When Effort Isn't Enough: How a Strengths-Based Approach Helped a Hospitalist Team Finally Break Through on Patient Experience

A practical, empathy-focused curriculum met hospitalists where they were — and the patient experience scores followed.

The Challenge

For a large not-for-profit integrated health system in the mountain west with more than 160 years of service to its region, the commitment to high-quality patient care has always been foundational. Yet despite that commitment, the health system found itself facing a stubborn and demoralizing gap in one of the most consequential measures of patient experience: physician communication. For a system whose hospitalist program serves as the backbone of inpatient care — with hospitalists functioning as the attending physician and primary coordinator of care for patients across multiple departments during their hospital stay — the physician communication composite on patient experience surveys had become a persistent source of frustration.

The hospitalists themselves were not indifferent. They were working under significant pressure — managing high patient census and complex caseloads, coordinating care across specialties, and serving as the central point of contact for patients and families navigating some of the most vulnerable moments of their lives. And yet, despite their effort and dedication, the experience scores were not reflecting the quality of care they believed they were delivering. The measure felt broken. The credit felt withheld. The team was frustrated, disappointed, and at a loss for what to do differently.

The CMO, Hospitalist Medical Director, and Office of Patient Experience recognized that the conventional response — more pressure, more metrics, more accountability — was not the answer for a team already stretched thin and genuinely committed to its patients. What was needed was a different kind of intervention: one that honored the expertise and dedication of the hospitalist staff, addressed the gap from a position of strength rather than deficit, and gave clinicians practical tools they could apply immediately in the context of their demanding daily practice. HXF was brought in to design and deliver exactly that.

The Solution

HXF partnered with the CMO, Hospitalist Medical Director, and the Office of Patient Experience to design a targeted, in-person development program built around a foundational belief: that the most effective path to improving patient experience is not to fix what is broken, but to expand what is already strong. The program was structured around HXF's CARES communication framework — a model for delivering highly-reliable, empathy-focused care experiences that meets clinicians where they are and builds from their existing strengths.

The full hospitalist staff of approximately 60 physicians and APPs was enrolled and divided into two groups. Each group participated in two in-person development sessions delivered one month apart, allowing time for reflection and application between sessions. The curriculum addressed the intersection of quality, safety, and patient experience — framing communication not as a soft skill or a survey strategy, but as a clinical competency with direct implications for care outcomes. Participants engaged with the CARES framework in depth and completed a teach-back component, reinforcing their learning by sharing key concepts with their own teams.

What distinguished HXF's approach in this engagement was not only the rigor of the curriculum, but the genuine care with which it was delivered. HXF coaches and the health system's own PX team and Hospitalist Medical Director provided individualized follow-up coaching following the group sessions — meeting each clinician where they were, acknowledging the real pressures of their work, and supporting them in applying new skills within the constraints of a demanding clinical environment. HXF also conducted a thorough review of patient experience survey results and open-ended patient comments, ensuring the development work was grounded in the actual patient voice rather than abstracted from it.

The Result

Within nine months, the results were clear. Participants achieved an average improvement of 10 to 30 national percentile points in physician communication — a range that reflects both the breadth of the cohort and the depth of the individual gains. Across the specific HCAHPS measures that define the physician communication composite, the improvements were concrete and consistent: Hospitalist Courtesy and Respect climbed from 81.7 percent to 92.3 percent on the Always response; Hospitalist Explain improved from 70 percent to 76.9 percent Always; and Hospitalist Listen moved from 71.7 percent to 73.1 percent Always. Each data point represents a shift in how real patients, in real hospital rooms, experienced the care they received.

The significance of these outcomes extends beyond the numbers. For a hospitalist team that had been working hard without seeing measurable recognition of that effort, the results validated something they had long believed but struggled to demonstrate: that they were capable of delivering an exceptional patient experience, and that with the right support, they could make that visible. The frustration and demoralization that had characterized the team's relationship with patient experience metrics gave way to something more sustainable — a sense of agency, competence, and renewed connection to the patient-facing purpose of their work.

What HXF's approach made possible in this engagement was a reframing of the challenge itself. Rather than treating physician communication as a performance gap to be corrected, the program positioned it as a professional capability to be developed — one that honors the complexity of hospital medicine, acknowledges the pressures clinicians carry, and builds on the strengths they already bring to the bedside. The outcome was not simply better scores. It was a hospitalist staff that felt seen, supported, and better equipped to deliver the kind of care that brought them to medicine in the first place.