Why Patient Experience Needs Transparency, Not Transactions
By - Is the art of delivering high quality healthcare – a field based upon the caring of patients during their most physically, emotionally, and spiritually arduous times – becoming too transactional? Is the simple goal of merely getting done what needs to be done to get through the day weakening the fabric of the industry? As the switch from volume to value continues, such questions require active discussion.
According to RJ Salus, Director of Patient Experience at El Camino Hospital, in a personal interview with RevCycleIntelligence.com about the importance of patient experience, a hearty yes answer to such questions rings true.
Salus says the healthcare industry needs to shift its focus away from that of a to-do list. Instead, focus needs to be placed upon the simple yet often overlooked art of providing moments of joy and delight for those patients who are suffering through vulnerable stages of their lives.
Do trying times call for desperate measures?
It is a very trying time for caregivers to keep up focusing on patient experiences, says Salus. Success means the ability to concretely meet and exceed the unique needs and preferences of different population segments – i.e. cultural, diagnostic, service line, gender-based, psychological, and so forth, he implies.
“We know what's on the horizon in terms of expansion of the values-based program and to outpatient and ED, hospice, and home health. Every industry, at least for Medicare payment, is moving toward that model,” Salus says. “It would be foolish to think that the commercial payers wouldn't start emulating what the government is doing.”
Is talk really cheap?
In terms of the quantification of goal measurement, Salus says although technology proves helpful, it has yet to fully catch up. “In healthcare, there’s this great amount of data from disparate sources. If we could figure out a way to look at it more holistically, we could define some of those as successes,” he confirms.
As HealthItSecurity.com reported, such technology plays a key role in happier physicians, nurses, and patients. For instance, secure mobile technology can strengthen the patient engagement experience by helping physicians and nurses spend more time with patients.
Patients are often interviewed across a variety of settings and provide verbatim feedback about their wants and needs. Focusing on one point in time amidst a mountain of captured qualitative data is the key to success, says Salus. Such information needs to be recognized in real time so it can be best understood what a patients understands within a particular moment, he adds.
“We don't look at it holistically. We just look at that point in time because that's where it's captured,” he says. “It helps the patient understand what their service recovery needs may be. You can quantify to some degree whether or not they're happy with you. If they start talking to their neighbors in a bad way, you start losing market share.”
Should physicians be learning how to communicate in med school?
Salus says many physicians and clinicians, outside of El Camino hospital, struggle with accepting the concept of patient experience. Salus says their common criticisms include: “I don't understand this patient experience thing. I don't know why you want me to do this. This is not what I went to medical school for."
This type of reaction to the incorporation and integration of patient experience efforts may be based upon fear, says Salus. Yet, what poses problematic is the notion that physicians are not really assessed on the effectiveness of their ability to effectively communicate.
“There are articles and blogs written about patient satisfaction leading to clinical errors because clinicians bend over backwards to do something that may be the wrong thing,” Salus says.
“That kind of mentality will almost always get in the way of improvement obviously. Other industries won't even let an associate talk to a customer without hours or days of training. In healthcare, a nurse finishes school or a doctor finishes school and they just go out there and start doing stuff. They're proctored on their clinical skills and not necessarily on their communication skills,” he adds.
Salus says efforts currently underway throughout El Camino Hospital to help strengthen communication skills include guided coaching, shadowing people, and promoting direct communication.
“We have done things like other institutions in terms of massive classes and educational seminars on communication tips and how to give the best experience. Those have a nice halo effect for a short-term," he maintains. "Long-term if you can meet the individual where they're at and give them some pointed tips – this could be as simple as knocking on the door before you enter – it moves the mountain a little bit quicker."
“Patient experience is the sum of every single interaction. It's not like I can just go to the nurses and say, ‘I really need you to behave today and communicate well.’ That doesn't work,” he explains.
What does work? Salus says a multi-faceted focus will improve overall patient experience. “It's the way we answer the phone. It's the way people are greeted when they first walk through the door. It is the clinical care at the bedside,” says Salus. “You can't just focus on one area and get really good at it in terms of improving the patient experience,” he adds.
The art of face-to-face communication lives on
Salus mentions a dual approach to quantifying patient experience goals: through survey data and process goals. “We don't want to just be chasing the test,” Salus says. “We want to be doing what's in the best interest.”
For instance, nurse leader rounding tools, says Salus, establish a feedback system, help quantify intangible information, and allow the chief nurse to know more information about how many people are rounding and how many patients were seen.
“The data we get from that is very meaningful and has actually helped us recover some patients when they've complained because we can go back into the system and look at any issues,” says Salus. “One of the biggest things that we do that many hospitals around the country do is purposeful hourly rounding. It's a tactic, but the strategy is really to increase face time with the nurse.”
Salus says this promotes an open line of communication and trust between patients and nurses. “I'm not worried about what a patient is saying about their experience in the middle of their experience because I don’t know if they're going to tell me the whole truth if it's not going well,” Salus states. “What I want to know is if they have a line of communication open.”
When hospitals are narrow-mindedly task-oriented, the result of such is merely more work, and rework, down the road, says Salus. “Hospitals and healthcare systems have made investments into patient portals that were built pretty much just to meet meaningful use requirements. They've had to be rebuilt because nobody actually wanted to use them. They got the task done, but they didn't do it in a patient-centered way,” he adds.
“When you do rounds in a patient-centered way and you're developing relationships as opposed to just ticking it off and filling your accountability off to your chief nurse or if you're constructing a new hospital or new space – when you design it for your customer, it's a win/win in the long-term,” says Salus. “We can avoid a lot of re-work when we involve our customers.”
Strong communication, says Salus, doesn't only increase organization loyalty, but has been proven to increase adherence into treatment plans. “If people like you and trust you, they're actually going to follow through with your recommendation,” he maintains.
The benefits of transparent communication are advantageous, says Salus. “90% of the time, people just want to say, ‘Thank you.’”
