Latest / Becker’s Healthcare Podcast / Erica Rubinstein, Vice President of Patient Experience at Mount Sinai Health System

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Erica Rubinstein, Vice President of Patient Experience at Mount Sinai Health System · Becker’s Healthcare Podcast

• 0:02
  - There's a small circle of people who truly
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  - understand what it takes to lead a health
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  - of getting a call wrong don't stay contained.
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  - Becker's fourteenth annual CEO and CFO roundtable
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  - executive level attendees
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  - around growth, financial sustainability,
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
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  - Join us November second through the fifth in
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  - Chicago.
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  - For the agenda and event details,
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  - visit beckershospitalreview.com
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  - and click on the events tab in the
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  - upper right.
• 0:51
  - Well, hello, everyone. I'm Rick Evans, the cochair
• 0:54
  - of the chief experience officer advisory board here
• 0:57
  - at Becker's HealthCare.
• 0:59
  - I've had the privilege of serving as a
• 1:01
  - Chief Experience Officer
• 1:02
  - at some of the great hospitals in America,
• 1:04
  - New York Presbyterian and Mass General.
• 1:07
  - Chief Experience Officers, or CXOs as they're called,
• 1:10
  - across the country play a pivotal role
• 1:13
  - in assuring that their organizations
• 1:15
  - understand the perceptions and real experience of patients
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  - and families and customers and their health systems.
• 1:22
  - And their
• 1:23
  - role is to assure that their organizations have
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  - a defined and robust strategy
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  - to continually improve their experience with the goal
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  - of maintaining the loyalty of our patients
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  - and remaining competitive in the markets where we
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  - where we serve.
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  - There is deep expertise across the CXO community
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  - in American health care and a body of
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  - knowledge
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  - about how to truly understand and improve the
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  - consumer experience. And today, I'm joined
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  - by not only one of my friends, but
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  - one of those innovative and expert
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  - CXOs,
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  - for a conversation about about her work. So
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  - So I'm joined today by Erica Rubinstein,
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  - the vice president of patient experience at the
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  - Great Mount Sinai Health System in New York
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  - City.
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  - Welcome, Erica. And if you could just briefly
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  - introduce yourself and and your role.
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  - Sure. Thank you so much, Rick. It's great
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  - to be here, and thanks so much for
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  - having me.
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  - Yes, as you said, I oversee patient experience
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  - for the Mount Sinai Health System. I've been
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  - in this role for
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  - around eight or nine years.
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  - It is my privilege to be able to
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  - lead our teams that do patient experience improvement.
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  - They are the folks that manage patient relations,
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  - day to day issues that come up. They
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  - manage language access services,
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  - department of volunteers.
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  - All of those things we feel are very,
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  - very pivotal to the overall patient experience.
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  - And so I'm just really thrilled to to
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  - be here with you and have a conversation
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  - today.
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  - Well, thanks. Thanks for joining.
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  - So we'll dive into a couple questions to
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  - understand,
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  - what it's like, for you and your team
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  - at Mount Sinai.
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  - So how are your patient experience metrics,
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  - tracking over the course of the year? What
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  - have you been... What have been some of
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  - your successes and and even some of your
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  - challenges?
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  - Yeah. Thanks for the question. It's been,
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  - it's been quite a year.
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  - I feel like there's been so much happening
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  - this year that,
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  - it's been a long year, and yet when
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  - I look back, I can't believe it's almost
• 3:22
  - October.
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  - We we started the year, as you know,
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  - with a a a really, a really challenging
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  - situation on our hands. Right? We are an
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  - organization
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  - that,
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  - has a lot of union activity.
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  - Mhmm. And we began our year... Really, we
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  - began the the the holiday season
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  - going into 2026
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  - planning for what we needed to be
• 3:48
  - labor action. And we certainly did have a
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  - nurses strike,
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  - for, the better part of
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  - two months,
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  - the January and February. And that was Mount
• 3:58
  - Sinai. It was New York Presbyterian.
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  - It was some of the bigger hospitals in
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  - the city.
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  - And I think it was perhaps the biggest
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  - nursing strike,
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  - maybe in history,
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  - certainly in recent memory.
