The Gist
- Real-time patient feedback transforms care. BJC Healthcare uses real-time patient insights to improve hospital experiences, ensuring concerns are addressed immediately.
- AI is boosting patient experience. Artificial intelligence helps analyze massive amounts of feedback, streamline communication, and break language barriers for better care.
- Emergency department transparency matters. BJC is enhancing ED experiences by providing digital wait time updates and proactive communication to reduce patient frustration.
- Physician training must evolve. Healthcare leaders are pushing for patient experience education in medical training to ensure providers understand the human side of care.
- Surveys are just the starting point. Regulatory patient experience surveys set the baseline, but real change comes from deeper insights and immediate action on patient feedback.
Jennifer Carron, patient experience officer for BJC HealthCare and a certified patient experience professional, is on a mission to improve healthcare interactions at every touchpoint. In this conversation with CMSWire’s Dom Nicastro on the CMSWire TV show Beyond the Call, she dives into the evolving role of patient experience, the challenges hospitals face in delivering high-quality care and how AI and real-time feedback are shaping the future.
From emergency department (ED) innovations to better physician training, Carron shares insights on bridging communication gaps, reducing friction and ensuring patients feel heard. She also discusses BJC’s approach to balancing regulatory survey requirements with deeper patient engagement strategies.
Now, let’s check out some key moments from the video interview.
Editor’s note: This transcript was edited for clarity.
Table of Contents
Why Patient Experience Is Important
Jennifer Carron: Yeah, so my career journey is unique as with many experienced officers. I originally was in the Air Force. I wanted to go into big business and my son became very ill when he was five years old, and we almost lost him due to poor care. We were very fortunate to land in a spot with a team that listened and understood. But what started with a routine visit ended up with a direct admit to the hospital in an emergency situation. That really changed my career trajectory.
I wanted to go into healthcare quality and make sure that we get it right for every patient. From there, I quickly realized that in healthcare, we really struggled to meet our quality outcomes because we do not include the voice of the patient. As an organization, historically, we’d sit around and talk about why a patient was readmitted—but where’s the patient in the conversation? And when we look back at root cause, are we including the patient’s family? That realization really blossomed my career. I’ve had a great career so far, really focused on including the voice of the customer in all that we do.
Here at BJC, we’ve grown quite a bit—44,000 staff, 28 hospitals across three states. I have the great honor and pleasure of supporting our staff and community as we further improve the experience and clinical outcomes for all.
Dom Nicastro, CMSWire: That’s an amazing start to your career in healthcare. You’re coming from a place of compassion. You really can just empathize with what’s going on in a patient’s mind, in their family’s mind. That must be the bedrock of everything you stand for in patient experience. You must constantly keep your family in mind.
Jennifer Carron: Yeah, lived experiences for sure.
Dom Nicastro, CMSWire: Yeah. So how are we doing? Give me the state of the state with patient experience across the board. I know you might say, “Hey, we’re doing great because I’m leading and watching it. My team’s crushing it.” But give me the real state of patient experience in healthcare. Are we getting better? You know, sure, we have patient portals now and we can text the doctor. That’s cool. I just went through an experience where I could do that—and they gave me the wrong information. So text doesn’t matter. Sure, it was convenient and quick, but they gave me somebody else’s chart, I think. So we’ve got room to grow. Where do you think we stand as an industry in patient experience?
Related Article: One Industry Ripe for Better Customer Experience: Healthcare
Where We Stand Today With Patient Experience
Jennifer Carron: I tell you, we are so far behind the service industry. You know, it’s funny when I get together with my service industry colleagues—I mean, healthcare is a service provided in the service industry—but healthcare is unique in that historically it’s been very physician-driven. Consumers don’t have much choice. It’s been a very formal experience between the patient and the health system.
Jennifer Carron: Over the last 10 to 15 years, because of numerous changes in the healthcare landscape and how we’re reimbursed, organizations have had to wake up and say, “We need to listen to our patients.” There’s a plethora of research over the last 15 years that demonstrates the importance of patient and family voice in clinical outcomes.
