CX Pulse Check - March 2025 - Experience Action

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Jeannie Walters (00:10):
Welcome to the Experience Action Podcast.
I'm Jeannie Walters, CEO ofExperience Investigators, and
today is my favorite episode ofthe month.
It's when we get to talk aboutwhat is happening out there in
the real world around customerexperience, employee experience
and, today, patient experienceas well.
And that's because I have avery special co-host with me

(00:32):
today.
Brian Carlson from VanderbiltMedical Center is here with us.
Brian, I'm so happy you're here.
Thanks for being here with me.

Brian Carlson (00:41):
Oh, it's my pleasure.
You know it's such an honor toget an invite and I'm really
excited about this.

Well, I am too, because we've had some fun
conversations on these topics inthe past, so I knew we would
have a good one today.
And, Brian, for those of theaudience who maybe don't know
you, can you give a littleintroduction?

Happy to.
My name is Brian Carlson.
I have the pleasure of servingas Vice President of Patient
Experience for VanderbiltUniversity Medical Center in
Nashville, Tennessee.
My background is HealthcareAdministration, Physician Group
Practice Management, but for thelast 10 years I've had the
distinct honor of serving andleading patient experience at

(01:23):
Vanderbilt and, yeah, I'mlooking forward to discussing
both patient and consumerexperience.
I love the bridge.

So, yes, yes, well, thank you for being here.
And when we talk about kind ofcustomer experience in general,
I think a lot of times whatpeople think about is that B2C
experience, but really thepractices, the best practices
that are out there, the tools,the way we have to tap into
really what are people feelingand thinking, all of that

(01:52):
translates to patient experienceas well, and in the last 20
plus years that has grown in somany different ways as a
discipline as part of differentorganizations, and I know I have
some doctors and healthcareprofessionals in my family and I
know they bring it up to me now.
So that's, it's definitely partof the culture.

(02:14):
Yes, it is, it is good.
So I want to start with a funone.
First of all, it's so hard tokeep up with all the shows that
we're supposed to be watchingbecause it's gotten so bad in my
house that now my husband, thisis true, my husband has a list

(02:34):
because we're watching someshows that it's my husband and I
are watching.
We're watching some shows withone kid.
We're watching some shows thefour of us.
You know it gets very confusing.
So he keeps a list becauseotherwise we sit down and we go
what are we watching again andwhat, what are we supposed to be
watching?
So one of the recommendationswe had recently was a show
called The Pit on HBO, or Iguess it's just called Max now.

(02:56):
So have you seen it?
Brian, have you seen this?

I have, yes, in fact, uh looking forward to
tonight's episode.

So we're we're only two episodes in.

Okay.
I won't do any spoilers.

It grabs you, though, right away.
It does it really is.
You're right there with it.
So in the very first episodethey made some news because of
patient experience and I'm goingto pull up this headline.
But, more importantly than that, there's a caption I want to
show too.
So let me do this, all right.

(03:28):
So the headline is Press GaneyCMO on The Pit: Doctor Report
Cards are Really About Systems.
Now this is from Newsweek.
And, one of my favorite parts ofthis discussion, I guess, is it
shows nNoah Wyle who is playingthe main role, the main

(03:49):
character, and the caption saysin the pilot episode of HBO's
medical drama The Pit, DrMichael "Robbi" Robinavitch,
portrayed by Noah Wyle, I thinkit's wiley or while uh is a
dedicated ER doctor who isreprimanded for his low Press
Ganey patient satisfactionscores, and it's quite a scene
in the actual show.

(04:09):
We noticed right away when thewoman started walking across.
We were like, oh, she's theadministrator, you could tell.
And so basically the idea inthis little exchange was he's an
ER doctor, he's got all thisstuff going on, he's taking care
of people they should bethankful to just be alive, right

(04:30):
.
And she's, of course, saying no,no, do you know how many people
said they would recommend ourhospital and kind of using those
terms that are present in a lotof the surveys that they send
out, and so it was this kind ofclassic conflict of are we just
worried about the satisfactionscores or are we worried about

(04:51):
other things?
And the point that was made inthis article was you know what?
It's never about one doctor,it's never about one thing, it's
about the entire experience,which I totally agree with.
So I'm just curious what didyou think about the show?
What did you think about thisarticle?

