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May 18, 2015

What hospitals overlook about the patient experience

Daily Briefing

    Patient experience is top of mind for health care providers across the country. And every member of the hospital care team—from administrators to service line leaders and everyone in between—is vital in ensuring a patient is comfortable and kept informed from entry to discharge.

    The Daily Briefing's Clare Rizer sat down with Jessica Suchy, a senior director for Advisory Board Performance Technologies and dedicated advisor for iRound's patient experience tool, to understand how health care's approach to patient experience is being transformed. Hospitals' strategy must be about more than raising HCAHPS scores, Suchy says: It's about improving patient satisfaction and building customer loyalty.

    Question: As a dedicated adviser, you work directly with hospitals to implement patient experience tools, analyze data, and connect institutions with peers undergoing similar process improvements. You have 'boots on the ground,' so to speak.

    So what do you see as the biggest challenges for hospitals trying to improve their patient experience?

    Jessica Suchy: In the work I do, we work mainly with nurses, so a lot of what we see in terms of patient experience is from the nursing viewpoint.

    The biggest thing we hear is that nursing leaders are being pulled in 20 million directions, and it is hard to dedicate adequate amounts of time to round on each patient. If they can make the time, many nurses tell me rounding and spending actual face time with patients is hands down the best part of their day.

    Hospitals and administrators recognize that face time is exceedingly important to patients and to care teams. As such, some organizations have developed fixes like "meeting-free rounding time," which are pockets of uninterrupted time that nurses and other clinicians can spend responding to patients' needs.

    Other challenges I've seen nurses encounter include finding people or teams with whom they can collaborate across divisions to make the most efficient use of time and resources. If you are a nurse leader with a 55-bed unit, finding time to round properly can be difficult, so it is vital that the entire care team is engaged in the process and that available entities step in to help when needed.

    Creating and maintaining a positive patient experience is not a nursing problem. It's everyone's concern.

    Q: Are there specific areas of the patient experience that hospitals seem blind to? Or areas where hospitals should be focusing more effort? 

    Suchy: More and more, I see that every entity at every hospital seems to be focusing on patient experience, and organizations are building their brands based on their responsiveness to patient needs. So in terms of where we're headed with quality improvement efforts, that is a great thing. 

    But just because hospitals are zeroing in their focus, doesn't mean there aren't areas where they slip up.

    Hospitals tend to get stuck on the patient-to-clinician interaction and forget about the "in-between" entities that can impact—positively or negatively—a patient's time in the hospital.

    Everyone from registration to transport to care team to discharge is part of the patient's overall experience, but when considering process improvements, hospitals often overlook these areas. So it is really important that providers remain alert and recognize that a patient's entire opinion of his or her stay can be colored by just one poor interaction.

    Q: So what would you say are the key areas where hospitals can improve their processes to better patients' stays?

    Suchy: It definitely depends on the hospital, but patients often experience unhappiness from a lack of responsiveness and lack of communication, too.

    I see a lot of opportunity for nurse leaders to individually coach nurses who may be less comfortable interacting with patients. It is an opportunity to manage up, especially because staff engagement can dramatically affect a patient's experience and your HCAHPS scores. Nurses are on the frontlines and are having the most day-to-day patient interactions, so it is important that they are communicative and attentive to patients who are already likely feeling vulnerable and potentially scared.

    For instance, if a technician just enters a patient's room, checks machines, and takes some notes, the patient might not understand what is going on and might become irritable or scared. But if that same technician follows rounding best practices like introducing themselves, sitting near the patient, and explaining exactly what they are about to do and why, the patient will feel more at ease.

    Q: You mentioned HCAHPS scores. How important are those—or any other measure assessing patient experience—to hospitals?

    Suchy: Hospitals and hospital executives focus on them a lot, particularly because they have an impact on value-based purchasing and reimbursement.

    Of course, hospital patient experience officers and directors also see the broader picture of the importance of patient experience, not just what is reflected in their HCAHPS scores. Oftentimes HCAHPS surveys aren't sent to all patients and hospitals only receive a fraction the surveys back.

    But I don't think patients really understand them—they just care about the care they're receiving.

    The entire landscape of the health care industry is transitioning, so as patients have more choices, it's important that hospitals commit to transforming care to stay competitive.


    Q:  How do you see the retail revolution changing the patient experience? How are hospitals adapting to that?

    Suchy: Patients have more choices now, and they are more willing than ever to share the details of their experience on sites like Yelp and their social media profiles. And if patients are posting unfavorable reviews about their time in the hospital, I think it is getting harder for hospitals to overcome that.

    As a result, hospitals utilize their grievance committees to field more formal complaints and focus on service recovery. It's all about communication with the patient so if they have a complaint, administrators and clinicians let the patient know how they plan to remedy it. The most important thing hospitals can do in these situations is to communicate (maybe even overly so) with the patient. Tell them: "We hear you. We hear what you're saying. We are sorry this is happening and these are the steps we're taking to follow up."

    I also see how hospitals are increasingly working to personalize medicine. With our iRound tool, patients' comments and personal preferences are captured: What kind of food they liked or didn't like the last time they were here, and so on. The tool also will soon offer the option for recorded discharge instructions so patients can continue their own care from home.

    Convenience, communication, quality care, and clarity are what patients are looking for and what hospitals should be focused on delivering.

    Want to improve your patient experience?

    Creating a positive patient experience builds loyalty—and loyalty could mean nearly $3 million of revenue potential for a typical hospital.

    iRound helps you improve the patient experience by gathering satisfaction data in real time while automatically disseminating service recovery requests and providing intelligent dashboards.

    See How iRound Can Help You

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