02 May The Satisfaction and Quality Relationship
According to an article on Philly.com, “Patients with a good understanding of discharge instructions are known to be less likely to need a return visit to the hospital.”
It turns out that satisfaction and quality are related, according to a new study from Cooper University Health Care.
Using data from more than 3,000 U.S. hospitals, the authors found that higher patient-satisfaction ratings on a five-star scale were associated with lower rates of readmission within 30 days of discharge.
Why would patients fail to understand or follow hospital discharge instructions? The question actually places the fault on the patient.
Many patients simply don’t understand the instructions given to them by their doctors or nurses. Many healthcare providers use medical jargon, words that are not part of everyday vocabulary. A patient who is told that their “ejection fraction is low” may think they failed a math test!
Sometimes patients don’t follow instructions because the patient’s agenda was never explored. Are they able to follow the plan? Are there barriers that might prevent them from following the doctors’ plan? Do they even want to follow the plan?
Patient satisfaction scores go much deeper than ‘whether or not the patient liked the doctor or nurse’ or ‘whether the food was restaurant quality.’ If patients think they have been heard, they are much more likely to follow through with the plan suggested by their healthcare provider. If they agree with, and can follow the plan, they are much more likely to do well and have a lower rate of readmission or return for the same problem. This relates directly to safety and ultimately outcomes.
This principle also applies to outpatient visits. Many offices are deluged with phone calls, emails and repeat visits from patients for the same problem that was addressed at the last office visit. We cannot afford to redo work because we didn’t get it right the first time. Getting it right does not just refer to getting the correct diagnosis. Of course, the correct diagnosis is paramount. However, without clear instructions, assurance that the patients’ concerns were addressed and a plan that the patient has participated in, understands and agrees to follow, the correct diagnosis will not be enough.
There are basic communication skills that allow healthcare providers to connect with patients. A stronger connection, with the emphasis on the patient, allows creation of plans that patients and their families are more likely to understand and follow. Recognition of the patient’s emotions is crucial. Patients are often still feeling ill at the time of discharge. They may be scared, anxious, even angry. Surveys repeatedly tell us the top rated items desired by patients from their healthcare providers are respect, attentive listening to their concerns, and clear explanations of instructions. It takes trust and a true connection for these things to happen.
The Institute for Healthcare Excellence has the privilege of working with healthcare providers from over 35 institutions. In doing this work, it is clear that most healthcare providers truly want to deliver an excellent patient experience. They just don’t know how. They are often technically excellent, sincere and dedicated.
In pre-course surveys for a basic communication course, over 50 percent of participants consistently answer that, for doctors and patients alike, just getting the correct diagnosis is not enough. Healthcare providers know that patients expect us to get the correct diagnosis, but they want something more. Participants repeatedly point out key attributes that patients desire: respect, attentive listening, compassion, connection, clear instructions.
The disconnect is that our healthcare workers are rarely taught and equipped with skills to make these patient desires a reality.
Basic communication skills such as paying attention, listening to understand, gathering correct information, including patients in planning and forming a solid connection are essential to excellent patient care, safety and outcomes. These skills can be taught. When prepared to deliver on these basic patient needs, healthcare providers can maximize the quality of the patient experience. And in doing so, they can increase their own personal purpose and satisfaction, opening the door to a life’s work that is filled with joy.
Written by, Sandra Argenio, M.D.