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INTRODUCTION

The capacity to care gives life its deepest significance.

 —PABLO CASALS

 

Nicole Draper didn't have a lot of experience with hospitals, but that changed quickly with the birth of her twin boys. Nicole notes, "Nick and Nate were born with a rare heart condition called dilated cardiomyopathy. We were told that there was no surgery or hope for the condition other than heart transplants. At the time, our home state of Arizona didn't perform infant heart transplants, so our family was off to UCLA, where my very sick boys were initially treated in the Neonatal Intensive Care Unit. My husband and I were obviously impressed by the knowledge and intelligence of the treatment providers, but also with their empathy, which was demonstrated in the way they communicated sensitive information." Initially, Nicole and her husband were advised that Nick was eligible for a heart transplant, but that Nate had experienced brain hemorrhaging that would affect his eligibility. Nicole adds, "In all of our meetings, staff members just kept communicating in such a compassionate way and spent so much time with us." During the course of Nick and Nate's care, a Los Angeles Times photographer and reporter followed the twins' treatment and wrote a series of stories about what ultimately turned out to be extremely successful medical outcomes for each of the brothers. Nicole notes, "Through the entire odyssey, we were amazed by UCLA. The medical professionals are incredibly skilled, and they are also really good with people. We were very impressed with the whole experience."

While stories of seemingly miraculous outcomes have consistently been common at UCLA, the leadership did not always hear that patients were "impressed with the whole experience." In fact, when David Feinberg, MD, MBA, the CEO of UCLA Hospital System, was promoted to his current position, he inherited an organization that had rich existing strengths in medical training, cutting-edge research, and the delivery of extraordinary clinical outcomes. But he was also faced with a significant opportunity. UCLA's overall patient satisfaction scores were in the 30th to 40th percentile range and in need of considerable improvement.

Prior to becoming CEO for the entire hospital system, Dr. Feinberg, then medical director of the Resnick Neuropsychiatric Hospital (RNPH) at UCLA, had led a turnaround in patient satisfaction scores in a challenging setting with neurologic and psychiatric patients. As a result of that success, he was prepared to create a similar turnaround throughout the UCLA system. Dr. Feinberg admits, "To be honest, being chosen for this job was rather daunting. This is a place where miracles are performed every day; however, when I talked to patients, I heard some disconcerting things. I'd gone to business school, and they told me that you should know your customer. But how much were we talking to our customers at UCLA, and why were our satisfaction scores so low? Furthermore, ...

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