'Healthcare is healing and about feeling': 10 patient care standards from Scripps CXO Dr. Ghazala Sharieff

Ghazala Sharieff, MD, corporate vice president, chief experience officer at Scripps Health in San Diego, and her team developed 10 standards for a superior patient experience.

1. Never have poor communication with patient. Always communicate effectively and be as transparent as possible. "Patients should be called back same day or receive response to email same day. My expectation as a patient is if I have a question, my physician will respond same day or at least within 24 hours," she said. "Clear communication about surgery should be given to the patient upfront prior to having surgery scheduled. My expectation as a patient would be to have clear understanding of when my surgery is going to happen to help with planning … [I would also like to be] given financial information upfront instead waiting to get a bill later. I would like to know what it's going to cost me to get medical care prior to having the services rendered. Many patients are not aware of what their out of pocket cost are and call us to complain about the bill."

2. Never let the patient experience long wait times. Always set expectations and offer options to the patient so they are in control. "We need to ensure that patients can easily access care and be able to communicate with their healthcare team seamlessly. When they arrive for their appointment, the team should be ready to receive them. That we have available staff to help orient the patients through our technology and navigate through our healthcare system," she said. "Patients should never be expected to adjust to our service; we must be willing to adapt our care to meet the needs of our patients, one size does not fit all!"

3. Never let the patient do the hard work. Help them by setting expectations, answering questions, and navigating through the health system. "Patients should never be bumped, especially with the bump date being pushed out very far. My expectation would be that if a patient is unfortunately bumped, the provider has the responsibility to accommodate the patient with let’s say within five days," she said. "That would mean a late day of scheduling or a weekend if need be. This is assuming no other provider could see the patient right away. Patients should never have long wait times. Respecting wait times is one sided. Patients get rescheduled if late, no penalty for providers if they are running behind."

4. Never hinder the patient from getting what they need. Always accommodate them. "Patients should never be confused about what the next steps are. Plan of care should be clear and transitions of care should be seamless," she said. "It shouldn’t matter what the phone number is to X-department, because our staff are already aware that the patient has a need. The patient should never feel they need to coordinate their own care. When plan of care involves multiple steps and appointments, someone should be working with the patient closely to ensure the plan of care is being followed."

5. Never fail to put yourself in the mindset of the patient. Always try to understand their needs and offer them options to make informed decisions. "From a simplistic perspective, the staff can never become indifferent and lose the perspective of the individual patient. Given the propensity to be task driven, it's critical that we continually support staff in 'being in the moment with the patient' and practicing the art of compassionate medical care," she said. "A patient should never feel that they are simply a percentage of a ratio. The providers need to focused on the continuum of care: when do we anticipate discharge, what will you need, how can we support you once you're home, how do we engage them in their long-term care."

6. Never be rude or unfriendly to patients; make sure the patient does not feel rushed and is in control. "Patients should never have to deal with rude or unfriendly staff or providers," she said. "With wait times I would add no wait on phones, lobby or exam room. Patients should never feel rushed, and should always be given the opportunity to ask questions."

7. Never judge the patient or create an unwelcoming and uncomfortable environment for them. "We are interested in what patient experience leaders think should be the standard for a great patient experience. I believe the standard should be the expectation of an exceptionally welcoming and comfortable environment," she said. "One where patients feel free of judgement, well informed and educated, in control of their care and loved. This responsibility as experience leaders rests with not only leadership but the staff as well."

8. Never turn a patient away. Always accommodate patients and always be respectful of their time. "Patients are waiting for weeks or sometimes months for a new patient visit due to the provider's preference schedule," she said. "Patients should never feel that we don't know what we are doing or that there is an inconsistency between sites; as leaders we should have standard processes. Patients should never feel they cannot trust us. Our answer should never be 'I don't know, it's not my department.'"

9. Never forget the importance of the patients' perspective. Always provide compassionate care and try to reduce stress. "Are patients signed up in the patient portal? If No then help them to do so," she said. "Utilize the itinerary during their stay and provide the right care, procedure and testing at the right time in order to maximize the benefit to the patient and reduce their length of stay. This might be a bit esoteric, but given what we are living right now and what I see the critical issue is the human connection. For example, currently with no visitors, many of the patients have the news on 24/7. The rehab staff, when they enter the room, now goes to the patient and says let's turn off the TV and focus on getting you home to your family. A simple act but it changes the entire dynamic and stress level of the patient."

10. Never allow the patient lose trust or confidence in providers or staff. "We, the healthcare team, should be the ones proactively doing outreach to our patients to provide support and education," she said. "When patients raise a concern, we pause, we listen, and we remedy their need. Patients should never feel like we do not care. Patients have a choice on where they want to seek care. Might they without a doubt choose Scripps because they know and can be guaranteed that with every encounter, they will feel cared for, they will feel heard, and they will feel that we value them as our customer and patient. Healthcare is healing and about feeling."

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