Jennifer Carron: As a nation, we’re trying to improve health outcomes—we’re trying to get diabetes under control, manage hypertension and reduce heart attacks. But we have to first fundamentally understand why each individual patient has the condition, the environment in which they live, and how we need to start speaking their language. Less talk about A1C levels, and more about what they want to accomplish in life—what’s their best life, and how can we help them achieve it?
Jennifer Carron: Healthcare organizations are starting to wake up. I think we’ve seen exponential improvement over the last 10 years. It’s getting highly competitive, and the requirement that we survey patients in many of our care settings—and the transparency of that information—has led to those changes.
Dom Nicastro, CMSWire: Yeah. Was that a regulatory requirement now to survey?
Jennifer Carron: It is. For example, a hospital stay requires us to randomly survey patients using a specific set of questions that we can’t deviate from. And all of that data is transparent. Anyone can go to CMS.gov and pull up any hospital’s data to see their patient experience scores.
Dom Nicastro, CMSWire: Wow, okay. So is that a CMS regulatory thing, or is it also a Joint Commission requirement?
Jennifer Carron: It’s CMS. Joint Commission also has some regulatory requirements. There’s also Magnet certification. So there are all sorts of new regulatory requirements and certifications that now include the voice of the patient—especially in the last 10 to 15 years.
Dom Nicastro, CMSWire: Yeah, yeah. So you have that data. I know the Office for Civil Rights mandates reporting of breaches if there are 500 or more people affected. So transparency expectations have been elevated, placing more responsibility on hospitals and the healthcare industry to be open about their processes.
Jennifer Carron: 100 percent.
Dom Nicastro, CMSWire: That’s good. Now, when it comes to your organization—so, BJC—you’re required to conduct surveys. How does your survey process work? What are some of the wins? What are the most effective survey strategies you use? And then, of course, you have to analyze all that data too. How’s that process going?
Jennifer Carron: Yeah, so I often refer to the CMS surveys as the bare minimum. But as an organization focused on health, we need to dig deeper and ask more specific questions that align with our strategic goals. We have to understand if we’re truly meeting the needs of our consumers and patients.
Jennifer Carron: Our survey program is broad and comprehensive. We employ real-time, in-the-moment data collection. Going back to the hospital example, we have nurse leaders who round on every patient and ask a series of structured questions. These questions help identify whether patients understand what’s happening in their care and if they feel included in their treatment decisions.
Jennifer Carron: This real-time feedback allows us to quickly pivot when necessary. If we only relied on post-discharge surveys, the opportunity to correct course during a patient’s stay would be lost. On average, a patient will interact with about 60 different team members over a four-and-a-half-day stay—that’s a lot of opportunities for service failures or communication gaps.
Dom Nicastro, CMSWire: Yeah, that’s a lot of potential touchpoints.
Customer Survey Successes
Dom Nicastro, CMSWire: Yes, yes, and improvement on the spot. I know a lot of CX consultants and vendors talk about real-time feedback, but this is literally the definition of it. If there’s a patient laying in a hospital bed telling you something and you’re acting on it in the moment, that’s as real-time as it gets. Is that a regular part of your CX voice of the customer program?
Jennifer Carron: It is, yes, in all of our hospitals.
Dom Nicastro, CMSWire: Wow, that’s a heck of a vantage point, Jen. Look at me, for example—I’m a consumer of Snickers bars, right? The Snickers people aren’t standing there watching me eat it. They have to get feedback after the fact. There’s not a bunch of researchers standing next to me going, “Hey you, how are you feeling? Do you like that bite?” But you have that real-time feedback in the hospital setting.
Dom Nicastro, CMSWire: Give me an example of when you collected a lot of data on an issue, saw it was recurring, and then implemented a course correction. Something you’re particularly proud of—does anything like that stand out recently?
Jennifer Carron: Yeah, I’ll share one with you because this is an issue that many hospitals struggle with. Across all industries, access is always at the top of the list for driving customer experience. And in our emergency departments (EDs), like almost every ED I’ve been in or every leader I’ve talked with, when wait times go up, experience scores go down.
Jennifer Carron: For years, we’ve been asking ourselves, “How do we get them in faster? How do we get them out faster?” But the challenge is, we never know what’s going to come through the door.
