The Pipeline

Improving orthopedic quality: Make a strong first impression


Samuel Gold, Service Line Strategy Advisor

Delivering quality in orthopedics has been a hot topic of discussion at AAOS because of the high degree of uncertainty around what “quality” actually means. Many presentations have addressed the importance of defining and measuring quality, its financial implications, and implementation strategies for orthopedic practices.

In particular, these discussions focused on how the patient perceives the quality of their care and why this is an important consideration.


Patient perception of care influenced prior to care episode

It is understood at this point that patient satisfaction scores will tangibly impact an orthopedic practice’s reimbursement, and a patient’s perception of the care episode can be divided into three categories:

  1. Assumptive: Opinion is formed from general reputation of orthopedic surgeons
  2. Presumptive: Opinion is formed from word-of-mouth, public reputation, online information
  3. Technical: Opinion is formed from treatment received

Historically, planners and physicians have evaluated their performance primarily on their technical outcomes; the assumptive and presumptive perceptions of care were not as diligently managed.

To appropriately understand how quality will be measured, the full patient experience—even the parts that occur well before the patient even steps into a physician’s office—must be considered. In fact, a patient will most likely have formed strong opinions about their expected care experience based on their assumptive and presumptive perceptions, alone.


Tactics to enhance patient experience

With this in mind, a number of physicians at AAOS presented strategies to improve the non-clinical aspects of the patient experience. Among the successful strategies discussed were:

  • Online presence: A well-managed website can build confidence around a practice’s offerings and technological savvy. The website can also be a valuable medium for physicians to indirectly communicate with current or future patients through welcome videos or blog posts. In addition, there are a number of websites that collect patient reviews of surgeons to serve as a valuable factor in patient selection of where to seek care. Encouraging patients to review their visit on these types of websites helps build a positive online presence.

  • Appointment scheduling: Appointment availability and ease of scheduling can begin the care episode in a positive light or can often be sources of great frustration if made inconvenient.

  • Patient intake: Progressive orthopedic practices are adopting tactics to enhance the patient experience in the waiting room by optimizing information collection and patient education during that time. One surgeon actually provided the patients with pre-programmed iPads that presented them with a video on what they can expect in their visit and posed specific questions to help the patient prepare for their conversation with the surgeon. Similarly, a second surgeon suggested that orthopedic practices can hire a volunteer to act as a pre-visit health coach. This non-medical professional can conduct a brief intake interview and pass this information on to the surgeon to help better structure the visit.

These small initiatives help a hospital practice establish a positive relationship with a patient well before they receive any form of treatment. Considering how important patient perception of care will be to future orthopedic business, it is vital that a planner consider these aspects of the patient pathway and not just the acute or technical care episode.

More from AAOS 2014

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