Many healthcare professionals are still uncomfortable with the term "customer service," yet many hospitals and medical practices are spending more time trying to deliver just that.
Many healthcare professionals are still uncomfortable with the term "customer service." They feel that focusing on non-clinical aspects of care relegates them to the level of car salesmen or checkout clerks. Patients don't visit the doctor for soothing music or kind words, they say.
Nevertheless, the advent of value-based purchasing and the need to keep patients in accountable care networks finds many hospitals and medical practices spending more time qualifying and training their people to deliver quality customer service. Also, many hospitals are adding pleasing amenities such as higher-end food courts and healing gardens, posting ED wait times online and adding touches like valet parking.
According to an article in Kaiser Health News, Inova Health System in Falls Church, Va., has recruited Paul Westbrook, a top executive with no background in healthcare. He has had a career with Marriott and Ritz-Carlton. He is one of many new executives in the industry who have been given the title "chief patient experience officer." Duties include making sure patients are communicated with properly by physicians, nurses and administrators. Leah Binder, president and CEO of The Leapfrog Group, an employer-based coalition that advocates for greater healthcare quality and safety, says: "There is a new recognition that the patient is important," and that hospital routines have traditionally been designed to suit employees, not customers. "The patient used to be maybe 10th on the list of a hospital's priorities," she adds.
The patient experience of care is a significant measure under an array of pay-for-performance programs. Though the penalties for poor achievement on questions such as how well their doctors and nurses communicated with them, whether their room was clean and quiet, and whether their pain was controlled are fairly minor, Westbrook said the recent sharp spike in patients' out-of-pocket expenses have made them more willing to comparison shop for care. Patients, he says, are going to look on the Internet and on Medicare's Hospital Compare website, and they are going to read comments and over time select hospitals based on those reviews.
According to the KHN article, most chief patient experience officers rise through the ranks of a health system and they talk in lofty terms about teamwork; leadership; and developing a philosophy and culture of compassion, service and respect for their institutions. However, on a day-to-day basis, the approach they use is very practical, such as emphasizing hourly nurse rounding. Caregiver-patient interaction is supposed to be meaningful and thorough.
Susan Eckert, chief nursing officer at MedStar Washington Hospital Center in Washington, D.C., tells her nursing staff to "actually sit down, look at the patient, talk a little bit, and give them several minutes of time during which they are the only thing that exists in the world." Another priority is having nurses call patients at home within 48 hours of their discharge to keep their recoveries on track.
At Yale-New Haven (Conn.) Hospital, management has made a concerted effort to lower noise so patients can get a good night's sleep. Hospital staff are also told to use "library voices" 24/7 and not to talk where patients might hear them. "Overhead page calls have been eliminated, beepers are kept on vibrate, doors are closed when staff members discuss cases, and efforts are made to reduced alarms, pings and beeps at bedsides," according to the KHN article.
The Cleveland Clinic requires all 3,000 staff physicians to take daylong relationship and communication classes, KHN reports. Back in 2010, when the hospital showed physicians what patients had to say about them, they were "shocked, dismissive and disbelieving" and complained, "This isn't true, the methodology is bad, the sample size is too small." James Merlino, MD, a surgeon at the Clinic, now serves as its chief experience officer. "We put physicians through communication training so they learn how to listen better, let the patient set the agenda and organize the encounter better," he told KHN. The result has been very positive and consequently there has been a big improvement in physician communication scores.
Another interesting aspect of improving physician communication scores has to do with the correlation between patient satisfaction and outcomes. Richard Staelin, PhD, of Duke University's Fuqua School of Business, wrote in the journal Circulation in 2013 that the death rate among heart attack patients was lower at hospitals where patient satisfaction scores were high, even when researchers controlled for the quality of care. Other research shows a correlation between patients’ perception of room cleanliness and infection rates.
Even physicians, notoriously skeptical of the value of treating patients with respect, involving them in their own care and communicating well with them, are slowly but surely starting to come around to an appreciation of the importance of patient satisfaction, Dr. Staelin believes.
For the life of me, I can't figure out why it has taken regulations and financial penalties to push the industry in this direction. Every other business sector puts customer service at or near the top of the priority list. After all, the patient is the reason for the existence of any healthcare entity, and yet in the scheme of things, too often they are treated with indifference.
Nevertheless, I take comfort in the fact that at long last things seem to be headed in the right direction.