Research Scholar Internship with Lehigh Valley Health Network - Final Manuscript

1. Running head: IMPLEMENTING MBTI® TO IMPROVE PATIENT EXPERIENCE AND
HCAHPS SCORES
Implementing the Myers-Briggs Type Indicator Report for Healthcare Professionals to Improve
the Patient Experience and Doctors’ HCAHPS Scores
Samantha Lutz
Lehigh Valley Health Network: Research Scholar
7/21/14

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Abstract:
Lehigh Valley Health Network (LVHN) wants to improve communication between
healthcare providers and patients by implementing a psychometric assessment called the Myers-
Briggs Type Indicator (MBTI) and a new application, the MBTI Report for Healthcare
Professionals. LVHN, in partnership with Consulting Psychologist Press (CPP), plan to
demonstrate proof-of-concept, and therefore, become industry leaders, by providing the
opportunity for healthcare providers to better understand their personality preferences and how
they can be leveraged to improve the patient experience and HCAHPS scores. By providing
these opportunities to providers, LVHN can improve patient care and the care experience,
enhance the health and effectiveness of their providers, and improve HCAHPS scores.

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Implementing the Myers-Briggs Type Indicator® Report for Healthcare Professionals to
Improve the Patient Experience and Doctors’ HCAHPS Scores
For years, organizations have been using the Myers-Briggs Type Indicator® (MBTI®) to
increase effectiveness and performance. Carl Jung developed the foundation for this assessment
and Katharine Briggs and her daughter (Isabel Myers) developed the concrete assessment itself
(Introduction to Myers-Briggs Type Indicator (MBTI®) Assessment [Intro to MBTI®], 2011).
According to CPP (Consulting Psychologist Press) the MBTI® has 4 dichotomies (see Appendix
A); these dichotomies are what define each individual’s personality (Walshe & Smith, 2011).
The MBTI® is known worldwide for its high reliability and validity (Intro to MBTI®, 2011).
The MBTI® is so successful that the company has produced supplementary assessments to
narrow in on specific applications to unique industries. Through utilization of the MBTI®, an
individual can enhance their self-awareness and performance thereafter. So if a healthcare
professional is, “unaware of their blind spots or of how they impact others; they can become a
‘walking disaster in the workplace, a leader who “may lead the troops over the cliff” (Koonce,
1996, p.19). This is an important quote for this study because Lehigh Valley Health Network is
experiencing complications with their doctors’ communication abilities and tactics. To make the
patients’ stay at the hospital better, we are hoping to utilize one of CPP’s MBTI® assessments
called, The MBTI® Report for Healthcare Professionals. This is a personality assessment for
those in the healthcare industry that relates the individual’s personality preferences to different
types of healthcare situations common in the medical field. The network is looking to use this
assessment to increase Hospital Consumer Assessment of Healthcare Providers and Systems

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(HCAHPS) scores for doctors. Not only will this lead to better care for the patients, but
ultimately, increased reimbursement throughout the payer mix.
The HCAHPS assessment is similar to the Press Ganey Report. It’s a standardized
assessment that hospitals use across the nation to attain objective feedback from the patients
and/or the patients’ families about their experience staying in the hospital. The HCAHPS runs an
incentive program through Inpatient Prospective Payment Systems (IPPS); so if there are high
scores, the hospital will receive a higher reimbursement. The HCAHPS covers 8 dimensions:
communication with nurses and doctors, staff responsiveness, pain management, communication
about medicine, discharge information, cleanliness/quietness of the room/stay, and, lastly,
questions about the hospital overall. It’s given to a random sample of patients and it is required
that the hospitals collect 300 surveys over 4 calendar quarters (HCAHPS Fact Sheet, 2013).
The HCAHPS survey is an important tool for the hospitals to use because it allows the
patient to provide candid feedback about their stay. “Patients report feeling increasingly anxious
and disconnected from their physician” (Reiss, 2012). That is what Lehigh Valley Health
Network wants to avoid at all costs. It’s important to know research states that establishing trust
between a patient and doctor is essential for an excellent hospital stay. “It only takes 15-30
seconds for someone to get a first impression before judging takes place” (S. Bhakunip, personal
communication, June 06, 2014). This then links to the patient reacting in one of two ways; fight
or flight (Manoj, 2005). If a doctor approaches the patient without establishing trust through
body language, addressing the patient as an individual, and being respectful, the patient will
stigmatize the remainder of their stay as a negative experience. While that patient’s physical
care may be exceptional in this instance, they will not categorize their overall stay as positive. To
avoid this, Lehigh Valley Health Network plans to administer the MBTI® Report for Healthcare