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  - Yep. I believe it was. And, you know,
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  - it was a big deal. We, we had
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  - our eye on, you know, how are our
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  - patients
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  - throughout that before, during and after.
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  - But we also had our eye on how
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  - are our nursing leaders, right, they really
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  - bore the burden of making sure that their
• 4:31
  - patients were safe, their patients were feeling
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  - loved and cared for,
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  - all the while welcoming in,
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  - travelers to to care for their patients.
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  - It was a trying
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  - time.
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  - It it felt like it was... Went on
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  - and on and on. It finally came to
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  - a resolution so that we could welcome back
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  - our our good nurses back
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  - back into our hospitals, which we were thrilled
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  - to do.
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  - And,
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  - we've been
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  - we've been recuperating from that. Right? And I
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  - think it would be fair to say... And
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  - I was, you speaking with my
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  - chief nurse executive yesterday, it would be fair
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  - to say that we're still
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  - recovering from that. We have a lot of
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  - dedicated,
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  - just unbelievably
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  - talented and caring
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  - nurse leaders that
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  - have stepped back
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  - and have had to really
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  - reassess
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  - what they want to be doing
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  - with their careers. And it just it just
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  - it shed a light on things for folks
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  - that we rely on so deeply for the
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  - patient experience. And so all that to say,
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  - that was probably one
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  - of our biggest challenges this year. But we
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  - faced
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  - several. Despite that, I will say,
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  - you know, we set our targets high. We
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  - set our goals high because we had a
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  - very good performance year against ourselves
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  - and and in the market,
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  - in '25.
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  - And so what we typically do here is
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  - we set our sights higher you know, the
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  - next year. We don't give anybody a break
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  - around here.
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  - And so
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  - we we are still looking at... Especially when
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  - it comes to inpatient, we could talk a
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  - little bit more. You know, I'm happy to
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  - get into detail about that. Just what... You
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  - know, where we're struggling. We typically pick up
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  - around,
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  - quarter two and certainly quarter three.
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  - We are picking up, I'm happy to say,
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  - but not to the level that we were
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  - at last year. And so Yeah.
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  - So that's been a challenge for us.
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  - And that really resonates. I mean, we saw
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  - the same dynamic at New York Presbyterian where,
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  - you know, again, if you're continually making progress,
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  - but you have a quarter where you have
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  - a major
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  - disruption, like a nursing strike,
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  - then that quarter is lost to progress. Right?
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  - And in some cases, you might even see
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  - a decline in ratings,
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  - for a period of time and then recovery.
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  - And you reference, there is some seasonality
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  - to,
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  - inpatient metrics. Right? So summer and fall tend
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  - to be less surge y.
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  - Yes. And that's a, you know, chance to
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  - make some progress. And it sounds like you're
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  - you're experiencing that at Mount Sinai.
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  - Yes. We are. You know, so I would
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  - say we're we're seeing a pickup now. We're
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  - hoping
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  - to buck our trend of not dipping in
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  - quarter four with inpatient.
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  - You know, shifting gears a little bit for
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  - successes, I will say Please.
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  - It's been a wonderful year for focusing in
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  - on areas like ambulatory
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  - surgery,
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  - and for that matter, our surgical space in
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  - general. Because, you know, as OAS caps has
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  - come to the forefront, we've kind of said,
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  - we need to just look at perioperative services
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  - in general. And the good news there is
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  - that we have amazing partners in that
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  - space. It's been just a pleasure and it's
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  - been actually,
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  - you know, insightful and fun
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  - to do some patient journey mapping with them
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  - over the last year and change. And now
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  - we're at a place where we've come to
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  - common ground across
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  - you know, pain points and what are some
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  - areas of opportunity, but also what are the
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  - strengths? And we're starting to see,
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  - the patient experience
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  - really show a steady improvement in areas that
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  - we have focused in on, like
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  - anesthesia side effects and
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  - information
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  - before and after the procedure,
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  - things like that. So that's
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  - been very exciting, steady
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  - growth with a strong, strong
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  - sort of governance structure there from our perioperative
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  - leaders.
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  - And I just want to mention one other
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  - area that's exciting for us this year as
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  - we move along in our
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  - ambulatory medical practice space. We've really worked together
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  - with
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  - our leadership in ambulatory and digital marketing in
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  - building our reputation
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  - and helping patients to easily find
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  - comments and reviews about our doctors when they
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  - go shopping online. Right? I'm using air quotes.