Dom Nicastro, CMSWire: Oof.
Jennifer Carron: It could be a natural disaster. It could be a major car accident on a highway. It could be flu season. You just never know. It’s unpredictable. So instead of trying to control the unpredictable, we focused on how to better manage it.
Jennifer Carron: Through the voice of the customer, AI and advanced analytics, we were able to identify that the core issue wasn’t actually wait time. It was the lack of communication during the wait. And when we looked at our patients 35 and under, they wanted digital updates—and they wanted them now. They wanted to understand why they were waiting.
Jennifer Carron: So we put a process in place where, when our ED surges and wait times go up, we have specific intervals for communication with patients. We also trained our staff with response behaviors tailored to those situations. Because of that, we’ve changed our experience scores from, “I would never come back there,” to, “I may have spent six hours in the ED, but there’s no place I’d rather be because the care team truly cared about me.”
Patient Communication Issues
Dom Nicastro, CMSWire: Yeah, so you’re providing emergency department (ED) patients with digital text updates about their wait time and status?
Jennifer Carron: Right now, we’ve put concierge staff in our ED rooms to provide updates, and we’re actively developing text updates as we speak.
Dom Nicastro, CMSWire: You know, Jennifer, if I lived in St. Louis—your area, right?—and I was two hours away from your hospital, but only ten minutes away from another hospital that doesn’t have that service and offers no wait time updates, I’d drive two hours to your hospital. Because that would actually be the shorter wait—or at least I’d get updates on where I stand in line.
Jennifer Carron: Yes.
Dom Nicastro, CMSWire: That is powerful. I’ve never heard of an ED integrating a digital experience into the waiting room like this. And honestly, I think long wait times at EDs are an epidemic. Some people avoid going to the emergency room entirely because they assume the wait is going to be insane.
Jennifer Carron: 100%, Dom. We see that in the data. And you also have to consider the family experience. Very few patients come to the ED alone. If you’re sitting in the waiting room with a loved one in the back, and you haven’t heard anything for three hours, you want an update. So now, the patient can identify a family member or friend to receive those updates, and we can send them along in real time.
Dom Nicastro, CMSWire: Right. That’s so true.
Dom Nicastro, CMSWire: I feel bad for people who think they’re “in” the process when all they’ve done is triage. They go through a quick intake—”What’s your name? How are you feeling?”—and then they end up waiting another six hours before getting a real assessment.
Jennifer Carron: Yeah, which brings it all back to communication, right? If you knew that your care team was working behind the scenes, running diagnostics and prepping for your treatment, you’d realize your care is progressing even though you’re still in the same spot. It’s so important to communicate that clearly.
Dom Nicastro, CMSWire: Yeah.
Dom Nicastro, CMSWire: Jennifer, a lot of leaders in the contact center and customer service space talk to us about agent experience. So this effort—digitizing as much as possible, especially in the ED—has to help with that, right?
Dom Nicastro, CMSWire: When I say “agent experience,” I mean the person at the front desk, the one handling everything coming at them—patients, family members, frustration, complaints. They’re often the ones hearing, “I’ve been here for seven hours. This hospital is awful.” How does this digital enhancement help support those frontline staff?
Related Article: Customer Service Crisis Management: Navigating Hurricanes, High Call Volumes
Frontline Staff Improvements
Jennifer Carron: Yeah, friction, friction, friction, right? Friction creates a bad relationship between the patient, the care team, and the entire experience.
Dom Nicastro, CMSWire: Yeah.
Dom Nicastro, CMSWire: It’s not a good fire.
Jennifer Carron: Every process, policy, or program we design is done through co-design. That means we involve the patient, their family, and the care team in the process to create a more harmonious experience. Strategically getting out in front of issues reduces friction. Empowering staff to respond effectively, training them through service recovery models, and providing a framework for de-escalation are all critical.
We also have a program called the Connect Recognition Program, which captures the voice of the customer and directs it straight to the staff members who improved their experience. We train our staff to create micro-moments—what we call “mission moments”—which are opportunities to enhance the patient experience in small but meaningful ways.
