Ways to make satisfied patients work for you
Ways to make satisfied patients work for you
Dissatisfied patients do more than just badmouth your hospital they also can cost you money, often in more ways than one.
They’re less likely to return to your hospital, will probably discourage others from using your facility, and usually cost more to treat, says David Furse, PhD, founder and chief consultant for Solution Point/NCG, an outcomes measurement and decision support company based in Nashville, TN.
What’s more, some payers are starting to pay much closer attention to patient satisfaction scores and using these numbers as important factors in deciding which hospitals get contracts and which don’t. This trend will only continue to grow as "prices continue to standardize and clinical variances also become more uniform," Furse predicts. "When this happens, what you are left with is the quality of the patient experience, and patient satisfaction is a very big part of that."
In his 15 years as a patient satisfaction consultant, Furse has created a guiding list known as "The Things You Need to Know About Patient Satisfaction." Recognize the issues, and follow the recommendations below and you will be well on your way to improved patient satisfaction scores.
1. Anarchists are in your process.
The first step is simply to recognize that dissatisfied patients are uncooperative patients. "When patients are uncooperative, they’ll cost you money," he says. "Your first order of business is to answer the question, How do you reduce the percentage of patients who are going through your processes badly?’"
2. Patient dissatisfaction costs you money by draining resources.
"When you have dissatisfied patients, more staff time is spent tending to the anarchists," Furse says. "The staff just doesn’t have the time to do the things that delight patients."
3. Satisfaction is related to functional health status.
Satisfied patients get better faster. "If patients are satisfied, they pay attention better," Furse explains. "They are more likely to comply with care procedures when they are in the hospital and when they leave. If you have good compliance, you get better clinical results and a faster recovery."
4. Patient satisfaction is more than just internal performance.
When Furse conducts patient satisfaction surveys, he divides the questions into two main areas. One is called total process, which evaluates patient satisfaction from admission to billing. The other scale is global satisfaction, which is related to the provider’s reputation. "This is what we call brag, recommend, return," he says. "In a nutshell, would you come back?" The difference between the total process score and the global satisfaction score is the forgiveness factor. "The forgiveness factor is how much of a break the patient gives the hospital," Furse explains.
5. Educate the patient first, then improve the process.
Too often, hospitals set off on a patient satisfaction improvement program by trying to improve processes. This is seldom the best place to start, Furse claims. "The first order of business should be to improve the patient by educating the patient," he says. This education covers the gamut from telling patients the best places to park vehicles, to detailing steps patients can take to improve their conditions, to explaining to patients about treatment strategies both in the hospital and any care they may receive as an outpatient.
6. Don’t just identify and label the problem; understand the root cause.
An example here is that if you are trying to improve nurse response time, simply trying to make the nurses go faster may not solve the problem. One hospital Furse worked with dug deep and found that the problem wasn’t that nurses were slacking but rather that they were getting far too many calls because patients were pushing the nurse call button for the wrong reasons, such as when they needed their water glasses filled.
The hospital solved this problem by educating patients about proper use of the nurse call button and also training housekeeping staff to help perform these small duties. Another hospital had a low score for the hospital food. The problem didn’t necessarily stem from the food but the fact that many patients were on special diets. "When they did a root-cause analysis, they found that 50% of the patients on special diets didn’t know they were on special diets," Furse says. "In this case, it was just a matter of telling the patients they were being placed on special diets.
7. Most solutions are local, not global.
An example here comes from another hospital that had food satisfaction problems. One unit had a 12% dissatisfaction rate, which was moderately acceptable, but the oncology unit had a 65% dissatisfaction rate. "What they found was that the smell of the food was making the oncology patients sick," Furse says. The solution here wasn’t to change the entire food service department but just the type of food and the way it was served to cancer patients. The hospital switched these patients to less aromatic food and also made sure that the servers lifted the cover off of the plates in the hall, letting the aroma out there, rather than right under patients’ noses.
8. It’s possible to improve satisfaction dramatically without increasing costs.
The issue here is twofold: one, instilling a caring, non-defensive posture in staff and two, learning how to identify patients who are about to have a patient satisfaction "train wreck." "A lot of this is just recognizing what is going on in a patient’s head and giving them the information they need in a non-defensive way," Furse says. "This approach can head off a whole lot of problems." An example he uses is the story of a daughter looking for her mother who had been taken out of intensive care. "The daughter walked up to the unit desk, looking to find her mother, and she was virtually ignored by the nurses and doctors who were working behind the desk. She stood there for what felt like a long time until she finally just screamed out: Will somebody please tell me where my mother is?’ Everybody behind the desk was completely shocked. That’s what we refer to as a train wreck."
The solution was to make it part of an employee’s job to anticipate such problems and then head them off before they reached a flash point. Sometimes this can be done with the use of trained volunteers, Furse says.
9. Keep patient satisfaction results in proper perspective. Novices often strive for quantum leaps in the patient satisfaction numbers. "When that happens, everybody gets an Atta boy!’" Furse explains. "Then they relax, and the numbers drop back off again. What you get is this zig-zag pattern. The emphasis should be on small, gradual, and sustained improvement."
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