Patient Experience Week, an annual event led by the Beryl Institute and, this year, observed April 27 through May 1, celebrates accomplishments, re-energizes efforts, and honors the people who work to improve patient experience every day. By supporting Patient Experience Week, facilities can show their employees they appreciate their hard work and encourage their continued efforts on behalf of patients.
When we consider the current crisis and risks those on the front lines of medicine are taking to protect the lives of thousands of Americans diagnosed with COVID-19, we can think of no better time to express our sincerest, most heartfelt gratitude than during an event designated for this express purpose.
Before we outline ways to recognize Patient Experience Week, let’s overview the evolution of patient experience and patient satisfaction and how hospital medicine has uniquely influenced and impacted its development.
Evolution of patient experience
To say that creating positive patient experiences has come to the forefront of medicine is a vast understatement. While hospitals and physicians have focused on improving care for decades, we can attribute the current emphasis on patient experience to two forces that form a vice grip around the industry: the effect of consumerism and the shift from fee-for-service to value-based reimbursement.
Healthcare consumerism
Rising out-of-pocket costs have turned patients into consumers who approach healthcare services with greater cost-awareness. Thanks to information freely available online — ratings and reviews of doctor and hospitals, recommendations from social network connections, etc. — patients are making more informed choices.
Even though the cost of healthcare is top-of-mind with consumers, having a good experience ranks highly as well. Of the 73 percent of people who stated some aspect of cost is important, more than 90 percent say patient experience is either very important or extremely important, a Beryl Institute survey reports.
Healthcare expert Nicholas Webb, in an article about the experience economy, said that health systems are now joining the “89% of companies that expect to compete mostly on the basis of customer experience.”
That’s not to suggest hospitals experience consumerism in the same way as restaurants or retail stores, although one expert says that’s where healthcare should be going.
“When compared to that of the restaurant industry, customer satisfaction in healthcare is discouragingly low,” said healthcare strategy consultant Jeff Blake writing for Becker’s Hospital Review. “Imagine a restaurant that focused only on the quality of the food; even if the cuisine was exceptional, customers would soon abandon the establishment for competitors offering comparable meals and a superior experience.”
Shift from fee-for-service to value-based reimbursement
It’s fair to say the switch from fee-for-service to value-based reimbursement, culminating in the Affordable Care Act (ACA) in 2010 with its emphasis on quality of care, turned the traditional model of healthcare reimbursement on its head.
Although 2010 marks a turning point, we can trace the emphasis on patient experience back to 2006 with the adoption of HCAHPS, the first national, standardized, publicly reported survey of patients’ perspectives of hospital care.
HCAHPS surveys were not intended to ask patients how satisfied they were with their care, but instead, report on the aspects of their experiences that are important to them.
(Note: The terms patient experience and patient satisfaction, while used interchangeably, differ. The Beryl Institute defines patient experience as, “The sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.” Satisfaction, on the other hand, is a sub-set of patient experience that focuses on whether a patient’s expectations about a health encounter were met.)
Another step in the value-based evolution toward more patient-centered care came in 2007 with IPPS, which eliminated DRG-related treatment biases and improved patient experience by giving Medicare patients access to the right care.
A final step, the Value-Based Purchasing program, established by the ACA, has had a direct financial impact on hospitals since it was instituted by CMS in 2013 to reward or punish hospitals based on performance on various measures, including patient experience.
All of these actions led a 2017 NIH study to conclude: “Positive patient experience is associated with increased profitability and a negative patient experience is even more strongly associated with decreased profitability.”
Patient safety
Financial reward isn’t the only reason hospitals should make patient experience a priority. A study by the medical journal BMJ Open summarized evidence from 55 studies and found consistent positive associations between patient experience, patient safety, and clinical effectiveness.
“The data presented display that patient experience is positively associated with clinical effectiveness and patient safety and support the case for the inclusion of patient experience as one of the central pillars of quality in healthcare,” the study said.
Hospital medicine and the rise of patient experience
Since its advent in the 1990s, hospital medicine is a movement marked by an emphasis on improving patient experience.
Burke Kealey, MD, SFHM, president of HealthPartners Medical Group, a nonprofit health care provider and health insurance company, writing for The Hospitalist, said, “The forces guiding our work and stimulating our growth have evolved, but the overarching theme of the last twenty years has been improvement.”