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  - And they hear about a doctor from another
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  - physician that they trust, but they wanna go
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  - and check it out themselves.
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  - We are now taking control of the narrative,
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  - I like to say, and we're publishing the
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  - comments,
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  - from our vetted, you know, patients,
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  - through our surveys up on our own Find
• 9:15
  - a Doc website. And it's been wonderful. It's
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  - been
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  - a a a boon for the providers that
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  - weren't regularly looking at those comments. Now they
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  - are,
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  - and they're
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  - overwhelmingly
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  - positive.
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  - And it... We've seen it boost. We've seen
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  - patient experience scores go up, but we've also
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  - seen providers come to us and say, hey.
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  - I'd really like some help.
• 9:38
  - You know, I... I'm seeing some issues
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  - with communication
• 9:43
  - here, and I, you know, I wanna I
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  - wanna improve on that. We've also seen the
• 9:47
  - number of docs that score in the ninety
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  - fifth and above
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  - percentile ranking go up each year, since we've
• 9:54
  - been rolling this out.
• 9:55
  - So... Yeah. Thanks. Really excited about that. Oh,
• 9:58
  - congratulations. And for our non p x listeners,
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  - you
• 10:02
  - know, you mentioned OASCAHPS. Everybody's pretty much familiar
• 10:05
  - with HCAHPS, an inpatient,
• 10:07
  - survey. But OASCAHPS is that ambulatory
• 10:10
  - survey that's now required, publicly reported.
• 10:13
  - And, you know, every hospital in America should
• 10:15
  - be thinking about how they're performing there because
• 10:18
  - ambulatory surgery is the front door, in many
• 10:21
  - cases to Mount Sinai or any hospital you're
• 10:24
  - in. And it's extremely sensitive to competition because
• 10:28
  - people can choose
• 10:29
  - usually many other places to go. So performing
• 10:32
  - well with OAS caps is really important.
• 10:36
  - It's now linked to reimbursement,
• 10:37
  - another reason why it's important.
• 10:39
  - And, you know, any of you out there
• 10:40
  - that are running a hospital, maybe not running
• 10:43
  - patient experience, you want to make sure that
• 10:45
  - you, you know, really are working closely with
• 10:46
  - your patient experience, people
• 10:48
  - like Erica, to have a strategy so that
• 10:51
  - you perform well and thrive in that environment,
• 10:53
  - not have it become an obstacle. So that...
• 10:55
  - That's really great to hear.
• 10:58
  - Now in terms of... You know, maybe we
• 10:59
  - can pivot back to, HCAHPS for a minute.
• 11:02
  - There is a brand new HCAHPS survey that's
• 11:04
  - been out in the field now for
• 11:06
  - six quarters.
• 11:08
  - And why I'm saying that is because at
• 11:10
  - the end of six quarters, that's when the
• 11:12
  - government starts to report out on those results.
• 11:15
  - So we're all sort of in in our
• 11:17
  - PX community waiting to see,
• 11:19
  - what these new,
• 11:21
  - HCAPS questions
• 11:22
  - about team care and others, what they look
• 11:24
  - like,
• 11:25
  - and how we're performing individually and then against
• 11:28
  - one another. So,
• 11:29
  - what are you, curious about with HCAPS two
• 11:32
  - point o? What are you waiting to see?
• 11:34
  - Yeah. HCAHPS two point o. Yeah. I can't
• 11:36
  - believe it's been six quarters.
• 11:38
  - We, you know, we are really curious. We
• 11:41
  - wanna understand,
• 11:44
  - whatever it is. Right? If we if we
• 11:45
  - go up or down or what our performance
• 11:47
  - is, what's what's driving that. Right? We we
• 11:50
  - did a lot when the when the survey
• 11:52
  - changed. We changed the mode,
• 11:54
  - in which we survey. We went all to
• 11:56
  - web mode, so web mode first and then,
• 12:00
  - mail if we don't get responses for follow-up.
