'I begin to consider what our patients experience at City of Hope...'

June 24, 2014 | by Traci Biondi M.D.

It is mid-afternoon on a Sunday at the cosmetics counter at Macy's. A woman approaches with smiling eyes and dewy skin in a crisp white lab coat. I feel at ease as she offers me a seat.

With a soft touch she applies eye makeup and powder to my forehead and chin. She is charming, attentive and eager to please as she hands me a mirror. I look and see a new subtle glow on my cheeks. And now I feel delighted, refreshed.

The presentation and delivery of customer service is excellent. The experience matters to me.

quality of patient care The quality of patient care can be, and is, measured in ways both large and small. But some of the most important aspects of the patient experience simply can't be quantified. Patients at City of Hope know this. So do their doctors, nurses and everyone else who works to make City of Hope different.

I begin to consider what our patients experience at City of Hope. What is it like to navigate through a cancer diagnosis and treatment? As an anesthesiologist, I often wonder what it might be like if it were me on the gurney waiting to be wheeled into the operating room.

Medicine is science. It is procedures, algorithms and check boxes. But for our patients it is perceived differently.

The Centers for Medicare and Medicaid Services (CMS) have developed specific quality measures that are a fundamental part of medical care. These measures, or indicators, translate into cost of care and ultimately payment for both hospitals and individual physicians. CMS monitors this by way of the check box. This is a deliberate, substantive list of indicators that are used as a kind of measuring stick to be sure we have not omitted critical details in patient care and health care processes.

Over the past few years, the patient experience has increasingly become a new focus for CMS. Patient satisfaction scores, which are available in a variety of languages and platforms, take into account cleanliness and friendliness as part of the pay-for-performance incentive.

Other measures include call-button response time and overall staff responsiveness. If the Jell-O is warm and the soup was delivered cold, CMS wants to know about it.

No doubt, our patients have come to expect the highest quality of care at City of Hope. Yet I wonder about the aspects of this experience that are not as directly measurable. There are so many intangibles that are truly difficult to quantify. And when it comes to patient satisfaction, are we measuring the things that matter?

Each day I witness countless small deeds that contribute to the quality of patient care. They may not be measurable by industry standards but certainly increase the value of the experience for the patients and families who seek care at City of Hope. These are people who have had to usher in a new normal at the sound of the words malignancy, metastasis and cancer surgery. I see a variety of small yet deliberate acts of decency and kindness that are immeasurably valuable. This is often before I ever meet my patient.

I see it in one knowing look from the nurse who has connected with my patient. She has the first glimpse into the depth of their fears while placing the IV in preparation for surgery.

Another listens to a father of twins whose eyes brighten as he begins to talk about his children and their plans when this is "all over."

I see it in the gentle reassurance given to a wife and mother who, despite disease progression, is far too busy for cancer.

There is also comfort in the guidance offered to our patients' families. The families who are recognizable by the whites of their eyes now cloudy with talks of chapters of a life for a loved one that is yet to be penned.

In the operating room there is the grace and kindness of the members of the operating room team as each person strives to help our patients bear the physical and psychological pain of cancer surgery.

This, as we all for a brief moment become polytheists, accepting the blessings and prayers bestowed upon us by a variety of patients from all manners of spiritual and religious backgrounds.

If the devil is in the details, then I believe the individualized attention and appreciation of each patient's story speaks volumes for the quality of care at City of Hope. I am proud to be part of this, as I believe City of Hope fosters a culture of pride in superior patient care. It's the foundation upon which we deliver and check the boxes for each and every quality measure as delineated by CMS. This matters to my patients and it matters to me.

If all of medicine is reduced to algorithms and check boxes, then who will be left to provide the caring part of medical care? I am confident we can count on City of Hope. And for this, there is no check box.


Traci Biondi, M.D., is an assistant clinical professor in the Department of Anesthesiology. The goal of the City of Hope Department of Anesthesiology is to deliver the safest and most compassionate perioperative care to surgical oncology patients while utilizing the most advanced evidence-based techniques.


City of Hope's exceptional level of cancer care was recently recognized by the American College of Surgeons Commission on Cancer with its highest level of accreditation, “Three-Year with Commendation.” 

Also, in 2013, City of Hope was the winner of two prestigious Press Ganey awards for our top-quality patient care, marking our fifth consecutive year of being honored by the health care industry’s leading performance improvement firm.

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