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Hospitals cannot focus their efforts to improve the patient experience on only a checklist of activities, but rather make them part of a broader strategic direction. In a recent Hospital Impact blog post, I offered four strategies for addressing patient experience as the new healthcare reality to reinforce this point. Yet, while no two hospitals follow the same plan (and I encourage you not to be fooled by a one-size-fits-all solution), there are a few common practices to consider.
In the 2011 study, "The State of Patient Experience in American Hospitals," we asked the question: What are your organization's top priorities for improving the patient experience? The responses were not surprising, as many related to domains comprising the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.
Digging deeper into the data, five top tactics emerged that were consistent with what I have seen in practice around the globe: noise reduction, discharge process, rounding, responsiveness of staff/communication and pain management. While this list is not the full complement of actions organizations need to consider in their strategic efforts to address patient experience, it does provide a practical starting place.
Noise reduction:essed in the HCAHPS survey, the issue of reducing noise has been shown to directly influence overall experience. A research report from The Beryl Institute suggests noise is not only annoying but also can have potentially harmful physiological and psychological effects on patients. Although noise is a subjective experience, and every person perceives the impact differently, in a hospital setting noise is often a reason for patient complaints and dissatisfaction.
Discharge Process: The concept of effective discharge is another HCAHPS-related area. According to an Agency for Healthcare Research and Quality (AHRQ)-funded study, patients discharged from the hospital who have a clear understanding of their after-hospital care instructions, including how to take their medicines and when to make follow-up appointments, are 30 percent less likely to be readmitted or visit the emergency department than patients who lack this information. Additional research concludes the poor transfer of information to patients, lack of timely post-discharge physician visits and poor patient knowledge, all add to preventable readmissions, which have serious implications on overall experience.
Rounding: Rounding has become part of the common vernacular in service excellence and quality care delivery. A study conducted by Northeastern Hospital in Philadelphia, in conjunction with Studer Group, showed that intentional rounding not only reduced call light use and falls, but also eliminated pressure ulcers, increased patient and staff satisfaction, and was even associated with other (anecdotal) benefits, such as a decline in medication errors, intravenous complications and overtime costs.
Responsiveness of Staff/Communication: Responsiveness also is addressed through the HCAHPS survey. Hospitals & Health Networks Daily's Haydn Bush suggests that communication trumps amenities or quality in driving patient satisfaction, based on the premise that communication allows for strong patient engagement. Ultimately he asks the critical questions many of us do: Did staff clearly communicate in a respectful manner? Were clinical decisions explained in a manner that suggested high-quality decision-making? Communication, the most basic of skills, can be one of the most critical levers of patient experience success.
Pain Management: Pain management, another area at the heart of the HCAHPS survey, is only partially about pain itself. It also encompasses staff's effectiveness in communicating, establishing expectations and ensuring access to needed information to help patients best understand how to manage pain situations. In its nurse handbook, the AHRQ reinforces the importance of controlling pain, suggesting complications related to inadequate pain management negatively affect hospital performance as it drives longer hospital stays and leads to greater readmission rates. Pain influences a patient's welfare and overall experience.
In defining patient experience as the sum of all interactions, shaped by an organization's culture, that influence patient perceptions across the continuum of care, every encounter provides an opportunity for action and impact on the overall experience. These five tactics simply propose common areas of focus. As you tackle the patient experience in your organization, regardless of which tactics you choose, remember it is one of the most critical strategic opportunities you have at your disposal to engage your consumer, manage the bottomline and strive for quality outcomes.
Jason A. Wolf, Ph.D., is executive director of The Beryl Institute, the premier thoughtleader on improving the patient experience. He is a recognized expert on organizational effectiveness, service excellence and high performance in healthcare.
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