Well, you know, first I'm thoroughly enjoying
the show.
I mean all the credit to theproducers, I mean the reality of
it is really very, very good towhat happens.
But I will have to admit thatfirst episode, you know, I think
it was in the first 10 minutesthat came about and and I almost
like I had my jaw just droppedand I had to pause and I'm like,

(05:31):
did they really just say that?
And then I had to rewind andwatch it again and I'll I'll
tell you two visceral reactionsI had right off the bat.
The first was the term patientsatisfaction.
That term is so yesterday, noteven yesterday, years ago, and

(05:52):
we need to move as an industryto stop using that term patient
satisfaction.
I think the second thing thathit me was the assignment of,
you know, Press Ganey patientsatisfaction scores, well
they're not Press Ganey scores,they're your, our patient
experience scores.
So that labeling also issomething that we struggle with,

(06:14):
you know, even even atVanderbilt.
But words matter and how youlabel those things go along a
long way.
So I had those two veryvisceral reactions from right
off the start.
And then I moved into being ahealthcare administrator and
being in patient experience, thewhole approach of it and just
the antagonistic nature of youknow, alerting and, in the

(06:36):
moment, which is appropriate toa degree, but there's a way and
a method that I think is moreproductive to doing that.
So, as you can tell, I was, Iwas triggered by it, just a
little bit.

It was kind of triggering.
I had a funny reaction as wellbecause when they, when I first
heard it, I said oh my gosh, arethey doing this?
Like I, literally, and myfamily, of course, didn't even
know what I was talking about,but it was so, it was so like I
don't know if this is the rightterm, but it was almost like a

(07:09):
little too on the nose.
You know what I mean.
Like it was, it was that bluntobject approach and I totally
agree about the term patientsatisfaction or even customer
satisfaction, like both of those, like get them out of there,
because that is not a realemotion and that isn't something
that we should be looking atfrankly.
So the but the whole idea ofyou know, this is on this one

(07:30):
doctor too, like like this is onyou, the ER, like the whole ER
is on you and and I think thatwas part of the point of the
article too was saying like hey,this is, this is something we
have to tap into this, we haveto understand what our patients
are feeling and what we can dobetter and all those things.
But half the time it's becauseof you know, I'm disappointed

(07:53):
because my bill was incorrect orI'm disappointed because I had
to wait longer than I expectedand it's really not about that
doctor-patient care.
Sometimes it is but it's justit really did strike a chord, I
think with all of us in theexperience business of you know
this is-.

Very much so yeah .

But it's so real, it's so much part of our
world that it made a hit TV show, so we should be celebrating
that.

I mean, there's probably some truth to that as
well.
There's a good side to it, yeah.
It did get some attention.

Exactly, exactly.
So.
I think the whole idea, though,of like managing to the survey
is, you know, unfortunately thatdoes live in some organizations
.
I think that's still happeningin some organizations, but we've
come a long way with that, anda lot of that is around
approaching this in a moreholistic way, about who are the

(08:46):
people we're serving, how can webetter serve them, what does
that mean for our organizationand our employees and everything
else.
So I know that's always beenyour holistic view, so I knew it
would trigger you.

It very much triggered.
But you know it is a signalpoint, it's a message and we
have to take it as such.
It's not the end-all, be-all,it is one data point.
And it can be a very importantdata point to signal, you know,
not only systemic issues butalso individual issues that may

(09:20):
need to be addressed.

That's right.
That's right, and I'm glad youmentioned that, because I like
to also say there's no one magicmetric, right, there's no one
thing that's going to tell you.
Humans are so complex and inhealthcare they're going through
trauma and emotion and allsorts of things, and so thinking
about not just what are theysaying and what is the feedback,

(09:43):
but also how are they behavingand what do we observe, I mean,
there are things that we ashumans do sometimes in stressful
situations and we can't evenrecall our own behavior.
So it's complex, it'scomplicated, but it's yeah.
I just thought, wow, I knew alot of people who were going to

(10:03):
have the same reaction that Idid to that.
So I'm glad that I wasn't alonein that.
And now we're kind of swingingthe pendulum pretty far from
that where, instead of thinkingabout screens and what we watch,
this one I thought wasinteresting it's not exactly

(10:25):
healthcare, but it's more aboutkind of this whole experience
world that we live in and that'sthe idea that Lush, which is,
you know, a retailer, they.
The headline is from MarketingBrew and it's what Lush learned
from three years of being mostlyoffline, and the quote here
says we were very early adoptersin something that felt crazy at
the time and now social mediafeels crazy, and that's from

(10:47):
Jack Constantine, the brand'schief digital officer.
So really their approach was,you know what, let's not really
add to the negativity, let's notparticipate in this.
Let's trust our customers tokind of tell other customers
about how great this is.
And of course, everybodythought they were crazy, but

(11:09):
they're really kind of leaninginto this and now, because it's
I mean, frankly, it's gottenharder to navigate online, it's
gotten more segmented anddivisive and all those things.
Now people are saying, well,maybe this is the way to go,
maybe we need to just put astake in the ground and
communicate with customersdifferently.
So I know social media ishandled differently in many

(11:33):
cases in healthcare, but I'mjust curious what was your take
on this?
Is this something that youthink more brands should lean
into?