Patients and their families are then given the opportunity to submit recognition forms for employees who made a difference. This feedback is digitally captured and immediately pushed to the employee and their leader. It’s streamlined, it’s direct, and it ensures those moments of great care don’t go unnoticed. We also celebrate these recognitions through monthly recognition programs across the entire system.
Dom Nicastro, CMSWire: That’s amazing. You’re truly walking the walk of great customer experience and great employee experience. CX meets EX, as they say. That’s fantastic.
So, improving the agent experience in real time is one thing, but how about your traditional surveys? What’s been your most successful customer feedback mechanism in terms of response rates? Some industry standards show only 5-10% of patients respond to surveys. What’s the best way to get patients to actually share their experiences? Is it while they’re still in the hospital bed since they can’t go anywhere?
Jennifer Carron: There are a couple of things to consider. Research shows that certain demographics of patients are reluctant to say anything negative while they are with us due to fear of retaliation. And that’s a very real concern.
That’s why upskilling our staff to build trust from the very first interaction is critical. Patients need to feel confident that their voice matters and that their feedback will be used to make things better.
Dom Nicastro, CMSWire: Yeah.
Jennifer Carron: Then, of course, we have the CMS-required surveys.
Dom Nicastro, CMSWire: Yeah, you have to.
Jennifer Carron: The CMS questions are rooted in clinical outcomes. For example, did the patient understand their care? Was the environment calm? Studies show that a quiet and restful environment promotes faster recovery. So while these surveys are clinically relevant, the issue is that they provide old data—we can’t act on them in real time.
That’s why we partner real-time feedback with nurse leader rounding. If I’m a nurse leader or unit leader and I notice that patients don’t understand their care, I can immediately start asking patients: “Do you understand your care? What are your next steps? How can I help?” That allows us to gather real-time insights and adjust the patient experience on the spot, rather than waiting for post-discharge survey results.
The other key factor is understanding correlations between different data points—whether in the outpatient setting, the call center, or the hospital itself. If a patient doesn’t understand something, they may disengage entirely. Identifying and addressing that in real time is essential.
You have your outcome data—the post-experience survey that you can’t change. But your real-time data acts as a process metric that helps you understand where you’re headed and lets you make necessary improvements in the moment.
Related Article: Embracing AI in Customer Experience for Better Patient Experience
Customer Data Collection Explained
Dom Nicastro, CMSWire: Yeah, so you’re collecting a lot of data. What kind of systems do you use to do that? And how do you balance the security side of things? Because that’s so crucial in your industry. Like I said earlier, you don’t want to end up on the OCR website saying that you had a breach of 500 or more patients. Handling those calls would be crazy—a really challenging endeavor. So how do you balance where you keep your customer data and how you keep it secure?
Jennifer Carron: Yeah, it is definitely a balance. And it depends on the point of entry and the point of care where we are receiving that information. Our digital website captures a lot of data. But the interesting thing about healthcare, when we talk about digital experience, is that if consumers are searching for a product and don’t get it—unlike in ecommerce, where they just move on—in healthcare, that could mean they don’t get care at all. That can lead to poor outcomes.
So we need to ensure that if someone is struggling with our website, we have pathways in place to help them find resolution. If they don’t go to the ED because of long wait times, we need a way to guide them to alternative care options. In those cases, we do track user behavior to understand their journey. We also have strict security protocols, with regular security reviews to ensure compliance and data integrity.
For surveys, patients must opt in. If it’s a digital survey, they must give consent. We continuously monitor this to ensure we meet all requirements and keep the data safe. Our cybersecurity and compliance teams work closely to protect patient data at every step.
Dom Nicastro, CMSWire: Yeah, cybersecurity teams must be crucial. I imagine there’s a strong partnership with IT and security teams. And I’m sure some of the survey data you collect wouldn’t be a HIPAA breach if it got out because it’s not tied to a patient’s identity. It’s just anonymized data rather than, say, “Dom Nicastro said he had a headache and needed treatment.” You might collect that somewhere, but you also have aggregated, non-identifiable data, right?
Jennifer Carron: Exactly, yep.
