A Discipline of Contrasts
An interview with Connect_CX friend and colleague Sheila Delaney Moroney from Minneapolis-based Hennepin Healthcare.
Current Title
Patient Experience Officer (PXO) and Senior Director of Patient Experience Services
Responsibilities of your role
Strategic: As PXO, Sheila oversees strategic initiatives informed by the voice of the patient, helping leaders understand what Hennepin Healthcare’s strengths and weaknesses are, and working with them to design and implement improvements.
Operational: Senior Director of Patient Experience Services. Under her purview are the Arts program, Spiritual Care, Patient Representatives, Welcome Services, the patient satisfaction survey, and Interpreter Services.
Educational background
Bachelors from Boston College (English), Masters in Public Health from the University of Minnesota
Memberships
Minnesota-based Women’s Health Leadership Trust, Founding Board Member, PX Policy Forum (under the Beryl Institute), serves on the board of PatientRevolution.org. Advisor to University of Minnesota Learning Health System Scholars Program in the School of Public Health.
Employer Info:
Hennepin Healthcare (HHC) is a billion dollar enterprise, located in downtown Minneapolis, a one-hospital system with 50 outpatient clinics. HHC is one of America’s Essential Hospitals, serving a hugely diverse patient population and is the #1 Trauma Center in the US based on outcomes; their Level 1 Trauma Center ER had 100,000 visits in 2019. HHC is home to a regional poison control center, a 100-bed inpatient psychiatric unit/ER, and is a teaching hospital to the University of Minnesota, training more than 70% of Minnesota’s clinicians.
Tell us about the career pathway that led to your current role?
What inspired me was my own experience as the daughter of a doctor: anyone in our family was able to receive exceptional care with just with a phone call. I wanted everyone to have that access when they needed it.
I always wanted to follow in my father’s footsteps (he was a surgeon) and go to Med School; alas, my educational pathway ultimately led in a different direction. But still, I wanted to be as close to the OR as possible without going to med school. My post-undergrad career started with 10 years in public affairs and fundraising at Boston Children’s Hospital and in community health in Boston’s inner city. After returning to Minnesota to complete my Masters, I was fortunate to find a job with former US Senator David Durenburger, who created the National Institute of Health Policy. I served as Program Director, gaining exposure to the wide breadth of healthcare excellence in the Twin Cities, and new understanding of how payment policy affects everything we do in healthcare, for better or worse.
In 2008, HCAHPS was getting a lot of attention. Hennepin Healthcare (HHC) created a position called “Customer Service Change Agent,” in response to the increasing importance of patient satisfaction. I didn’t really like the title and asked to have it changed, and here’s why: I believe that Patient Experience transcends any other customer experience. There is something sacred about the encounter between the care provider and the patient that is unlike any other consumer or customer exchange. My career trajectory reflects how the role has evolved and what started out as a customer service job focused on elements of hospitality (such as valet parking, good food, room service) aren’t sufficient by any means. These things don’t speak to the heart of what PX is all about.
What are the most pressing challenges in your health system right now?
We currently have two related challenges. First, the financial challenges associated with serving a primarily Medicaid population with complex medical and social needs. We serve a disproportionate share of uninsured, underinsured and people with very complex lives: 30% have limited English proficiency, and 65% are insured through a government payer.
The second challenge is the health disparity in our community. It’s a real concern for us, especially since statewide, Minnesota has a reputation for excellence in healthcare, yet we deliver unacceptable outcomes for minority populations. In addition, competition and consolidation in our marketplace are making it more complicated for providers and consumers/patients alike.
How do you address these challenges in your work?
Given our financial constraints, there are not a lot of resources to many of the programs/initiatives that might be considered traditional PX best practices; so my focus is to continue to inspire and inform leaders and staff with feedback and insights from patients. To help them understand their individual roles and responsibilities and recognize what exceptional care and service looks like. And to create standard work that ensures our service is consistent no matter where a patient enters the system. PX and employee experience are inextricably linked so I also regularly share the good things that patients tell us about our service so that staff are inspired do their best work.