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Professionals to doctors in order help them better understand their personality preferences in
order to promote better doctor-patient interaction.
There has not been 3rd
party research or case studies done to support the specific
application effectiveness of the MBTI® Report for Healthcare Professionals. But there has been
extensive research done on the original MBTI® report that proves its validity and effectiveness
for making its users more self-aware. Additionally, the end users of these types of tools are also
highly satisfied. Participants from that study rated the MBTI® as well as the 360 Feedback
assessments on their ability to provide a higher level of self-awareness. This study showed, on a
Likert scale listed 1-7 (7 being highly satisfied), that both assessments had high means for
satisfaction (average was 5.36-6.18). The participants were interviewed and mentioned that the
two assessments helped them improve skills related to decision making, fostering motivation,
understanding other’s behaviors, flexibility, and the effects their actions have on others
(McCarthy & Garavan, 1999). Research also shows that “the more aware an individual is of his
or her workplace behavior, the more effective the individual is perceived to be by other raters
such as his/her peers and/or supervisors” (McCarthy & Garavan, 1999). If utilized effectively,
patients will perceive their caregiver as “better” and give the network higher HCAHPS scores.
One of the barriers to implementing this strategy is the cost; which is nominal. Also,
Lehigh Valley Health Network has successfully implemented the original MBTI® assessment in
the work place previously. Research has shown that other companies that have utilized the MBTI
follow suite. Donna Draper, the Vice President of Human Resources of the IDE Management
Group spoke about how they used the MBTI® to improve the communication in their health
network to create a common language across the organization in efforts to decrease conflict

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overall. She says that the program was so successful that they paid back their investment on the
MBTI® assessment tool within in 1 to 3 months after its delivery (Draper, 2014).
The hypothesis is this: if Lehigh Valley Health Network implements the Myers Briggs
Type Indicator Report for Healthcare Professionals, then they will experience a higher level of
care with patients, therefore increasing their HCAHPS scores for the network.
Methods
This project is currently being developed. Lehigh Valley Health Network, organizational
development, is currently seeking sponsorship to determine the feasibility and prioritization of
this project with other patient experience, service initiatives. There will be a stakeholder analysis
conducted to ensure alignment, collaboration and engagement (e.g. Network Office of
Innovation and Research [NORI], Dr. Jeff Etcheson, and others).
Participants
Lehigh Valley Health Network is refining the selection criteria to identify
participants. This criterion includes such things as sponsorship, local leadership engagement and
support. It is planned to have a small contained pilot area. That area must receive HCAHPS
scores, have a stable hospitalist team, and show the most room for improvement. There must be
willing and available participants in the nursing staff and active collaborative rounds on the unit.
Materials
Lehigh Valley Health Network plans to work with the MBTI® and Peer Review
assessments. The first assessment that will be used is the MBTI® Complete; this allows the
participants to take the full assessment on their own time and at their own pace. The participants
will also be able to learn about their own preference type. Once this assessment is completed,
they will receive the MBTI® Report for Healthcare Professionals. This assessment will also give

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them their preference type, but, in addition, it will supply the participants with examples and
training exercises that relate to their profession. Those involved will also be subjected to a peer
and self evaluation assessment. This will be given before and after the trainings.
Procedure
The program will begin with the administration of the MBTI® Complete and Self-
Evaluation, as well as a peer evaluation. Prior to any training, all outstanding assessments must
be completed. Participants will then attend the application and review of the MBTI® Report for
Healthcare Professionals. At this point they will be coached through skill building based off of
their assessment results in hopes of improving communication and performance during
collaborative rounds. To see if progress is being made, a maintenance strategy will be
implemented. Colleagues, through observation and periodic evaluation, will be able to reaffirm
or augment the original assessment’s recommendations. If necessary, another self assessment or
peer evaluation may be appropriate.
Results
Lehigh Valley Health Network plans to collect all scores from assessments and compare
them to the relative scores from other participants as well as to historical HCAHPS and Press
Ganey results. Not only will the network be looking to see if there are any significant
correlations in those areas, but they will also be analyzing the self and peer evaluations both
before and after the training process. There will then be a statistical analysis to see if there are
any significant correlations.

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Discussion
To be able to achieve optimal results, Lehigh Valley Health Network needs to be clear in
communicating how much value this research will add. This value will be added while working
towards all goals of the Triple Aim; better health, care, and cost. If utilized successfully, the
participants will have better health through enhanced metacognition and more effective ways to
manage stress based off of their personality preferences. Their patients will experience better
care during their time with the network with more emotionally aware doctors. And lastly, the
increased reimbursement as a result of better HCAPS scores will support the goal of better cost.
The network can support efforts to achieve these goals by applying a model I created
myself. It’s called the ETM model (see appendix B). The ETM model is based/related to
Maslow’s Hierarchy of Needs because in order for someone to move to the next level they must
fully achieve the level they’re currently on (Maslow, 1954). To help healthcare professionals
implement changes in their own lives, the network needs to focus on these key elements of
behavioral change. They must Explain, Train, and Maintain.
If they can properly explain the purpose of this project, how it can help, and what
HCAHPS are all about; the doctors will be more willing to participate. Past research shows that
doctors have incorrectly believed that HCAHPS scores are related to their competency of
providing care, not the quality of the patient experience. Under this false assumption, it has been
found that practitioners have broken ethical boundaries in order to attain better scores; e.g.
prescribing a med that may not be needed, or not performing a risky procedure). By properly
explaining what the HCAHPS and MBTI are, these providers will gain a sense of security with
the project and form a trusting relationship with the network that is free of judgment of the
participant’s competency.

