It’s no secret that patient outcomes, service quality and patient satisfaction continue to grow in importance in the healthcare community. Since 2008, the Center for Medicare and Medicaid Services (CMS) has required hospitals to give all Medicare patients the opportunity to complete a survey (Health Care Attitude and Patient Perception Survey) (HCAPPS) about their care experience. Hospitals that are safe, pleasing and comfortable are likely to be rated high by patients, potentially influencing hospital choice, market share and bottom-line results.
Patient satisfaction will continue to grow in importance under the health reform law because it will be tied to how healthcare organizations receive funds. In fact, Medicare is scheduled to adopt a pay for performance approach beginning in 2012.
In a March 15th New York Times article by Theresa Brown, entitled “Hospitals Aren’t Hotels,” the author makes a case that the new pay for performance healthcare legislation may be incentivizing the wrong behaviors. She argues that evaluating hospital care in terms of its ability to offer positive experiences could easily put pressure on the system to do things it can’t, at the expense of what it should. For example, she points out that “a lot of care can be invasive, painful and even dehumanizing. Even worse, sometimes curative care is no longer an option” and physicians and staff have the tough job of telling their patients this horrible news.
“Hospitals are not hotels, and although hospital patients may in some ways be informed consumers, they’re predominantly sick, needy people, depending on us, the nurses and doctors, to get them through a very tough physical time….But a survey focused on ‘satisfaction’ elides the true nature of the work that hospitals do. In order to heal, we must first hurt.”
I agree that patient satisfaction scores, in a vacuum, are not a clear and holistic picture of the entire care outcome continuum. However, hospitals that intentionally design their physical space and staff behavior to help treat people with kindness, love and respect will excel in all categories; not just patient satisfaction. It truly does pay to explain to patients when they will hurt and why; respecting their needs goes a long way. That’s not a hotel; it’s a center for healing.
According to the Hastings Center Report, (Jan-Feb 2011) there are five major healthcare trends that have completely changed the landscape of how healthcare is and will be delivered. They include the growth of evidence-based design, the safety/quality revolution, pay for performance and increasing consumer transparency, sustainability and green design, and access to capital. The wonderful thing about each of these major trends is that they support and enhance one another. Take for example, the larger single patient room. Single patient rooms improve clinical outcomes by reducing hospital-acquired infections, adverse drug events and falls. They also improve patient satisfaction by helping ensure a patient has the privacy to rest and heal more swiftly. Increasing room size by one hundred square feet also allows family members to say overnight with the patient, increasing their satisfaction and involvement in care.
There is definitely a business case to intentionally design the ideal patient experience and facility that enhances the quality of care and patient satisfaction. Increased market share, the ability to attract and retain talent, the creation of operational efficiencies and the ability to enhance an organization’s reputation in the marketplace and community are all positive outcomes of improving the patient experience.
However, plain and simple, it’s just the right thing to do. The most successful healthcare organizations are improving the patient experience because they feel that way too. They have embraced the philosophy of “Doing unto others what we would have others do unto us.” They have made the commitment to provide unconditional love to their patients and their families. The result? According to ABIHM Board of Directors Member, Nick Jacobs, FACHE, in his blog entry dated March 18, 2012 his hospital had the lowest restraint, readmission, lengths of stay and infection rates of its 18 peer hospitals. Most importantly, even though the patients came from the same pool of humanity, they had the lowest mortality rates, not to mention, both the hospital’s employee and patient satisfaction rates were in the highest possible percentages. Simply goes to show that an environment influences all who lie within it, not just consumers.