How patients perceive the quality of their communication with their nurse, their doctor, or any other care team member, informs how they engage in their own care plan. So my work is also focused on helping clinicians and others understand that patient experience is not about HCAHPS scores or CMS star ratings, and just “making the customer happy,” but rather it’s about improving health outcomes and each person’s sense of well being. The ratings, while a necessary tool, are not the ultimate aim of a successful PX strategy.
Overall, I try and help all staff understand that they have a role to play whether they’re patient facing or working in a supporting role. Whatever job they have, each staff member can find a way to make a personal connection, to consider the whole person they are caring for or supporting; what matters to the patient should be the first question everyone asks.
Ultimately it doesn’t matter if we don’t have all the bells and whistles that are being built into healthcare settings everywhere; if we’re engaging patients as human beings, everything else will follow.
Share a brief story about an event that inspired or impacted you — that keeps you going every day.
Throughout his career, my Dad was a breast cancer surgeon. When my Mom got breast cancer (she’s since survived 25 years and counting!) and completed her treatment, I asked him “what did you learn from this?” He said “I have been giving this diagnosis to thousands of women for years, but until now I never had an idea how much it affected the whole family behind every patient I see.”
My father was renowned for his bedside manner and compassion, yet even the most well-intended providers may not fully grasp the nuance that a diagnosis can bring, and the impact for families. I hope I can continue to inform and inspire so that all care team members can enhance their ability to notice the little things and recognize what matters most to patients.
How do you see the discipline of Patient Experience evolving, short and long-term?
While this originally started focused on customer service, it has evolved to encompass the entire human experience. This revolution now includes staff experience as well as patient — we are all intertwined in this healthcare world because of our shared humanness. Human connection paired with exceptional care and service is the key.
The discipline is still emerging and dealing with things like how to address the distinction between “consumers” vs. “patients;” should we use Net Promotor Scores vs. assessments about how well we connected emotionally in a healthcare interaction; are we improving industrialized healthcare or delivering more kind care? None of these are wrong. Patient Experience is a discipline of contrasts.
PX is becoming much more relevant to organizational strategy. The PX leader is at leadership tables more often. I see awareness of the value of this field when hear from CEOs about what’s keeping them up at night: improving patient experiences is at the top of the list. Business as usual is not working. We must partner with and listen to our patients more effectively to transform the ways we design and deliver care and achieve the Quadruple Aim. The PX leader is helping the other leaders truly integrate the voice of patient into their work, which is the next frontier.
Consumers do care about the ratings: these simplify the process for patients trying to make a choice about where to go for healthcare. But I resist the notion that it’s an authentic reflection of a healthcare relationship. This is a double-edged sword: I worry that the discipline will be co-opted by ratings and we’ll lose the deeper meaning of what the Patient Experience should consist of.
But as I say above, it’s not just about ratings. HCAHPS and CMS Star ratings have complicated things, in some ways positively, in others challenging. The advent of PX survey tools has raised the profile of the work, made it as relevant as financials or quality & safety measures. But sometimes we get distracted by numbers when we should be thinking about meaningful health and well being.
Any conferences you’ll be attending/speaking engagements to share?
I’m leading a webinar with the Beryl Institute in May on Experience-Based Design.
When you’re not at work, what occupies your time?
My husband and I have been building a house which is all-consuming. Meanwhile, we are enjoying living in downtown MSP as empty nesters: we’re trying to take in every single restaurant and wine tasting in the downtown area before we move. Otherwise, we enjoy spending time with my many siblings and nieces and nephews; traveling whenever we can; snowshoeing in the winter, and spending time in summer at our cabin.
Finally, what was the best $20 you ever spent?
I love to travel, so my answer comes from a trip to Amsterdam many years ago: we paid an extra $20 for an upgrade from a youth hostel so we could have a less seedy place to sleep. Well worth it!
Originally posted March 8, 2020 on Connect-CX.com