• 12:02
  - And so I really would love to understand
• 12:05
  - how did that how did that help us
• 12:07
  - or hurt us. Right? We did see some
• 12:09
  - response rates tick up when we started to
• 12:12
  - do that. And, you know, part of that
• 12:13
  - was just because we, we did a we
• 12:15
  - did a lot of work to get our
• 12:17
  - email capture rate up,
• 12:19
  - before we went on web mode, only we
• 12:21
  - had some really poor email capture rates at
• 12:23
  - some of our hospitals. And that was a
• 12:24
  - good, you know, motivation and impetus
• 12:27
  - to get those rates up.
• 12:30
  - I think also just with the, you know,
• 12:31
  - the case mix adjustments and things like that,
• 12:34
  - I'm just curious to understand all of that
• 12:37
  - a little bit better.
• 12:38
  - And and, again, like I said, is it
• 12:40
  - is it really truly due to a shift
• 12:43
  - and an improvement
• 12:44
  - or not in the experience, or is it
• 12:46
  - due to the change,
• 12:48
  - you know, in in the survey and and
• 12:50
  - in the methodology?
• 12:52
  - I'm really curious about that too. And again,
• 12:55
  - for non PX listeners,
• 12:57
  - different modes,
• 12:59
  - are are more or less used by different
• 13:01
  - demographic groups. So if if you have a
• 13:04
  - younger demographic, that potentially
• 13:07
  - will change perceptions.
• 13:09
  - Actually, sometimes our younger patients are some of
• 13:11
  - our toughest customers in terms of their expectations,
• 13:14
  - and that's because, us older people raise these
• 13:16
  - kids.
• 13:17
  - Yeah. So...... Fault.
• 13:19
  - Yeah. So there'll be a lot to find
• 13:21
  - out when this,
• 13:22
  - these results are publicly released, and that's imminent,
• 13:25
  - over the course of the fall.
• 13:27
  - And so we can maybe, Erica, compare notes
• 13:30
  - when that happens. Yep.
• 13:32
  - Moving away from, you know, actual surveys and
• 13:34
  - dashboards and scores, which we've been talking about,
• 13:36
  - what's the theme that
• 13:38
  - you keep hearing from patients that really never
• 13:40
  - quite makes it onto the onto the dashboard?
• 13:44
  - Yeah. That's a great question.
• 13:46
  - You know, when I when I hear that,
• 13:48
  - the first thing I think about is
• 13:51
  - relationships
• 13:52
  - and that sort of... If I could measure
• 13:53
  - that,
• 13:55
  - connection rate, I'll call it.
• 13:58
  - Right? So
• 13:59
  - we we do ask certain questions, but do
• 14:02
  - we really get to the heart of
• 14:04
  - how
• 14:06
  - understood
• 14:07
  - does a patient feel?
• 14:09
  - Right? The the nurse could provide information. The
• 14:12
  - doctor could provide
• 14:14
  - courtesy and kindness.
• 14:17
  - They could, you know, get all their test
• 14:18
  - results and their care plan and everything else.
• 14:21
  - But does that patient really feel like, wow.
• 14:24
  - I I just connect with them. Every time
• 14:27
  - I go to Mount Sinai for my care,
• 14:28
  - it really truly feels like my medical home.
• 14:31
  - I love that term. People say, oh, Mount
• 14:33
  - Sinai is my is my home. It's it's
• 14:35
  - the home for my health care. I just
• 14:37
  - had a patient say that to me the
• 14:38
  - other day.
• 14:40
  - That feels really good when people say that
• 14:42
  - because what are they saying? They're saying this
• 14:44
  - is where I feel understood, and I feel
• 14:46
  - seen and heard,
• 14:48
  - and I feel like you know me as
• 14:49
  - a person. You don't just know me as
• 14:51
  - my my diagnosis walking through the door.
• 14:55
  - And I think we do a lot of,
• 14:57
  - you know,
• 14:58
  - speaking
• 14:59
  - to our staff around how are you getting
• 15:02
  - to know your patient and, you know, what
• 15:05
  - does that feel like? Right? And and when
• 15:07
  - I speak to patients, we try to draw
• 15:08
  - out those stories so that my team can
• 15:11
  - always share a story
• 15:13
  - of this is how you connected. This is
• 15:15
  - how you made that patient feel at home.
