning to inpatient care to be as easy as possible.

"We have a responsibility there," Rudolph says. "The transition and connectedness is very important to me, because that's where people feel disconnected from their health care. ‘Why didn't my doctor know about what happened in the hospital?’ The data and records become very important."

Another focus is on improving the physician experience by recognizing the impact it has on patients. For Saint Thomas, it is important that providers feel that they're delivering exceptional care — because they are, Rudolph says. And when executives value the important work of providers, it improves the total patient experience.

"I keep my pulse on getting them more time to be healing. There is incredible work being done to redesign workflow and getting our providers back to the bedside," she says. "We in the health care industry are also in the service industry. We’re here to serve."