Dom Nicastro, CMSWire: So that’s one advantage—you can still analyze data while mitigating the risk of breaches.
Jennifer Carron: Right. A great example of that is our post-discharge survey data. We keep that data behind the firewall, very secure. But we also convert it into star ratings and patient comments that we publish online—completely de-identified. Patients can search for providers and see their scores and reviews with full transparency. But if we need to investigate a specific experience, we can do that securely behind the firewall.
Dom Nicastro, CMSWire: Yeah. Do you have to get physicians on board with patient experience? Do they care? Because I imagine they just want to fix the patient.
Jennifer Carron: Hahaha! Well, yeah, I mean, it’s interesting, right? Physicians have an agenda every time they meet with a patient, and that’s to diagnose and treat. Patients, on the other hand, have their own agenda—they want to explain what’s going on with them.
There’s actually research that shows physicians interrupt patients within 11 seconds of them explaining their symptoms or history. So, yes, a big part of our work is helping physicians understand the importance of listening, slowing down, and appreciating the patient’s perspective. When they do that, it actually saves them time in the long run.
We have a pretty robust onboarding program for our physicians and advanced practice providers. We also have 2,300 patient and family advisors who volunteer their time to provide input on their experiences. These advisors help train and coach physicians and other clinicians on improving patient interactions.
In addition to that, we prioritize timely feedback. Within 24 hours of a patient’s visit, physicians receive their survey results. Historically, this data was so delayed that if a patient complained about something like, “The doctor didn’t listen to me,” it was hard for the physician to recall the interaction. Now, by getting that data immediately, they can reflect on the experience and make adjustments in real time. It’s been incredibly effective in bridging the gap between traditional healthcare delivery and the modern healthcare ecosystem, which focuses on shared decision-making.
Dom Nicastro, CMSWire: Surgery’s done. Surgery’s done.
Dom Nicastro, CMSWire: Yeah.
Dom Nicastro, CMSWire: Yeah, I had a nurse practitioner recently who I was talking with about my care, but my wife is also very involved in my care. She actually rejected a medication they tried to prescribe me—because, well, she runs the show.
I told them, “My wife said no to that,” and I was bracing for a snarky response, like, “Well, I know what I’m talking about, and she doesn’t.” I was expecting that pushback, at least in some form.
Jennifer Carron: Okay.
Dom Nicastro, CMSWire: But instead, they were very compassionate—probably thanks to surveys like yours at BJC HealthCare. The nurse practitioner simply said, “That’s okay, we understand that patients have opinions too, and if you ever want to revisit that decision, just let us know.” It was a very thoughtful and respectful response.
So you mentioned training and coaching physicians using the CX data that you collect. Are they receptive to it? How willing are they to adjust their approach based on the feedback?
Biggest Barrier in Healthcare…
Jennifer Carron: Well, you know, each physician is different. I think we have a long way to go, but we’re doing a really great job of bringing the physicians along. I’ll tell you, Dom, the biggest barrier in healthcare is that we are not training our physicians during their residency to understand the service side of patient care.
By the time they graduate and we say, “Okay, go be a doctor,” they don’t know about any of this. So when they receive patient feedback, they’re often shocked. They don’t understand it. And many times, their reaction is, “I just need to make my patients happy.” But patients don’t want to just be happy—they want to be heard, they want to understand their care, and they want to have a voice in it.
We’re making progress, but as an industry, we have to integrate this into medical academia. We can’t keep waiting until after physicians have graduated and been placed on a national stage to succeed without the proper resources and training in patient experience.
Dom Nicastro, CMSWire: Yeah, especially since younger generations today are so focused on experience. Sometimes, the product itself doesn’t even matter as much as how they were treated. Were you available when they had a question? Did you respond to their tweet or DM? Could they text you information? Did you text them updates? All of that matters now.
So you’re right—this needs to be embedded into residency training. And by the way, I’ll wrap up the physician talk with this: I was at a conference once, and a physician just laid it out plainly. He said, “You know why we’re moody all the time and don’t like being told to do anything? It’s because we’re perfect.”
He explained that by default, every course, every certification, every step of their training has required perfection. If they weren’t perfect, they wouldn’t have made it. So when someone tells them they’re doing something wrong, it goes against everything they’ve been conditioned to believe about themselves.
