Patient Experience - Des Moines University PDF

PATIENT EXPERIENCE Ashley M. Dikis, DPM, FACFAS, DABPM Assistant Professor Des Moines University OBJECTIVES 1. 2. 3. Recognize the connection Recall the effect of Recognize the basic between p...

PATIENT EXPERIENCE Ashley M. Dikis, DPM, FACFAS, DABPM Assistant Professor Des Moines University OBJECTIVES 1. 2. 3. Recognize the connection Recall the effect of Recognize the basic between patient positive patient concepts of experience during the experience on liability communication during clinical encounter and the and productivity the clinical encounter clinical quality outcomes for care provided INTRODUCTION Why do we care about the patient experience? ○ Increasing evidence linking patient experience to important clinical and business outcomes ○ Market and regulatory trends ○ Initiatives calling for including patient experience into performance- based compensation systems, board certification and licensing ○ Why wouldn’t we? It’s the right thing to do.  INTRODUCTION Patients already assume that you have the technical and clinical knowledge o Their experience is how they judge whether you are delivering quality care Available evidence tells us that communication and interpersonal skills are just as important to patient outcomes as technical and clinical capability Experience versus Satisfaction “I’m not here to be their friend. I’m here to tell them what they need to do to get better. I’m not going to hold their hand. My skills will keep people coming back.” PATIENT EXPERIENCE: CLINICAL QUALITY OUTCOMES Studies show positive correlation between experience and prevention/disease management o Patients with diabetes demonstrate improved self-management and QoL when they have positive interaction with their provider Improved adherence to medical advice and treatment plans  PATIENT EXPERIENCE: BUSINESS Correlated with key financial indicators Improved employee satisfaction o 4.7% decrease in turnover Relationship quality affects likelihood patient will seek care with another provider o Cost of acquiring a new customer/patient is 5-10x the cost of retaining one PATIENT EXPERIENCE: BUSINESS CAHPS HOSPITAL SURVEY Hospital Consumer PATIENT SURVEYS Assessment of Healthcare Increased Providers and Systems transparency Ability to compare CG-CAHPS providers by reported metrics Clinician and Group Consumer Assessment of Healthcare Providers and Systems  82% Most important factor influencing loyalty to a provider: Customer Service  PATIENT EXPERIENCE: BUSINESS CMS includes survey results in their value-based purchasing formulas which can penalize or reward hospitals Private sector expected to follow suit (it’s already happening!) with major insurers expected to include patient satisfaction in their reimbursement formulas. PATIENT EXPERIENCE: LIABILITY Good patient experience associated with lower medical malpractice risk 2009 study demonstrated that with one point drop in patient satisfaction score (“very good” to “good”) there was a 21.7% increased risk of being involved in malpractice activity PATIENT EXPERIENCE: LIABILITY Reasons most cited in malpractice claims: Didn’t listen Didn’t return phone calls Showed little concern or respect for patient condition Rude Didn't spend enough time Didn’t adequately answer questions PATIENT EXPERIENCE: PRODUCTIVITY Physicians can be both productive and offer excellent patient experience PATIENT EXPERIENCE: C-L-A-S-S PROTOCOL Communication skills experts at MD Anderson Whether delivering difficult news or performing a routine patient interview, the process is the same PATIENT EXPERIENCE: PRACTICAL ADVICE Be open to the data Self-reflection But what about the staff?! Our facilities?! It’s not just me! ○ Interaction with the provider is the number one most important factor in patient experience FIRST IMPRESSION DO DON’T Be prepared Walk in and expect patient to relate o Review available records everything about their prior State your name care/workup Allow patient to begin speaking, Assume patient knows who you are offering history and other pertinent Immediately begin with your information without interruption assessment and recommendations If you need to use computer, Jump into the exam without explain what you are doing and why describing what you are doing  PROXIMITY DO DON’T Arms length for traditional social zone Invade space without Social distancing explanation or permission Be aware of cultural preferences that may affect rules surrounding physical contact COMMUNICATION NON-VERBAL Handshake? Sit/Stand, Eye Contact VERBAL Listening is just as important as speaking COMMUNICATION DO DON’T Allow patient to speak Interrupt or ignore Offer clues that you are paying o Average 18-23 seconds attention Minimize patient’s complaints Paraphrase or repeat or issues ○ “If I’m hearing you correctly…” Blame the office/staff Demonstrate empathy Aggressive Assertive EXAM DO DON’T Educate patient Stay silent Describe what you are doing and o Patients want to know what you are looking for what’s going on! Take the opportunity to educate ○ Both positive and negative findings  MOTIVATION Patients need to understand their condition, goals and the treatment plan in order to feel motivated Give the patient power of choice ○ Make decisions together ○ Accountability WRAPPING UP THE VISIT Inform patient of recommendations Remember: they are RECOMMENDATIONS only because patients have a choice Once decision is made, repeat what the patient needs to do and what you will do Offer affirmations and encouragement Be clear on follow-up and how to reach out if any issues arise Do you have any questions?  CONFLICT RESOLUTION Even with the best intentions, sometimes things just won’t go well Resolution is the goal ○ Opportunity for growth ○ Everyone doesn’t have to agree ○ Remember, patients are in pain/scared/frustrated (and often dealing with other factors in their lives) Address those factors within your control in a respectful manner SUMMARY How does patient experience impact clinical outcomes? How does patient experience impact risk of liability? How does patient experience impact clinician productivity? Do’s and Don’t for communicating in a clinical setting Remember: How would you want someone to treat you or a family member? REFERENCES 1. Fullam F, Garman AN, Johnson TJ, et al. The use of patient satisfaction surveys and alternate coding procedures to predict malpractice risk. Med Care 2009 May;47(5):1-7. 2. Boffeli et al. Patient experience and physician productivity: debunking the mythical divide at HealthPartners clinics. Perm J 2012;16(4):19-25. 3. MDAnderson Complete Guide to Communication Skills in Clinical Practice. 4. Snyder, Bo. A Physician Guidebook to the Best Patient Experience. Series: ACHE Management Series. Chicago : Health Administration Press. 2016. eBook. 5. Beeson, Stephen. Practicing Excellence. 2006. 6. The CAHPS Ambulatory Care Improvement Guide. AHRQ 2017. 7. Zolnierek and Dimatteo. Physician communication and patient adherence to treatment: a meta-analysis. Med Care 2009; 47(8): 826-34. 8. Lecture material by Dr. Paul Dayton & Dr. Colin Pehde. Des Moines University. 9. Patrick Oben. Understanding the Patient Experience: A Conceptual FrameworkmJ Patient Exp. 2020 Dec; 7(6): 906–910.  THANKS! Copyright Notice: This presentation may contain copyrighted material used for educational purposes under the guidelines of Fair Use and the TEACH Act. It is intended only for use by students enrolled in this course. Reproduction or distribution is prohibited. Unauthorized use is a violation of the DMU Integrity Code and may also violate federal copyright protection laws. CREDITS: This presentation template was created by Slidesgo, including icons by Flaticon, and infographics & images by Freepik.