While not emphasizing interpersonal communication for hospital personnel — who, after all, are in the business to help people — may not seem like much of a transgression, it can have a huge impact on hospital profitability and HCAHPS scores. As certain aspects of healthcare become automated for efficiency, and as meeting performance metrics becomes essential for hospital finances, it can be easy to stop focusing on parts of the process that seem like they should be easy for healthcare providers to maintain. However, failing to employ resources to improve communication with patients may leave a hospital with disengaged providers, miserable patients and financial troubles.
Michael Cassatly, DMD, president and executive business and leadership coach at MedAchieve, says the most common obstacle to patient satisfaction is the need to take time to refocus on taking time to connect with patients. "Physicians' hearts are in the right spot. They want to connect with patients, but they feel like they're being pulled in so many different directions that they are too scattered," he says. He finds that physicians and other healthcare professionals who invest in career time-outs to reframe the importance of patient connections are ultimately more satisfied with their careers.
To help physicians reconnect, Dr. Cassatly will ask them to create solutions from what they know about their environments. "We'll talk about a number of challenges they face to communicating well with patients, and we'll work up solutions together," he says. "The issues are coming completely from the physicians, where they want to go and where they want to be." He finds that this self-directed method makes communication rehabilitation successful in approximately80 percent of cases, compared with the quarter of those who would ultimately make a permanent change with recommendations that had simply been handed down.
"Essentially, less strain on patient-physician relationships leads to more successful medical outcomes, lower costs and greater career satisfaction for the entire healthcare team. There's less employment turnover and more teamwork," Dr. Cassalty says. "The entire process is multifactorial, and it's hard for people to realize that there are more effective things to focus on than HCAHPS to improve patient satisfaction."
Steve Pu, DO, has implemented a working model for communication improvement, much like Dr. Cassalty suggests, at Kennett, Mo.-based Twin Rivers Regional Medical Center, where Dr. Pu is a physician.
In 2012, Twin Rivers was at the bottom of the barrel within its company division for patient satisfaction scores. Realizing something had to change, the hospital deployed a focus group of physicians, hospital employees, patients and families led by Experia Health, a healthcare consulting company, to improve operations and HCAHPS scores. It was Twin Rivers' first time involving patients in hospital changes, and, according to Dr. Pu, the first time the patient point of view became clear.
The focus group's input led to the birth of the "sacred moment," a protocol during which providers, usually nurses, spend 10 to 15 minutes with each patient addressing only his or her immediate needs, fears and concerns, support services and anything else that may put the patient at ease.
At first just a standardized set of extra questions, the sacred moment program met resistance. The hospital staff wasn't thrilled about adopting yet another piece of paperwork. This is when Dr. Pu volunteered to take charge of the program. He helped streamline the sacred moment so that it fell in step with the already-present nursing assessment form. Through Dr. Pu's leadership, after a few more months the staff began to get a sense of camaraderie from working toward a shared goal.
This sense of connection among staff members led to another overhaul at Twin Rivers: provider satisfaction improvement. Bringing patient satisfaction to the plate allowed Twin Rivers staff to get the ball rolling on cultural and environmental improvements for themselves, leading to a more productive and communicative workplace for all.
The sacred moment program is now about 18 months old, and flourishing. The sacred moment itself has also continued to evolve. "Now we ask nurses to begin the connection and let it go to where it's going to go. The most important thing is that the first patient impression is uninterrupted time. We need to make that first impression a positive one, because we want the impression that we're there to take care of them again," says Dr. Pu.
Twin Rivers' new commitment to incorporating both patient and employee satisfaction into daily operation is producing tangible results. In 2012 the hospital improved its satisfaction scores by 30 percent and went up in all HCAHPS categories, from being at the bottom among Twin Rivers' hospitals to being the first in satisfaction and financial performance in its company division. "Our experience shows a fundamental feature of patient satisfaction: that it must be part of your culture," says Dr. Pu.
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