Patient relationships in the age of technology and 8-second attention spans: 5 Qs with Dignity Health's SVP of quality, patient experience

Meaningful patient encounters are the building blocks of high-quality healthcare and positive patient experiences. Health systems cannot achieve the latter two without first engraining this foundational practice into clinicians' daily routines. 

Actively listening to patients and addressing their concerns helps physicians build stronger, more trusting patient-provider relationships. The practice also paves the way for patients and physicians to collaboratively create individualized care plans, which patients are more likely to understand and follow. However, some physicians find it difficult to hold genuine conversations with patients while also balancing a heavy workload and other administrative duties.

"Many individuals who choose healthcare as a profession do so in part of their inherent desire to help others," said Tracy Sklar, senior vice president of quality and patient experience at San Francisco-based Dignity Health. "But even with the best intentions, there are challenges."

Ms. Sklar said the secret to meaningful patient interactions does not lie in making more time for physicians, but in helping them make the most of the time they already have with patients. Technology plays a big part in this at Dignity Health, where "humankindness" is seen as a key component of healthcare. The 41-hospital system is implementing its own mobile apps and joining Apple's health records project to promote more effective, caring interactions between physicians and patients.

Ms. Sklar discussed the importance of meaningful patient interactions and elaborated on Dignity Health's initiatives to achieve them during a conversation with Becker's Hospital Review.

Editor's note: Responses have been lightly edited for style and clarity.

Question: What are the challenges to fostering caring human interactions and beneficial patient relationships?

Tracy Sklar: In my discussions with our care teams, they mention that a lack of time can be a barrier to connecting with others, including patients and families. However, studies have shown that some simple actions really do not take more time.

At Dignity Health, we use the acronym "HELLO" (say hello, make eye contact, listen, learn and offer assistance) to remind each of us to take the necessary steps to establish a connection during each patient interaction. Eye contact, smiling and offering a warm greeting can help physicians build a connection. Similarly, the process of clinicians narrating the care — such as while taking blood pressure or reviewing a medical record — can increase connection without need for additional time.  

Q: How can technology help facilitate these interactions in hospitals? 

TS: There are many ways technology can inspire better interactions — not only between clinicians and patients, but among members of a clinical team. Teamwork is important to patients. If they see all members of their team communicating well and on the same page with respect to their care plan, it helps them feel safer. The proper implementation of new technology for clinician-to-clinician interactions can help facilitate better care for our patients.    

Technology can also inspire patients to take control of their health, most commonly through apps that provide feedback on personal health conditions or that serve as a resource for information.

Hospitals and technology companies alike are helping healthcare become more consumer-friendly, which encourages better interactions in a care setting. For example, Dignity Health has partnered with Apple so patients can carry their personal medical records on their phones, which helps them take charge of their health and have better conversations with their physicians. 

Q: We live in an age of digital distraction, where technology is often seen as a barrier to authentic human interactions. How can hospitals ensure technology is adding to — and not detracting from — meaningful patient-physician reactions? 

TS: People don't respond to technology for the sake of technology. They respond to technology that helps anticipate and meet their needs. Any new technologies introduced into a care setting need to consider the principles of human-centered design. Building new technology into an existing workflow helps ensure it will be put into use more easily and will, therefore, be used more often.

We should also be conscious that not everyone will react the same way to the introduction of technology in a care setting. For example, some older patients might think introducing an app into the patient experience will complicate their care journey. But if you don't offer apps to those who expect them, such as millennials, they will wonder why you aren't providing them with digital health access. Hospitals need to make sure they are always meeting the patient where they are in their journey.

Q: What type of initiatives has Dignity Health rolled out to foster more meaningful patient encounters? 

TS: In recent years, we've introduced several innovative technologies into our system. Our My Baby app provides expectant mothers with the information they need to manage their pregnancies. It helps them keep track of milestones, monitor baby kicks and build their own unique birth plan. By empowering our patients with the information they need to make the best health decisions, we are also enabling them to have more productive conversations with their physicians.

We have also introduced a set of five patient experience principles that we developed in partnership with hundreds of patients and their families. These guide our staff on what their patients need in a care setting. These principles include knowing the patient as a person, keeping them informed about the decisions that affect them, empowering them, comforting them when they are dealing with difficulties and keeping them safe.

Underlying many of these principles is the single action of listening. Listening is critical to empathy, and empathy is the cornerstone of developing a caring human interaction. We need our patients to understand that we are their champions, supporting them through their vulnerable time wherever possible.

Q: What benefits has Dignity Health seen from these initiatives?

TS: We have evidence that demonstrates our efforts to create better patient interactions have made a difference. Over the last two years, we have improved our HCAHPS percentile performance — assessing patient loyalty and the likelihood that they would recommend Dignity Health — by 24 percent. This tells us that our focus on putting the patient first, whether by implementing new technology or evolving the way we treat each of our patients with 'humankindness,' is indeed furthering our mission to provide high-quality care for all.

More articles on patient engagement:
How clinicians can use technology to find patients who don't take their pills
Most patients say administrative, support staff did not treat them with respect
UChicago Medicine cuts inpatient sleep disruptions with EHR tool

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