Patient's Perspective In Health Care

  

s we go into more details about what patients want, we ask ourselves what patients are using as basis to pinpoint their "patient satisfaction." Patient Surveys tells us that patients are looking at the following factors:

a)      How often did nurses communicate well with patients,

b)      How often did doctors communicate well with patients,

c)      How often did patients receive help quickly from hospital staff,

d)     How often was patient’s pain well controlled,

e)      How often did staff explain about medicines before giving them to patients,

f)       How often were the patients’ room and bathroom kept clean,

g)      How often was the area around patients’ rooms kept quiet at night,

h)      Where patients given information what to do during their recovery at home (U.S.HHS, 2011).

      So, not only are patients telling us that what they need when it comes to medical assistance, through these surveys, patients are telling us what is important to them; and doctors and leaders need to listen up. Now on the other hand, there are many doctors that are taking the initiative and are seeing the “light” of what engaging with your patients and customizing services to their patients needs can accomplish: more patient retention, more referral and more pay, thus more revenue.  Howeve, we are also seeing an increasing trend of doctors that use this as a strategic advantage.  By focusing primarly on the “patient satisfaction” aspect of medical care, they are being more selective on who they see, and who they refer.

     In a report done by healthLeaders, and commented by KevinMD, “Already, more than 80% of doctors said patient pressure influenced their medical decisions. And in primary care, linking bonus pay to patient satisfaction could cause physicians to be more selective in who they see, subtly keeping patients who they know will score them well, and referring disagreeable ones to other providers” (KevinMD, 2011).

     So, now we have the irony that if you are not a well satisfied patient your are not "good patient", and physicians will send you elsewhere. Here I see an ethical dilemma. What comes first? Patient’s perspective on satisfaction vs. medical service perspective. In other words, if we completely focus on what the patient says, do we compromise the medical quality of care and the access of care?

     This is a great question to debate, because it tells us what we can expect if the wheels turn completely.

     There has to be a balance. For example, if a patient constantly feels the need for prescription drugs, should a doctor deny this, even though the drug could “control the pain well” (see patient satisfaction survey question “d”). So, I see that a balance must be met. Patients should be also educated enough to see the line between good medical care and bad medical, and good patient focus care and bad patient focus care; because if not, we risk losing care from excellent doctors, because of our uneducated patient perspective.

References:

KevinMd.Com. (2011). Op-ed: Patient satisfaction doesn’t mean the best medical care. MedPageToday’s. Retrieved June 26, 2011 from URL: http://www.kevinmd.com/blog/2010/04/oped-patient-satisfaction-medical-care.html

U.S. Department of Health & Human Services (2011). Survey of Patients about Their Hospital Experiences Graphs. HHS.gov. Retrieved June 26, 2011 from URL: http://hospitalcompare.hhs.gov/Graphs/hospital-Graph.aspx?hid=100007,100006&stype=GENERAL&mCode=HCAHPS&graphState=FL&tab=HCAHPS

"Service Serves" - Patient's Perspectives Feeds The Bottom Line

A patient’s perspective in the quality of healthcare is a vital part of an organization’s success. Enhancing a patient’s perspective on the quality of care they have received is an investment. It brings “greater profitability; improved customer loyalty and increased referrals; it teams staff towards a common goal, brings positive staff morale, retention, and recruitment benefits; and brings strong community support” (Michelli, 2011, p. 225).

In fact, empirical evidence gathered by UCLA’s health system says: 1) “Even in difficult times, 50 percent of consumers will pay more for a better service experience”; 2) “A full 68 percent will sever a customer relationship because they were treated poorly”, 3) “companies that are successful in creating both functional and emotional bonding with customers have a higher retention rate (84 percent vs. 30 percent)”, and 5) “The cost to attract a new customer is 6 times the cost to save one” (Michelli, 2011, p. 227). An even stronger finding was that out of all the patients that leave a provider for poor quality, only 15% reported it was due to “product” reasons; in other words, 85% left because of poor service (Michelli, 2011, p. 226).

So then we ask ourselves, if patients play such an undeniable role in a physician’s success, what keeps them from centering they mission towards “patients”?  In the book Prescription for Excellence, it states that “the healthcare industry has lagged in accepting this concept for several reasons:

“Customers are not loyal in the traditional sense because they usually wish to avoid using the healthcare system except when necessary”

“Most customers are insulated from price due to health insurance, and often fail to care about cost, only wanting the best, newest procedures”

“Clinical care is often viewed by physicians as completely separate from traditional customer or administrative services’

Clinicians believe great medicine will gain forgiveness for poor service” (Michelli, 2011, p. 228).

However, what these healthcare organizations and physicians do not grasp is that ‘word of mouth” is a powerful tool that can either make you or break you. A patient’s perspective not only influences his/her behavior, it can tarnish another’s. One example, was when I was getting ready to have my first daughter Amelia, I really wanted to deliver at Hospital X vs. Hospital Y, because of its new facility, great food, and the best in technology. But, one day when discussing my options to a person I met, she advised me to not deliver at Hospital X, to instead go to Hospital Y because of poor customer service. I had changed my plans to deliver at Hospital X, until the last minute I had a change of heart. I wanted to give Hospital X a chance of my own, and I did not regret it. But, my perception was altered (at least temporary) by word of mouth, and it could of cost Hospital X, two (2) deliveries of my own, and many referrals from me.

When leaders put focus on delivering quality service with the patient’s perspective in mind it brings staff together. Employees become engaged when they feel that their contribution is substantial “The mission/purpose of my company makes me feel my job is important” (Michelli, 2011, p. 236).

             In conclusion, a patient’s perspective is a key role in any organization. In healthcare, it was will make success sustainable without limits.

References:

Michelli, Ph.D, Joseph A. (2011). Prescription for Excellence. McGrawHill. Co-published with Second River Healthcare Press

What Quality Means to Me - Part 2

 I have been reading an excellent book "Prescription for Excellence" by Joseph A. Michelli. This book talks about how UCLA Health System (UCLAHS) has become a top tier medical institute due to their commitment to care, which breaks down into five different principals: " 1. Commit to Care, 2. Leave No Room For Error, 3. Make The Best Better, 4. Create The Future, and 5. Service Serves Us" (Michelli, 2011).

From an HSA graduate student perspective, the combination of these 5 principals is an excellent example of what quality means to me, and should mean to all health care systems. Quality in a successful health care system required "the innovation of Apple, the commitment to safety of NASA, and the customer service of Ritz-Carlton" (Michelli, 2011, pg. 1). This approach has worked for UCLAHS, and I ask myself are all hospitals as committed to these principals as UCLAHS? and if not, why not? How will they survive, in a market where customers (patients) are becoming self aware and more educated on their health and health care.

From an HSA student perspective, quality is understanding that every aspect, every personnel in a health care system contributes to the outcome "customer/patient satisfaction". That each department, each staff member, each procedure matters in providing the quality of service that patients require and demand, because ultimately "Service Serves Us".

Reference:

Michelli, Ph.D, Joseph A. (2011). Prescription for Excellence. McGrawHill. Co-published with Second River Healthcare Press, pg. 1