The patient experience: In the hospital

Main Line Health July 17, 2017 By Cathy Harmer, MPH, MSN, RN, NEA-BC, CPXP, Barry Mann, MD, and Barbara Wadsworth, DNP, RN, FAAN

Coming to the hospital with all their unfamiliarity, vulnerability and worries, patients have made it abundantly clear in feedback both public and private that their level of satisfaction relies heavily upon how hospital staff members—especially their physicians—interact with them. Physicians are the “chiefs of influence.”

“Consider the patient and the patient’s experience, or test, or hospital room as a Sacred Place,” wrote one patient. “When you enter a Sacred Place, there is a specific behavior that is connected to that. Please consider that when taking care of your patients, because as one, I am scared of what is going to happen during my experience.”

Certainly, treating our patients with kindness and respect is simply the right thing to do on a personal level. The ripples of that respect reach far. Your interactions with patients have the greatest impact on shaping their hospital experience, and can even improve outcomes. Better physician communication—at a level patients understand—has been shown to correlate with higher patient follow through with care post discharge. A good experience and, even better, a good outcome will influence patient satisfaction, which in turn helps determine reimbursement through the Centers for Medicare and Medicaid Services’ HCAHPS patient satisfaction survey. The survey is required by CMS for every hospital in the US, and the results are easily accessible to the public online.

That survey contains three questions patients are asked about their hospital stay that are relevant here:

  • How often did doctors treat you with courtesy and respect?
  • How often did doctors listen carefully to you?
  • How often did doctors explain things in a way you could understand?

In the range of available options, the only response that CMS counts is “Always,” which is a pretty specific expectation. Main Line Health’s aggregate score for doctor communication is 81.4 percent, which is a pretty specific challenge.

To help meet that challenge, Main Line Health launched a comprehensive training program last year called “I am the Patient Experience.” The program aims to build a stronger understanding of what truly matters to patients and improve upon our ability to deliver on that. Training for the system’s 10,000 employees was mandatory and completed within a seven-month period. While training is not mandatory for Main Line Health’s 2,000 physicians, it is considered essential education, and physicians are strongly encouraged to attend an upcoming session. (See accompanying article for details.)

Additional MLH programs are also helping improve communication with patients, including the Family Partner Advisory Councils at each Main Line Health acute hospital. While these provide opportunities to share plans and listen to patient feedback, the impact of face-to-face communication between physicians and patients is most effective in supplementing quality care with a quality patient experience day after day.

Great care includes great communications. Are your behaviors best in practice? In today’s highly competitive landscape, we need to be doing it better than everyone else.

At Main Line Health, Cathy A. Harmer, MPH, MSN, RN, NEA-BC, CPXP, is system director of patient experience; Barry D. Mann, MD, is chief academic officer; and Barbara Wadsworth, DNP, RN, FAAN, is senior vice president of patient services and chief nursing officer.