100 Ways to Succeed #162:

Process > Outcome.
Happy Staff, Happy Customers.
Kindness Is Free!
(Kindness SAVES $$$$.)

You’d think that “getting well” was the heart of the matter when it comes to evaluating a hospital stay.



In one giant survey, Press Ganey Associates queried 139,380 former patients at 225 hospitals on “patient satisfaction.” After the data were collected, they teased out the 15 most powerful determinants of said Patient Satisfaction.

Are you ready?


Not a single one of the Top 15 sources of patient satisfaction had to do with the patient’s health outcome. All 15, in effect, were related to the quality of the patient’s interactions with hospital staff—and employee satisfaction among staff members.

The study is reported in Putting Patients First, by Susan Frampton, Laura Gilpin, and Patrick Charmel. The authors are leaders at Griffin Hospital in Derby CT. Year after year it ranks near the top (Top 10 on several occasions) of Fortune magazine’s Best Companies to Work For list—one of the rare, and often the only, health care institution to do so. (It also tops the charts on damn near every other measure you can name from patient safety to financial viability. The so-called Planetree Alliance, run out of Griffin, is the epicenter of the “patient-centric care” movement.)

The authors use the Press Ganey data as the jumping-off point for discussing the process and tenets that guide their work with staff and patients at Griffin:

“There is a misconception that supportive interactions require more staff or more time and are therefore more costly. Although labor costs are a substantial part of any hospital budget, the interactions themselves add nothing to the budget.

“Kindness is free.

“Listening to patients or answering their questions costs nothing. It could be argued that negative interactions—alienating patients, being unresponsive to their needs, or limiting their sense of control—can be very costly. … Angry, frustrated, or frightened patients may be combative, withdrawn, and less cooperative—requiring far more time than it would have taken to interact with them initially in a positive way.”

The Big Lessons here—and they are BIG—are several:

(1) Process “beats” outcome in evaluating an “experience”—even one as apparently “outcome sensitive” as a hospital stay. The positive quality of staff interactions were more memorable than whether or not the health problem was fixed.
(2) Happy staff, happy customers. Want to “put the customer first”? Put the staff “more first”!
(3) Quality is free—and then some. We learned (well, most of us learned) when the “quality movement” dominated our consciousness that not only was quality free—but doing the quality thing right actually reduced costs, often dramatically.