• 15:18
  - And I think that's something we need to
• 15:19
  - do a better job of,
• 15:21
  - you know, maybe not on a line item
• 15:23
  - on a dashboard, but but always,
• 15:26
  - sharing
• 15:26
  - stories and always making sure that that that
• 15:29
  - is a part of the experience of care.
• 15:33
  - I love that point. And you think about,
• 15:36
  - like, everything else in health care, it's... There's
• 15:39
  - so much... Is focused on data, and patient
• 15:42
  - experience shouldn't be immune from that. In fact,
• 15:44
  - it's important that we are data driven and
• 15:47
  - evidence based.
• 15:48
  - But what motivates our teams sometimes is much
• 15:52
  - more the narrative
• 15:53
  - and the stories that help them reconnect with
• 15:56
  - purpose.
• 15:57
  - So, yeah, we gotta do data, but we
• 16:00
  - have to
• 16:01
  - capture hearts and minds,
• 16:03
  - to get the experience that we want. Right?
• 16:06
  - Yeah. Absolutely.
• 16:08
  - And in New York, I mean, loyalty is
• 16:10
  - really important.
• 16:11
  - You know, we we... You and I have
• 16:13
  - known each other a while. We work for
• 16:15
  - we're we're colleagues. We also work for competing
• 16:17
  - hospitals,
• 16:18
  - and it's easy in New York to pick
• 16:20
  - something else if one isn't working for you.
• 16:21
  - Sure is. Yep. Right down the road. It
• 16:24
  - really is. Exactly.
• 16:27
  - Maybe we could wrap up, today with a
• 16:30
  - little bit of your thoughts on... And we
• 16:32
  - were kind of just addressing it. There's employee
• 16:35
  - experience,
• 16:37
  - and patient and family experience effect in our
• 16:40
  - circles.
• 16:41
  - Erica, you and I talk about human experience,
• 16:45
  - and how, really, everyone's having an experience. Right?
• 16:47
  - So,
• 16:48
  - can you talk about how much of patient
• 16:51
  - experience is really employee experience, how you think
• 16:53
  - about that nexus?
• 16:56
  - Yeah. That's something that's really top of mind
• 16:58
  - for us at Mount Sinai. In fact,
• 17:00
  - we just launched our fifth ever workforce engagement
• 17:03
  - survey on Wednesday of this week. We're really
• 17:06
  - excited that it's launched and will be open
• 17:08
  - for the next couple of weeks.
• 17:11
  - This is a
• 17:12
  - dataset. It's a listening tool. It's it's a
• 17:15
  - way that we have to be
• 17:17
  - engaged with our workforce in order to understand
• 17:20
  - what drives them.
• 17:22
  - You know, five plus years ago, we weren't
• 17:24
  - measuring that, and and we really need to
• 17:26
  - be
• 17:27
  - listening and and and
• 17:29
  - always trying to hear and understand,
• 17:33
  - what is it that our workforce
• 17:35
  - is is struggling with, and what are they
• 17:37
  - really
• 17:39
  - connecting with and what's bringing them back to
• 17:41
  - work every day and and feeling proud. Just
• 17:44
  - like a patient would feel proud to say
• 17:45
  - my doctors are at Mount Sinai, my care
• 17:47
  - is at Mount Sinai, we want staff to
• 17:49
  - feel proud to say I work at Mount
• 17:51
  - Sinai.
• 17:52
  - We know that patient experience
• 17:55
  - goes up
• 17:57
  - and shows improvement and has a close relationship
• 18:00
  - as our
• 18:02
  - employee experience
• 18:03
  - goes up. But you know, I wouldn't say
• 18:06
  - that the the employee experience
• 18:09
  - is,
• 18:11
  - equal to the patient experience. I wouldn't say
• 18:13
  - that it is it is the only thing.
• 18:16
  - Right? It's it's more about how
• 18:19
  - our employees
• 18:20
  - are sort of the delivery system. They are
• 18:22
  - the delivery system of the experience of care,
• 18:25
  - but they're also the only way that our
• 18:27
  - patients get a feel for what is the
• 18:29
  - culture
• 18:30
  - at that organization.
• 18:32
  - It's through the employees.
