By Ted A James, MD, MHCM, FACS
April 27, 2018
Leaders of health care organizations facing mounting administrative challenges and diminishing resources may question the importance of focusing on the patient experience of care. Improving patient interactions not only speaks to the inherent values of our profession in health care, but a growing body of evidence correlates improved patient experience with improved clinical outcomes and organizational performance, making patient experience a key strategic priority. I can also attest from my efforts developing patient-centered care models, as well as from my own journey as a patient, just how important the care experience is to overall well-being and satisfaction with treatment.
Importance of the Patient Experience:
Several recent studies have demonstrated the positive impact that patient experience has on clinical outcomes across a wide range of disease areas, clinical settings, and population groups, primarily due to process improvement and patient engagement. Better patient experience is also associated with decreased medical liability claims and improved physician satisfaction. The findings provide strong evidence for incorporating patient experience as an essential aspect of quality in health care. Furthermore, in an age where technology promises to provide greater convenience, choice, and control, we see that health care has lagged far behind and only rare pockets of consistent service excellence exist among a much larger array of fragmented care, limited access, inefficiency, and frustration for patients. We fail to provide patients with the degree of interactivity and engagement they have come to expect from all other aspects of life.
Elements of Patient Centered Care:
Contrary to some ideas, this is not about having a grand piano in the lobby, five-star food in the cafeteria, or providing patients with endless prescriptions for antibiotics and opioids. Rather, it is about the quality of encounters with each member of the health care team across the continuum of care. Our goal should be to achieve high-quality interactions during which patients feel they are valued and listened to, their opinions are taken into consideration, and they receive clear explanations. From a patients’ perspective “excellence in patient care” is the expectation; it is empathy, compassion, and respect that differentiates value. It doesn’t require more time, since it is more about quality than quantity. For example, data demonstrates that simply sitting instead of standing while talking to patients increases their perceived duration of time spent with the clinician.
Research from Harvard Medical School, on behalf of the Picker Institute and The Commonwealth Fund, compiled data from interviews with patients, family members, physicians, nonphysician hospital staff, and pertinent literature reviews to delineate what patients valued most in their experience with health care. This was categorized into eight principles of patient-centered care:
- Respect for the patients’ values and preferences
- Coordination and integration of care
- Information, communication, and education
- Physical comfort (pain management, assistance with daily living, hospital surroundings)
- Emotional support and alleviation of fear and anxiety
- Timely access to care
- Involvement of family and friends
- Continuity and secure transition between health care settings
These principles reflect the patient viewpoint that is integral to improvement efforts and provides the framework for how we must redesign care to best meet the expressed needs of our patients.
Call to Leadership:
As leaders in health care we can be strong advocates for enhancing the care experience. The importance of patient experience must be communicated widely and demonstrated consistently in our policies, procedures and actions. We can help dispel common misunderstandings by reinforcing that we are not creating a ‘Disney’ experience or catering to patient whims, but rather striving to improve our patient interactions. We can overcome resistance to change by sharing data on how patient experience effects key outcome measures, and providing training to help clinicians improve their skills in service excellence. Finally, we can actively engage in and support efforts to redesign care to better meet the needs of our patients.
Dr. Ted James is a medical director and vice chair at BIDMC/Harvard Medical School. He is an alumnus of the Harvard Health Care Management program and is involved internationally in leadership development and health care transformation. Follow Dr. James: LinkedIn / Twitter
*OPINIONS EXPRESSED BY OUR GUEST AUTHORS ARE VALUABLE TO US AT LEAN FORWARD, BUT DO NOT REPRESENT OFFICIAL POSITIONS OR STATEMENTS FROM HARVARD MEDICAL SCHOOL.