No matter how long you study your Hospital Consumer Assessment of Healthcare Providers and Systems scores, you don't really know what it's like to be a patient in your hospital until you are one.
Thanks to a vegetable-chopping session gone awry, I recently experienced my first ER visit and, a few days later, my first out-patient surgery. This also marked my first time being a hospital patient in my adult life.
Having reported on healthcare for several years, I've always been on the lookout for the marketing director's touch in whatever hospital I'm in while visiting ill friends and family members.
Things like unclear directional signage, new flatscreen TVs, and internal marketing efforts always stood out to me. But as a patient, I suddenly regarded the care experience through a whole new perspective.
And it's one I don't think any survey could capture.
I took copious amounts of mental notes throughout my ER visit, surgery, and subsequent occupational therapy and follow-up appointments. This proved to be not only educational, but a great distraction during the ordeal. (It should also be noted that I'm typing this with one hand. Please hold your applause, as I must.)
Coincidentally, the patient experience and patient satisfaction happened to be top of mind as I'd just been reading about the details of the patient satisfaction survey element of the pay-for-performance system built into healthcare reform.
As I'm sure you're well aware, the coming year will be the first that hospitals will either receive a bonus or lose money depending on their HCAHPS scores.
Medicare is expected to dole out nearly $1 billion in payments to high performing hospitals over the next year. Hospitals are required to complete at least 100 patient surveys over a year, though larger facilities will likely complete many more.
I received treatment at one such large facility, a top-ranking health system in Boston, and was surprised with my patient experience. Here are some snippets from my unofficial patient satisfaction survey.
The ER
What shocked me most about my ER visit is that I was seen immediately. After years of writing about ER wait time apps I'd assumed I would have at least 30 minutes of anxious downtime before seeing a doctor, but I was in a room and being examined within 10 minutes. Huge points there.
Unfortunately, the wait time began accumulating as I was bounced among residents, attendings, med students, X-ray techs, consulting surgeons, and nurses. I didn't feel there was one person at the helm of my care. The one redeeming factor was the nurse who stopped in after a particularly long wait period and asked if she could get me a glass of water and some magazines. It's little touches like this that can make a big difference.
Obviously there were many more emergent cases than mine that night, but I learned that the patient—especially in the emergency room—can feel as though they have little control over their care. Having one consistent caregiver, whether it be a doctor or medical assistant, would have put me more at ease.
Out-patient surgery
Propofol. That is what my anesthesiologist muttered casually as he began to administer the drug at the onset of my surgery. "Woah, woah, wasn't that MJ's sedative of choice?" is the last thing I remember asking before I found out what exactly made the milky white not-meant-for-home-use substance so enjoyable.
Kidding aside, it would have been nice to have been briefed on any and all medications in advance, as a courtesy.
After the brief surgery, there was again more waiting. I know there are many clinical reasons to keep an eye on day surgery patients before discharging them, but I'd have preferred to have been given a ball park wait time. And again I was shuffled between several nurses who all looked the same... unless that was just the propofol.
Follow-up care
The first thing I saw while waiting for my surgeon at his office for a follow up appointment was the dust in the corners of the room. You'd think a high-ranking hospital would hire a thorough cleaning crew.
Luckily my surgeon and his office staff have great bedside manners that all but make up for the dust bunnies on the floor (which I have since commented on). He answers all my inane questions (which I preface with, "forgive me, I'm a journalist") and even happily fills out my HR forms right then and there. He would rank high on the "My doctor always communicated well" survey question.
Before you write my surgeon off as being born with a patient-friendly personality, bedside manner can and is being taught at organizations around the country. Sometimes providers just need a little coaching about keeping eye contact, truly listening, and then responding without using too much jargon.
The main thing I learned from this relatively minor ordeal is that no matter how long you study survey results, you don't really know what it's like to be a patient in your hospital until you are one.
Marianne Aiello is a contributing writer at HealthLeaders Media.