That was an eye-opener for me. But of course, there are compassionate physicians, like the one I mentioned earlier who responded with empathy when my wife rejected a medication for me.
Jennifer Carron: Yeah, yeah.
Jennifer Carron: And I completely understand that perspective. The experience I had with my son was directly impacted by a physician who didn’t listen. It wasn’t a structural issue, it wasn’t a process failure, it wasn’t a delay in care—it was simply a physician who said, “I told you to do this. Go home and wait 10 days.”
That decision had consequences. I see both sides of it. I believe all physicians go into medicine because they want to practice medicine. But not all physicians fully understand the importance of patient experience.
Dom Nicastro, CMSWire: Wow. Yeah.
Dom Nicastro, CMSWire: You know, Jennifer, I think a lot of CX leaders listening can relate. Just replace “physician” with “CEO.” As an experience leader, you’re trying to get physicians—just like CEOs—to understand the importance of experience and why it matters.
I want to start wrapping up, but before we do, you mentioned earlier the acronym AI…
AI and Future Goals
Dom Nicastro, CMSWire: You said you’re actually implementing AI into those ED settings. Give me the tangible ways AI is actually helping to improve experience—something that you couldn’t do before.
Jennifer Carron: So a couple of ways. One, AI is taking large, large chunks of data and creating meaning out of it. I mean, we have, I don’t know, 300,000 surveys and comments, and within each comment, we could have anywhere between one to 20 different sentiments. Humanly, it is not possible to ingest and make meaning out of all this data. AI is allowing us to pivot, respond, and move more quickly to deeply understand what’s driving the experience.
Big picture, AI in healthcare is helping us move faster in diagnostics and assisting with reading X-rays. The field of radiology, for example, is making significant progress there.
I also think about health disparities. We serve over 40 different languages at BJC. AI is helping us take an educational piece and convert it into a patient’s preferred language within seconds. That’s another great space for AI. I don’t think there’s an area we shouldn’t investigate at some point. We need to act cautiously and keep learning from it, but AI will exponentially improve healthcare delivery and overall community health.
Dom Nicastro, CMSWire: I love it. And final question for me—of course, it’s only for me, I’m the only interviewer on this thing—who else would it be? The final question is, here we are, what’s something you really want to accomplish in the experience arena at BJC by the end of 2025? Some big project or even a small one?
Jennifer Carron: My list is long. Yeah, my list is long. But if I had to narrow it down to one, it would definitely be improving the ED experience. There are so many people that come to the ED because they feel like they have no other choice. I think it’s a great opportunity for us to build customer loyalty, earn trust, and improve the overall experience.
Dom Nicastro, CMSWire: Yep. You know, I’m going to give a little bit of leeway to hospitals on this because I do think we’ve treated the ED as a primary care physician setting in many cases. Not all, but many. And EMTALA, right? That law says hospitals have to treat patients, period. People may not know the name of the law, but they do know they have the right to be seen. And I like that law.
Jennifer Carron: Yeah.
Dom Nicastro, CMSWire: But I do think patients could do a little better in how they use the ED. That’s just me.
Jennifer Carron: Yeah, I think so too. But on the healthcare side, I think we could do a better job of providing other pathways. Not everyone who comes in is appropriate for the ED. Maybe they should go to urgent care or a virtual visit instead. But do patients know that? Do they have access to those options?
Dom Nicastro, CMSWire: Right, so it comes back to education and empowerment through digital channels. I get it. It’s all on the list. I expect Jennifer Carron to get it done at BJC Healthcare this year. No excuses.
Hey, you’ve been great—really great. Thanks for letting us into your world and giving us a look behind the curtain. Also, thanks for being a CMSWire contributor. We’ll make sure people know how to follow your insights on the platform as well. Can’t thank you enough.
Jennifer Carron: Sounds great, Dom. It’s always awesome to connect. Love your humor and approach to this topic.
Dom Nicastro, CMSWire: I love your approach as well. Great team here. Thanks for joining us on CMSWire’s Beyond the Call. You have a good one.
