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Patient Experience: Hospitals' Holy Grail?

By Steve Whitehurst, for HealthLeaders Media  
   September 30, 2011

The topic of value-based purchasing regulations, including the emphasis on HCAHPS scores, has been burning up keyboards, email boxes, and phone lines across healthcare. Many providers and professional associations have expressed concern.

However, in an era when we are attempting to align disparate incentives from the old healthcare framework, we need to ask ourselves: How much attention would we give the patient experience if HCAHPS scores were not so heavily weighted?

Gone are the days of focusing on the acute episode of care and getting paid for the number of procedures performed on a patient rather than for improving outcomes. By the same token, gone are the days when no one knew how patients perceived the care they received. With increased transparency, pay for performance ramping up, and social media communications increasing in popularity, the patient experience has become the key differentiator among healthcare providers. Even legislation has elevated its importance.

Under healthcare reform, hospitals will focus on key pay-for-performance measures, including meeting clinical standards, reducing hospital-acquired infections and lowering the 30-day readmission rate. While improving clinical care and protecting the bottom line are critical to the health of patients and the sustainability of hospitals, there may be a temptation to short-change the way patients experience their care, which has always impacted outcomes, and now, the bottom line.

For the initial rollout of the program, there will be 13 measures. While the first measures focus on how well hospitals follow evidence-based practice guidelines, the final measure focuses on how well hospitals enhance the patient experience.

So while hospitals will need to tighten their belts with regard to expenses, they also need to prioritize their capital investments in resources that improve care delivery and the patient experience. According to the HealthCare.gov website, the Patient Experience of Care Measure will use HCAHPS scores to calculate the following:

  • How well nurses communicated with patients
  • How well doctors communicated with patients
  • How responsive was the hospital to patients' needs
  • How well caregivers managed patients' pain
  • How well caregivers explained patients' medications to them
  • How clean and quiet the hospital was
  • How well caregivers explained the steps patients and families need to take to care for themselves outside of the hospital (i.e., discharge instructions)

The patient experience score represents one-third of the final grade, and many hospitals and associations are sounding the alarm and asking whether they can be graded on a curve.

But grading on a curve isn't in the best interest of patients. We must stop putting silos around the various facets of healthcare. If hospitals are graded on a curve, then they may focus on safety and the bottom line, while ignoring the patient experience. The truth is, the patient experience impacts both.

A patient's experience with his or her local healthcare provider is critical to achieving true health reform. The patient experience is not an isolated event. Rather, it is the sum of all interactions, shaped by an organization's culture, that influence patient perceptions across the continuum of care. There is no silver bullet or checklist to follow. Instead, the patient experience is comprised of every impression and encounter a patient (or family member) has with your health system. Whether it's making a phone call for additional information, scheduling an appointment, or whether your website is easy to navigate, every interaction impacts patient perception.

Like it or not, the patient experience is the holy grail for healthcare providers. That said, hospitals need to focus on their culture, not on their grade. If the focus is on the score, we've missed the point. We need to keep the focus on the patient.

Think about it. When you have a relationship with someone and believe they care about you, you are more likely to trust them, follow their advice and communicate with them honestly. When you have an isolated encounter with someone, you're less likely to take the risk.

The same thing is true for healthcare. Building relationships with patients is the single most important thing hospitals can do to make a lasting change in the delivery of care. When the focus is on building a relationship with every patient, every time, there is better communication, better compliance, better coordination of care, and better outcomes. And yes, an enhanced bottom line as well.

See Also:
Dartmouth Atlas: Readmission Rates Show 'Not Much Progress'
Readmission Rates Revealed for 292 Worst Hospitals
Selecting a Strategy to Stop HAI


Steve Whitehurst is senior vice president of the patient experience at The Beryl Companies.

 

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