As I returned home after my recent total hip replacement surgery, I saw it again: Our nation’s best health systems may deliver exceptional service at point of care, yet miss the mark at so many other healthcare journey touchpoints. For me, it was just an annoyance. To others, it can be a barrier to accessing care, or to getting the follow-ups that complete their care protocol. For health systems, it isn’t just a matter of being “nice” and building business, but of creating healthcare equity.
The surgery itself was a showcase of precision, caring, and professionalism. The vast team – my surgeon, nurses, anesthesiologists, physical therapists, and so many others – each introduced themselves, explained their role, and handed off to the next person in ordered procession. It was seamless and nurturing. As I was rolled into the OR, I felt in the safest of hands. I wondered how much effort and incremental improvements had brought them to such systemic perfection. In addition to my surgeon’s extensive training, how much care had been put into the process – by the whole harmonized team – to get it exactly right?
A disconnected healthcare journey
And then I returned home. The cord was cut, the coordinated care gone, and I was on my own. After surgery, my nurse had tried to hand off next steps to me. But unlike the care-team hand-offs, I didn’t fully understand my role, and I was drugged up and in pain. I had 12 medications prescribed. She gave me a chart listing them all, which to take once a day, twice a day, three times a day, on a full or empty stomach, each for differing numbers of days or weeks. Seven were required, five to take only if symptoms flared and necessitated them.
As a healthcare strategist, I often share this factoid: Patients forget about 50% of what their doctors tell them by the time they get home. So I knew to repeat everything back to make sure I understood. Already I had missed parts, so we talked through it more, until I felt sure I grasped next steps.
But that was at the hospital. At home, I found the medication names on my pill bottles didn’t match what I saw in my chart. After some initial confusion, I realized I had received generic versions. I went online to translate the text on my pill bottles to the words on my chart. And then to sort them into which to take when and why and how. I had the background to understand the mismatch and the means and confidence to find the translations. But what happens to those who don’t?
All that care and attention to process at the hospital. So why not the same effort and incremental improvements after? Making the discharge instructions, including that chart, more user friendly would take vastly less effort than building the hip replacement surgical protocol.
The healthcare journey is confusing
And this doesn’t take into account booking the surgery in the first place, or scheduling the post-operative check-up.
It took about 20 phone calls and some insider knowledge to book my surgery, and about a week of calls to schedule the post-op. That was partly due to bad luck. There’s one single person who books appointments for my surgeon. When she’s sick or out for any reason, nobody can schedule or ask a question or get through. But even for absences of a week or more, her voice mail message isn’t updated. She also won’t accept scheduling by email (for HIPAA reasons, although I book by email with plenty of other providers). So I call and call, confused, wondering what might be the issue. (Mind you, once on the phone, she’s absolutely lovely. It’s just getting that connection that’s an ordeal.)
This is why we build journey maps
If I were to plot the full arc of my hip replacement journey – from the moment of diagnosis (hip dysplasia and end-stage osteoarthritis) to post-operative recovery – you’d see plenty more problematic touchpoints featured. Things that don’t necessarily ruin the healthcare delivery process, but certainly make it more complicated – and limit the number of people who get access in the first place. (And I’m not taking into account all the issues around health insurance, FMLA and short term disability, which can be even bigger barriers.)
I’m not complaining about my situation. I feel tremendous gratitude for the care I received. And I’m in awe of my surgeon and the team who together delivered what feels to me like a miracle – my cranky hip is gone, replaced by a brand new hip that gives me greater range of motion, no pain, and a normal gait.
We can improve the healthcare consumer experience
So why share this? To urge our incredible, world-class health systems to consider the full healthcare journey – before, during and after point of care – and the full spectrum of needs among those who go through that journey. To help healthcare consumers navigate convoluted systems so that they can receive quality and equitable care from start to finish.
I’ve created these types of journey maps for so many health systems. But over and over again, I encounter clear lines in the sand – the interactions leading up to the point of care belong to one group in the hospital, care to the clinical team, and post-care, patients are so often on their own. Let’s erase those lines and acknowledge that the healthcare journey is one connected journey. All touchpoints matter, and all should connect seamlessly.
This is a shared responsibility across healthcare groups: clinical, operations, marketing. And it will ease the burden not just of the patient, but of the system, to improve health outcomes for all patients.
So to my hospital, my surgeon, and my whole care team, I say, deeply felt: Thank you. Seriously, I mean that. But also – As you look at where to go next, look beyond your hospital walls and consider the full healthcare journey.