Yeah, um, you know.
So I mean, to me, social mediais just another avenue by which
we can communicate each other,but it serves many different
purposes.
It creates community, it cancreate identity and it can also,
you know, be an informationsource and and whatnot, but I

(12:01):
think, you know, we're at astage now where it almost feels
like, you know, I've heard acouple different great quotes
about social media.
There's truth whispered andopinions shouted, and David
Brooks said social media is anillusion of social connection,
judgment everywhere andunderstanding nowhere.

(12:22):
And I think, if you think aboutthat from a brand perspective,
you know you are trying toattract you know people to your
product, to your company, toyour healthcare organization,
but also use it as a way topotentially communicate in this
place.
And you know, we, healthcare isnot as heavy in social media.
Although it's growing, you know, healthcare is usually a little

(12:48):
bit behind the consumer brands.
It's certainly playing anincreasing role in the
healthcare space but we arehaven't entered the area quite
where the consumers are whereit's, you know, it's, it's
everything, you know, everythingis generating through social.
But what we're also having todo is how do we manage what

(13:08):
comes in because, to your point,it feels like it's just another
avenue to communicate with thebrand but also communicate with
a megaphone to let everybodyknow what may be working well
and what may not be working well, and of course we don't want
that image.
So then we have to address thatvoice and acknowledge it and try

(13:29):
to take it offline and dealwith it.
So to me it's another channeland as a company, you have a
choice to make.
You know how many channels doyou want to speak to your
customers through?
And you know, I applaud Lush tosay you know what we think we
can communicate with ourcustomers without having to lean
in, uh, you know, to thesemajor, you know social media

(13:51):
companies.

Yeah well said.
And I think the other thingthat kinda struck me about this
and one of the reasons that itbridged a little bit with
healthcare and patientexperience is because, you know,
in healthcare there are so manyrules and regulations and,
frankly, just concerns aboutprivacy and issues that a lot of
organizations don't have toreally address.
And so one of the ways that Ithink for a long time now, 15
plus years, there have been someprivate communities for people
with, you know, if you identifywith a certain disease or health

(14:28):
condition or something, thereare all these private
communities that are available.
There are things like in-personeducation forums in healthcare
systems, and they really kind ofhave already been leaning into
creating community in differentways.
And I think what Lush is doingis essentially following that
kind of older blueprint wherethey are creating some private

(14:51):
communities.
They're creating some morein-person events and things like
that.
So I do, like you know,everything old is new again, I
saw something about aneighborhood in I think it was
Texas and they said, well,nobody knew their neighbors and
it was all this land, and sothey created a neighborhood

(15:11):
where houses are closer togetherand they have front porches and
they and I was like I literallylive in that neighborhood, but
my neighborhood is, like youknow, more than a hundred years
old outside of Chicago and it'sjust.
But it's that idea of we do ita certain way, we try other
stuff, and then sometimes we goback to what worked originally,
and so I think that might besome of what's happening now,

(15:35):
and so I do think it'sinteresting to watch, and I
think that the only thing thatgives me pause is that when we
create all of these privateareas, we're putting a lot of
pressure on people to find them,to find where they can find
people who can support them, andit's just one more place, right
, like I feel like, okay, I'vegot to check my inbox and Slack

(15:57):
and my social media inboxes andall that.
It's just one more place.
So, yeah, I think we're at aturning point.
I just don't know which wayexactly we're turning.

Yeah, I mean it makes, makes I read something
not too ago, ago you You knowthat we're in the attention
economy.

Yes.

How are you, you know, how are you grabbing
people's, people's attention?
But then we're also, you know,there's the epidemics of
loneliness and whatnot, and, andwe need community.
We need stronger communitiesand social media, and these
platforms do benefit, butthere's a balance to that of
just one more thing that we'reasking people to participate in
and giving them an option and achoice to do it, but as a brand,

(16:37):
as a company, how much can yourely upon that to build the
business?
You know you actually tyingoutcomes to it, like you're
expecting something out of it,versus this is just another
forum in a community that we'rejust trying to create under the
umbrella of you know whatever itis you're going through and
give you access to people youwouldn't otherwise have.

Right, right, yeah, big questions, big
questions.
It's not just about the survey.

It's not just about the survey.
No.