• 18:34
  - And so if we haven't built
• 18:37
  - a culture
• 18:38
  - that cares for each other, you know, like
• 18:41
  - you said, the human experience, if that's not
• 18:43
  - palpable and that's not fault,
• 18:46
  - patients are going to easily be able to
• 18:49
  - pick up on that
• 18:50
  - to almost, you know,
• 18:52
  - to the point where we see it in
• 18:53
  - our comments all the time, patients calling out.
• 18:56
  - You know, I think these staff that you
• 18:58
  - know, were assigned to me are really struggling.
• 19:00
  - They seem overburdened and stressed. And, you know,
• 19:04
  - it's... For us, it's, making sure that
• 19:08
  - we are designing systems
• 19:10
  - that are supporting staff so that they can
• 19:13
  - give and provide the best experience. We see
• 19:16
  - that in our workforce engagement survey, the survey
• 19:18
  - the last
• 19:19
  - survey that we conducted from last year.
• 19:22
  - More and more people wrote and took the
• 19:24
  - time, and we're so grateful to write in
• 19:26
  - the comments,
• 19:27
  - hey, I want to give the best and
• 19:29
  - safest experience to my patients. That's why I
• 19:32
  - come to work every day. And I want,
• 19:34
  - you know, I want support
• 19:36
  - in doing that. And then they had great
• 19:38
  - suggestions as to how we should support them.
• 19:41
  - And so I do think it's their experience,
• 19:43
  - and it's on us to help
• 19:46
  - shape the systems and design the systems together
• 19:48
  - with them that that make it easy for
• 19:50
  - them to bring the good experience to patients.
• 19:53
  - Exactly. Things that make it easier for them
• 19:55
  - to connect.
• 19:57
  - That's really, really so important. And it... I
• 20:00
  - think you might agree. Patients don't
• 20:03
  - give us extra credit for being clinically great.
• 20:06
  - They expect that. Oh, yeah. What they give
• 20:08
  - us credit for what what breeds loyalty is
• 20:11
  - the discretionary effort, the minute extra minute to
• 20:14
  - answer a question. It's all those little touches
• 20:17
  - that
• 20:17
  - connect, as you said before, people together,
• 20:20
  - and that create loyalty. But the staff, our
• 20:23
  - our colleagues have to be free to do
• 20:24
  - that. They have to feel empowered to do
• 20:26
  - that, and that's hard work.
• 20:28
  - Right? It's hard work. That's a great point
• 20:31
  - you make too about, you know, my organization,
• 20:34
  - your organization.
• 20:35
  - The expectation is that they're gonna get that
• 20:37
  - excellent clinical care. But what differentiates?
• 20:41
  - Right? They wanna feel that they're in an
• 20:43
  - environment that is well oiled,
• 20:46
  - and everybody enjoys working together, and they feel
• 20:49
  - confident and comfortable in the decision they made
• 20:52
  - to come to our organization. Because like you
• 20:54
  - said, they can choose
• 20:55
  - nearly anywhere in the five mile, 10 mile
• 20:58
  - radius, you know.
• 21:00
  - The key word you just said, it's about
• 21:02
  - confidence, not so much about happiness. It's confidence
• 21:06
  - that brings him back. Right? Absolutely.
• 21:08
  - Absolutely.
• 21:10
  - Well, I'm so grateful for, your time today,
• 21:12
  - for your joining,
• 21:14
  - me and for the expertise that you both
• 21:16
  - shared and that I know you bring every
• 21:18
  - single day to
• 21:19
  - a great organization like Mount Sinai.
• 21:23
  - And, you know, we're hoping that this podcast
• 21:26
  - helps others learn about things they can do
• 21:28
  - to make their patient experience better. And we're
• 21:30
  - hoping that these conversations can help leaders across
• 21:33
  - health care
• 21:34
  - understand better,
• 21:36
  - what patient experience is really about, how it's
• 21:38
  - measured, how it's improved.
• 21:40
  - It's it's a domain of expertise
• 21:43
  - that folks like you, Erica, bring to the
• 21:45
  - table for your organization every day. So thank
• 21:47
  - you again for your time and for joining
• 21:49
  - us. Rick, thank you so much. I always
• 21:52
  - enjoy speaking with you, and it was just
• 21:54
  - a pleasure to be on with you today.
• 21:56
  - Thank you.