In the article, Dr. Kealey recounts how the rise of the patient safety and quality movement coincided with the emergence of hospitalists.
“[W]e, collectively, in becoming aware of our quality deficits, gained newfound empathy for what patients were going through,” he said. “This focus on patient experience again plays into our strength and the opportunity we have as a specialty.”
In a separate The Hospitalist article, Dr. Kealey talked about the “Triple Aim” of healthcare.
“In today’s world, hospitalists must give the best quality care while giving a great experience to their patients, all at an affordable cost,” he said. “This concept of triple focus has given rise to a new term, ‘Triple Aim’ … It symbolizes an understanding that all three areas of quality MUST be joined together to achieve true success for our patients.”
How hospitalists can improve patient experience
In what ways can hospitalists improve patient experience? Consider these practical tips:
Start with HCAHPS
“Given that HCAHPS is the standard by which hospitals, health systems, and individual hospitalists are judged, it is vital for us to understand the core drivers of measured patient experience — especially the factors within our control,” said a 2015 article in The Hospitalist. “Armed with this knowledge, we can more effectively promote a positive experience within our daily patient care.”
Practice empathy
“Remembering to practice empathy for our patients in the midst of our very busy and stressful workdays is an excellent start,” The Hospitalist article said. Express empathy in the way you speak, ask for the patient’s feedback, and listen to his or her responses with minimal interruption. Particularly during a pandemic like COVID-19, this is easier said than done—but start with the intention and do the best you can.
Recruit and retain the right providers
An SCP Health blog post said improving patient experience starts by recruiting and retaining the right providers. Even though the post was directed to EM physicians, the advice is just as applicable to HM.
Continually communicate your thoughts
Continuous communication with patients and their families is one sure way to improve patient satisfaction. Let them in on your differential diagnosis, what you think is likely and unlikely, and how you plan to narrow down the list.
Other ways to enhance patient experience include:
- Setting up patient-centered provider training programs and aligned incentives for patient satisfaction scores;
- Enhancing continuity of care and streamlining clinical handoffs with integrated EM, HM, and ICU services;
- Delivering accessible care to remote or immobile patients through telemedicine technology (particularly important during the social distancing measures required during the current COVID-19 pandemic);
- Capturing patient feedback at the point of care with patient surveys;
- Preventing readmissions and supporting patients in the transition from hospital to community care with door-to-door care management.
Celebrating Patient Experience Week
Let’s circle back to where we began by talking about Patient Experience Week. Even though social distancing and lockdowns affect traditional ways to honor physicians, nurses, and other clinical staff, here are some ideas hospitals can implement:
- Write handwritten appreciation notes to providers;
- Include examples of positive change in new provider orientation;
- Let those who led patient experience efforts present at various floor meetings and shared governance committees;
- Apply initiatives across multiple departments, if possible, and permit those involved to be influential in that roll-out;
- Recognize efforts on the website, internal employee newsletters, hospital signage, and external communications to donors, supporters, and subscribers.
Once our nation has healed from this pandemic and gatherings are allowed again, consider these ideas:
Kick-off event
Hold a special kick-off event. Show the Beryl Institute’s “I am the Patient Experience” video. If your organization has its own video, show that as well.
Open house
An open house is an excellent opportunity to introduce hospital employees and volunteers to the patient experience efforts taking place in your organization. It may even be timely to share examples of how your hospital teams still ensured patients had the best experience they could—even in the midst of a national (and very personal) crisis.
Education seminar
Use Patient Experience Week to share educational resources on improving the patient experience. (If you want to recognize Patient Experience Week during its traditional timeframe, you could hold this seminar virtually via webinar or live video stream.)
Recognition luncheon
A luncheon during Patient Experience Week is an excellent way to honor clinicians. Depending on your budget, you can have a potluck, special luncheon prepared by your hospital’s dietary staff, or catered meal in a conference room.
Conclusion
Influences such as consumerism and value-based reimbursement have made improving patient experience central to any hospital’s mission. SCP Health works with hospitals to implement workflow and process innovations that improve patient experience, drive patient volume, and increase repeat business in a long-term, sustainable manner. In this time of crisis, we’ve tweaked and innovated our offerings to help support clinicians, hospitals, and communities who are faced with the devastating effects of COVID-19.
