The Wrong Metric

The Stopwatch CMS Provider Data Catalog — Hospitals: Timely and Effective Care (public reporting of ED time measures) The Joint Commission — ED-1: Median Time from ED Arrival to ED Departure for Admitted ED Patients (specification manual) Thompson DA, Yarnold PR, Williams DR, Adams SL — “Effects of actual waiting time, perceived waiting time, information delivery, and expressive quality on patient satisfaction in the emergency department,” Annals of Emergency Medicine, Dec. 1996 (1,631 respondents; actual waiting times not predictive of overall satisfaction; perceptions, information delivery, and expressive quality were, P < .001) Sonis JD, Aaronson EL, Lee RY, Philpotts LL, White BA — “Emergency Department Patient Experience: A Systematic Review of the Literature,” Journal of Patient Experience, 2017 (107 studies; staff–patient communication cited 78 times, wait times 56, staff empathy and compassion 45) Rick Evans — “Healthcare’s communication puzzle is getting more complex,” Becker’s Hospital Review, May 21, 2026 (“At its heart, improving the patient experience is all about communication.”) Mattson C, Bushardt RL, Artino AR — “‘When a Measure Becomes a Target, It Ceases to be a Good Measure,’” Journal of Graduate Medical Education, Feb. 2021 (Goodhart 1975; Strathern phrasing; GME examples) The Feature: Sven Gierlinger and Northwell Health Becker’s Hospital Review — “3 Questions with Northwell Health Chief Experience Officer Sven Gierlinger,” Dec. 5, 2017 (Ritz-Carlton background; “First came a tingling in my fingers and toes; and within days, I was paralyzed”; “for 90 days and nights, I was 100% dependent”; “crystal chandeliers” quote; gratitude reflection) Sven Gierlinger — “‘Hospital food not fit for a dog,’” Northwell Health Insights, July 7, 2023 (2000 hospitalization: three months, intubated, feeding tube; 2014 CXO start; verbatim patient comments; 9th → 84th percentile food scores; Bruno Tison; 10M+ meals/year; budget-neutral overhaul; Dowling letters; originally in MedPage Today) Barden A, Kalman J, Gierlinger S, Baker D, Giammarinaro N, Rousseau N — “From Monologue to Dialogue: The Pursuit of Relationship Centered Communication Across a Large, Integrated Healthcare System,” Journal of Patient Experience, Jan. 2024 (2015 baseline 29th percentile; RCC design; 46 volunteer faculty; COVID/Zoom pivot; June 2017–June 2023: 3,300+ providers trained; doctor communication 36th → 58th percentile rank vs. Press Ganey national peers; “Listen” +24 points; likelihood-to-recommend 42nd → 64th; adult hospitals at/above median 4 → 8; authors’ caveat that RCC “may not be the only factor”; faculty quote) Khan A, et al. — “Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study,” The BMJ, Dec. 2018 (Patient and Family Centered I-PASS; seven North American hospitals; harmful medical errors down ~38%) Harvard Medical School Division of Sleep Medicine — “Study Finds Harmful Medical Errors Fell 38% Following Implementation of a Multicenter Program to Improve Doctors’ and Nurses’ Communication with Families” The Counterweight: The On-Time Machine Forbes SJ, Lederman M, Yuan Z — “Do Airlines Pad Their Schedules?”, Review of Industrial Organization, 2019 (1990–2016: schedule times grew more than actual flight times; recorded delays fell while flights take longer; DOT 15-minute on-time definition; airlines speed up flights near the threshold, per Forbes, Lederman & Tombe 2015) Background Reading David Maister — “The Psychology of Waiting Lines” (1985; the classic on perceived vs. actual waits) Products Mentioned Experience Helpdesk Johns & Taylor