So, speaking of that, speaking of health care
and all of these different ways,you know, one of the things
that I think sometimes it's easyto forget is when we talked
about business and health carein the past, there was a time
where we didn't really askpeople how was your experience

(17:26):
right?
There was a time where this wasnot part of the equation of
success, and I always bring uphow, you know, customer
experience really startedbooming because customers
suddenly had access through theinternet, through social media,
through these different toolsthat they didn't have before to
help their voices be heard, andI think the same thing can be

(17:47):
said about, you know, healthcareand doctor scores and all these
things that didn't reallyhappen in the past.
So when we look back at what'shappened in these industries,
there is this evolution that'skind of happened and I think
we're still in it.
We're still really changingwith the times and everything
else.

(18:07):
This headline is from HealthcareDesign and the headline is how
has Designing for the PatientExperience Evolved in the Last
25 Years?
And so I really startedthinking like, wow, I bet those
first few years, there was somuch resistance to this, right?
Like you know, this isn't theway we've always done it and we

(18:30):
just respect doctors andeverything will be fine, and I
think that now one of the pointsof the article was this is
about so much more than weoriginally thought.
This is about the environment.
This is about lighting choices.
This is about you know, whatdoes the waiting room feel like
when you walk in?
How do you check in digitally?

(18:52):
All of these different things.
And so it really just struck meof kind of how far we've come,
and I know you've been in thebusiness a while, so I'm just
curious, like what are some ofthe changes that you've seen?
What do you see this continuingto evolve to include?

Yeah, I mean I certainly we have, you know,
become more and more thoughtfulin, you know, environment design
, facility design.
You know warm spaces.
You know natural lights andit's not just the, you know, old
hospital ward with you knowfour walls and green walls and

(19:32):
stuff like that.
You know that the environment ispart of the healing process.
I think where I still seeopportunity and the evolution
needing to go is there's so manydifferent layers to that
experience that we have to takein mind in design of the
environment we're creating.
It's not just the patients,it's also the family members.

(19:56):
What's the environment we'recreating for them?
Because, you know,unfortunately, especially in the
hospital setting, some patientsare unconscious, they're in a
bed, they may not even be awareof what's going on, but the
family members and the lovedones are there 24-7 to care for
their family member.
What's their experience withthe environment?
What's the staff's experienceof the environment?

(20:20):
Because we know that the staffexperience directly goes into
the patient's experience.
So how are we designing theirworkplaces to be functional and
efficient and also, you know,warming to them and comfortable,
because that's where they spendthe majority of their time
their, you know, wake days is inthat environment um and then

(20:41):
you also have to keep inconsideration things like, you
know, cleanliness.
How do we design it to keep itclean?
You know, how do we design itto keep it safe from infection
and all all the stuff that hasto go in there?
How do we design it to keep itquiet?
How can we design anenvironment?
Because quiet, restfulness isso important, especially when
you're in the hospital settingyou want to, you're not feeling

(21:02):
well.
Rest is one of the best thingsfor healing, for the body to
heal, but if you're gettingwoken up by noises all over the
place and doors clanging.
So how can we be thoughtful inthat space as well?
And I know many architects andhealthcare designers are trying
to balance all of those things.
Oh, by the way, with all thebalancing of just the needs for

(21:23):
space and all the competingdemands, you know, when you
design a new facility, you'regiven a blank which I've been
involved in and you think, oh,we have plenty of space.
And all of a sudden you knowyou're having to make decisions
about what you have to like cutback on or cut or limit the
space because there's so manycompeting demands of what needs
to go into it.

So Yep, it is.
It is so complex.
And I think the the other thingthat I think we've learned kind
of as a well, I hope we'velearned as a society is that it
isn't just about that, thatinteraction between a doctor and
a patient you know, nurses haveso much to do with the

(22:03):
inpatient experience how cleanyour room is has a real impact
on patient outcomes, likemedical outcomes, right.
So there are so many differentlayers to this and I think one
of the things that I'mencouraged to see is that I
think about, you know, it wasprobably more than 25 years ago
now, but my mom used tovolunteer at a local hospital

(22:27):
and I remember thinking like,what are you doing?
And she was a special edteacher, always, you know, full
of empathy, and so her volunteerrole was to sit in the waiting
room of the ICU and just bethere to talk to families, and
she would bring her needlepointand she's like I would talk to

(22:48):
them if they wanted to, not ifthey, you know.
And I remember when she firsttold me about it she said well,
the nurse said it takes like thenurses can't keep up anymore,
and so they found this need andthey kind of said, ok, well,
we've got a volunteer, let'sfigure this out.
And I thought about that and Iwas like I bet there are so many
little ad hoc moments like thatwhere people were looking at

(23:10):
this and saying this experiencecould be a little better.
We don't have the staffing orthe skills or whatever, and so
all these little things werehappening.
And then 25 years ago, peoplekind of put a name to it and now
we're looking at it moreholistically, just like you
described, and I think that aswe move through, we're going to
find more and more of thoselittle moments where there's a

(23:31):
gap or there's a point offriction or there's something
where we say this could be alittle bit better for the people
we serve.
And we're going to continue tolearn from one another about
that too.

