Several “best practices” have proven successful in boosting patient-satisfaction scores and can be readily adapted to a variety of local hospital settings, says Dr. Short, who is a speaker in SHM’s Hospital Value-Based Program Toolkit webinar series (see “Best Practices,”).
Cleveland Clinic has greatly boosted its physician communication scores by sharing HCAHPS performance data with physicians and by gleaning best practices from its high-scoring physicians, which include, for example, ensuring that residents and fellows speak with attendings before rounding with patients to ensure staff alignment and care coordination, Dr. Merlino explains.
Cleveland Clinic also is rolling out to its entire medical staff a communication training program taught by a carefully selected team of peer physicians, which Dr. Merlino says is proving to be very effective in boosting patient satisfaction and improving care by enhancing patient-physician conversations. The program features Kaiser Permanente’s “Four Habits” model to help organize medical interviews with patients:
- Invest in the beginning by creating rapport quickly, and let the patient know what to expect.
- Get the patient’s perspective by asking for their ideas concerning the meaning of symptoms and the request for care.
- Demonstrate empathy by being open to the patient’s emotions and conveying empathy verbally and nonverbally.
- Invest in the end by delivering diagnostic information, explaining the rationale for tests and treatments, involving the patient in decision-making, and reviewing the next steps.5
“Organizations have to evolve in an increasingly value-based healthcare environment by developing a culture that can adapt to any set of questions or regulations that CMS mandates,” Dr. Merlino adds.
Next-Generation Patient Satisfaction Measures
Tools to guide patients and healthcare/hospitalist teams toward more satisfying dialogues with patients—as well as tools to improve their outcomes—are becoming increasingly available, says John Wasson, MD, emeritus professor of community and family medicine at Dartmouth Medical School and a member of The Dartmouth Institute Patient-Reported Measure Trust, which is developing and testing next-generation, patient-reported healthcare measures.
One example is Howsyourhealth.org, a family of communication-enhancement tools designed to build patient confidence in managing and controlling their health problems by helping them “get what they want and need exactly when and how they want and need it,” Dr. Wasson says.
“Hospitalists and their teams might begin to think about processes that enhance a patient’s health confidence, which is very strongly associated with many outcomes,” he notes. The hospital version of the tool—at Howsyourcare.org—immediately provides information tailored to patients’ needs, as well as a summary hospitalists can review with their teams in order to improve patient/caregiver confidence for successful management of conditions when discharged, Dr. Wasson says.
“Overall patient satisfaction is not particularly useful for predicting health confidence,” he says. “Information quality tailored to patient need is what boosts patients’ health confidence—and has real power to improve patients’ clinical outcomes.”
Christopher Guadagnino is a freelance medical journalist in Philadelphia.