Skip to main content

Many, many years ago, I used to love playing a game on my computer called Theme Hospital. In the game, you would build a hospital with its many intricacies, staff it and then operate it, treating sick patients.

While the game was a basic simulation of what happens running a hospital, some of the requirements are very much the same as operating real hospitals in the real world.

In healthcare, we are often stuck in the traditional project management triangle of frustration, looking to balance cost, quality and time. In the game, it was often quite fun to try and balance all three. In reality, this is the challenge we’re all working to overcome—which is very tricky and typically not very fun.


Patients don’t have to accept waiting times as the normality in clinical care. Waiting times are actually a symptom of the way in which we conduct our business. They are a by-product of the way in which we choose to set up our organisations.

Don’t believe me? Ask yourself this simple question: If we accept that long waiting times are normal, why do patients consistently complain about them?

Time is valuable to all of us, in varying degrees. For our patients, in the context of their healthcare and treatment, time is even more precious. Making sure that we value that perception of time—the patient’s perception—is key to delivering good, valued experiences.


Delivering services of any kind will cost money. Whether it’s the patient needing to pay directly (or indirectly) for receipt of a service or the operational expenditure in delivering the service, cost always comes into play.

In most organisations, cost is the ultimate, underlying motivator for making a change. A direct example would be a consumer price increase for a service because someone has made the evaluation that the particular service isn’t generating enough revenue.

Interestingly, many studies have found that cost can actually be a secondary concern to consumers if the service is giving them what they want and when and how they want it— unless the cost is outrageous, of course.

Cost makes up a component of perceived value in the patient’s mind. An important part, but not always the main part.


To understand and balance quality in our triangle of frustration, we often try and put our patients’ hats on for ourselves. For a physical product, this seems to be easier as our tactile responses come into play. “This feels like good quality because it doesn’t bend when I try and flex it,” for example. With service delivery, quality can often become muddled with both time and cost because the definitions of quality are harder to discern.

How should we define quality in our services? The answer might seem obvious, and it’s a lot harder than most think—we need to ask our patients. Quality is often quite subjective, and when we try to make assumptions about what others might consider to be ‘good quality,’ we can end up only seeing a part of the picture.

For our patients and even our staff, the idea of good quality needs to be as accommodative and flexible as possible.

Patient Experience?

By now, you may be asking, “So, how does patient experience help balance time, cost and quality?”

Perhaps a better question to ask might be, “Can we afford to let any of these components slip?”

In order to get the strongest outcome for any work, involving the patients in our work is key. In fact, it’s so important that consumer panels are often key requirements that need to be met by various national standards, especially in healthcare.

By including the voice of our customers, our patients, in the change, and truly responding to how they are defining time, cost and quality, we will always end up with a better outcome than if we simply assume what we think is a good balance.

Winning The Game

There is no silver bullet here. No cheat codes. And you can’t get your friends to come over and finish the hard levels for you (sorry, Kevin!). In order to get the right balance, you’ve really got to roll up your sleeves and get down to business.

Involving our patients in our organisations makes a lot of sense. After all, they are the ultimate consumers of our services. Getting their definition of value early will point us in all of the right directions regarding time, cost and quality.

It’s not an easy thing to win… but it’s worth putting in the effort up front to get the right outcomes at the end.