Because, yeah, the other thing we have to
remember there is you know we'vebeen talking here about an
inpatient scenario.
The vast majority of care nowis provided on the outpatient
setting.
Well, that's a different designthat you have to consider.
You know local, is it?
You know proximity, you know,so we decrease.

(24:02):
Is there adequate parking?
Is there good wayfinding tofind it, because the buildings
can be complex?
You know what is the waitingroom environment, you know,
given that there are delays, anddo we keep people, you know,
occupied and you know,entertained as best we can while
they have to, unfortunately,wait?
And then you know, obviously theexam room or the, you know,

(24:24):
outpatient surgery center roomis their comfort and all that
kind of stuff.
So you know, there's equaldemand of design ideas for the
outpatient settings which are,you know, more likely to be
built these days than inpatientbeds and inpatient towers,
although that's happening aswell, and then?
You layer on top of all that.

(24:44):
We have all these old buildings.
How do we refurbish them?

Right.

How do you go in and try to update, which is not
an easy operational plan, totake them offline?
Because you know that haseffects.

Absolutely.

It is a complicated nut to crack.

That was one of the things that struck me about
watching The Pit, was when youfirst see him walk in and you're
like oh this is an old hospital, this is, this is an old
building and it's, you know,they just have to kind of make
do with that space, and I thinkthat's that's part of the
realism of it as well.
Just to your point.
And and then you layer on topof that with this whole idea of
you know when, when people aretalking about outpatient and all

(25:33):
of this, they might needsupport at home, and so they
might need people who areoutside of the healthcare system
.
So how do we ensure thatthey're getting that type of
care and support that they needas well?
So it is, I mean, just full oflayers and different pieces of
the experience, and I think thatbeautifully brings us full

(25:53):
circle.
So well done, Brian.

Well, you navigated that, you guided that.
So well done.

We started with The Pit and we kind of ended
with The Pit, but yeah, it's.
I mean, there is always so muchto talk about when it comes to
patient experience and just theevolution of healthcare as we
know it.
I think there is so much goingon there and I really feel like
in these next few years we'regoing to see even more as we

(26:22):
embrace digital and AI and allthese other tools that are out
there as well.
So you know we'll have to talkagain.
What do you think?

We'll have to.
We will have to talk again If Icould if I could just make one,
one final statement, and thatis just to say that you know
there's a lot that needs to befixed in healthcare.
Don't get me wrong but we dofar more right than we do wrong.
And there are amazing thingslives saved, lives courses

(26:53):
corrected every single day andwe have to keep our focus on the
tremendous and humbling workthat the care you know
physicians, nurses the care theyprovide because they really do,
you know, amazing things insometimes very difficult
situations and, like I said, wedo far more right than we do

(27:15):
wrong.

I'm really glad you said that.
That's a really excellentreminder, and I think it's easy
to focus on things that can gobetter, but, man, when you talk
to people about their bestexperiences, those are life
changing, those are reallypowerful, and that's because of
exactly what you just said thepeople involved and the work

(27:37):
that they're doing and hear hearto all of those people and and
the scientists doing researchand everybody like, let's just,
yeah, throw our digital armsaround them all.
So excellent point.
Thank you for bringing us backto that and just thank you for
being here, Brian.
This was a great conversation,as I knew it would be, and if
people want to reach out orlearn more about you, what's the

(27:59):
best way for them to do that?

Yeah, I mean, I think LinkedIn is the place to
do it.
So you know, follow me orconnect on LinkedIn, and yeah.

Excellent.
Well, we will put that in theshow notes as well, so people
can follow you, because I knowyou also post and share things.
So thank you for doing that.
So, and thank you everybody forbeing here.
As always, we love yourquestions, so don't forget you
can leave me a question ataskjeannievip, and during the
other weeks of the month that'swhat I do I answer your

(28:34):
questions, so don't be shy there.
And if you have ideas for CXPulse Check or anything else, go
ahead and reach out to us atexperienceinvestigatorscom,
where you can also find learningresources, including our CXI
Compass, which can tell youwhere you are on your customer
experience journey and how tocontinue that.
Thanks for being here and we'llsee you next time on the

(28:55):
Experience Action Podcast.

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