Tennessee Oncology

Judging Quality through the Patient’s Experience

An older adult can leave a medical appointment with a treatment plan and still feel uncertain about what happens next. Who should they call with a question? Which office is arranging the referral? Does a family member need to take time off work? Can they manage the plan at home?

These questions belong at the center of healthcare quality. A plan is only useful when the person receiving it understands it and has the support to follow it.

As Senior Manager of Quality and Value-Based Programs at Tennessee Oncology, I approach healthcare through the lens of quality, accountability and continuous improvement. My experience in healthcare operations has shaped a simple conviction: we must judge the quality of care partly by how manageable we make it for patients and families. Clinical measures help us evaluate performance, but they cannot tell the whole story of someone’s experience.

This subject is personal for me, too. My father lives with Alzheimer’s disease. That connection gives me another reason to think carefully about dignity, patience and the role of families in an older adult’s care. When I consider a process or an improvement opportunity, I ask myself whether it would help someone I love feel supported. Would the instructions make sense? Would our family know who to call? Would he be treated as a person with a lifetime of experiences and relationships?

Making Care Personal and Understandable

For older adults, particularly those navigating cancer care alongside other health needs, the experience can involve several clinicians, appointments, instructions and difficult decisions. Each office may fulfill its responsibility, yet the patient can still be left trying to connect the pieces. Healthcare leaders need to pay attention to those spaces between services.

We can begin by asking a better question. Along with what is the matter, we should ask, what matters most to you? The answer may be maintaining independence, attending a family celebration, remaining comfortable or understanding how a proposed treatment could affect everyday life. Those priorities deserve a place in the conversation and in the care plan.

Clear communication is equally essential. A patient should not need a healthcare background to understand the next step. Plain language, a short written summary and an invitation to explain the plan in their own words can help a care team identify what needs further explanation. Asking what questions you have also creates more room for conversation than asking whether everything is understood.

Clinical measures help us evaluate performance, but they cannot tell the whole story of someone’s experience.

Caregivers deserve thoughtful attention, too. With the patient’s permission, a trusted family member or support person can be included in discussions. But we should not assume that a person is available at every hour, understands every instruction or can take on every task. Asking what support they can realistically provide helps us build a plan that fits the household. Including a caregiver should also preserve the older adult’s voice and choices.

Building Reliable Connections between Services

Coordination needs a clear owner. Patients and families should know whom to contact, what to expect after a referral and who will follow up when information is missing. Someone will call you. It is an incomplete handoff. A useful handoff explains who will call, the expected timeframe and what to do if the call does not come.

Healthcare organizations should examine whether their processes work outside the clinic. Can someone arrange transportation? Are instructions accessible to a person who has difficulty hearing or reading? Is there a practical option for someone who does not use a patient portal? These are questions about whether our services can actually be used.

In my role at Tennessee Oncology, I believe the purpose of quality improvement is to make care better for the people who depend on it. That requires listening as deliberately as we measure. Patient and caregiver feedback should help shape workflows, staff education, and improvement priorities. A recurring concern about unanswered calls or confusing instructions deserves the same disciplined attention we give other performance problems.

I believe value-based care has its greatest meaning when value is recognizable to the person receiving care. That means care that respects their goals, offers understandable choices, and follows through on commitments. It means families leave with a clearer path forward.

As both a healthcare leader and a daughter, I want older adults to feel heard, respected, and supported. I want families to have confidence that their questions matter and that someone will follow through. Our responsibility as healthcare leaders is to build systems that make those expectations part of everyday care.