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Providing healthcare professionals with the adequate training on their individual type
preference and how they can leverage their type effectively in any given situation is the core of
this project. Trainings could be in the form of webinars, professional coaching, or other
informational experiences. Through this training, the physician will gain a new level of self-
awareness and understanding. They also will build better self-esteem, independence, and
personal responsibility. All of these are skills that are innate in all of us, but the goal of this
project is to make the participant that much more aware of their unique style and where it is most
effective. Additionally, it will become more apparent when a participant must “flex” their own
style to best suit the needs of the patient.
It will be extremely critical to maintain all the knowledge and skills fostered through the
training phase. The network can help participants maintain their training by implementing
incentives or through observation methods. If the participant successfully makes it through the
maintaining phase, they are most likely fully implementing the training into their professional
life. Additionally, those through this last phase will have made great strides for their own
personal growth as well; creating a happier, better practitioner.
The ETM model could be a strong resource, but in order to effectively implement it,
LVHN needs to have the results to the MBTI® assessments. The reports themselves will help
participants better understand how to foster a better patient care experience. Most importantly is
the Healthcare Professionals Report because it covers many different issues that appear in the
medical field. The peer reviews will help the network examine and study consistency between
the MBTI® results and the peer and self-evaluation results; improving validity.
One of the changes we expect to see due to the implementation of this strategy is better
communication with patients, families, and staff. Better communication will also promote more

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openness within the individual so they will become more willing to flex their type preference
when a certain situation demands it. With the use of flexing, the individual will ultimately face
less stress in their lives. Limited stress with the participant will ultimately lead to less stress for
those who work around them; thus creating a more supportive work environment.
The key fact, that this strategy supports the Triple Aim, will undoubtedly draw support
throughout the network as to the value of this strategy. Lehigh Valley Health Network will be
industry leaders once this study is completed, which means that the network will receive
significant publicity over conducting the first published research using this assessment and new
report. This will show that LVHN is committed to bettering its colleagues and ultimately its
patients and community. A weakness of this study is the lack of time the network has to initiate
this project. It’s important to implement this pilot before the implementation of Epic takes place
because too much change may lessen the effectiveness of the training techniques and
participation.
For future studies it is recommended to come up with a script, a layout of what needs to
be completed, said, and administered to complete this pilot. Also, it’s important to keep gaining
opinions about what the team thinks about what needs to be done to avoid certain outcomes and
to see if any fresh ideas come through to enhance this study.

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Appendix A

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Personality Preferences Preference Meaning
Extroversion vs. Introversion Where one gets their energy from
Sensing vs. Intuition What one pays attention too
Thinking vs. Feeling How one makes decisions
Judging vs. Perceiving How one prefers to live life

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Appendix B

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References
HCAHPS fact sheets. (2013, January 1).Centers for Medicare & Medicaid Services
(CMS). Retrieved from www.hcahpsonline.org
Introduction to the Myers-Briggs Type Indicator® (MBTI®) assessment. (2011). CPP
Incorporation. Retrieved July 08, 2014, from
https://www.cpp.com/pdfs/Introduction_to_MBTI_Assess.pdf
Koonce, R. (1996), Emotional IQ, a new secret of success?. Training & Development,
50(2), 19.
Manoj, P. (2005) Five tips for generating patient satisfaction and compliance. Family
Practice Management, 12, 44-46. Retrieved from
http://www.afp.org/fpm/2005/0600/p44.html
Maslow, A., & Herzeberg, A. (1954). Hierarchy of needs. AH Maslow. ea., Motivation and
Personality. Harper, New York.
McCarthy, A. M., & Garavan, T. N. (1999). Developing self-awareness in the managerial
career development process: The value of 360-degree feedback and the MBTI. Journal of
European Industrial Training, 23, 437-445. Retrieved from http://www.site-
fusion.co.uk/files/writeable/uploads/webfusion58M065/file/mbti-
selfawarenessinthemanagerialcareerdevelopmentprocess.pdf
Riess, H. (2012, January 1). Teaching empathy can improve patient satisfaction:
Physician health matters. Massachusetts Medical Society. Retrieved from
http://www.massmed.org/News-and-Publications/Vital-Signs/Back-Issues/Teaching-
Empathy-Can-Improve-Patient-Satisfaction/
Draper, D. (2014). Healthcare management group finds success with Myers-Briggs®

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Assessment. CPP: TechValidate. Retrieved from: http://www.techvalidate.com/product-
research/cpp/case-studies/D36-25F-D5D
Walshe, K., & Smith, J. (2011). Chapter 20: The Myers-Briggs Inventory (MBTI).
Healthcare Management (2nd
ed.). New York, NY: Open University Press.