PATIENT SATISFACTION

Dr. Suskhan, SpOG(K)

Divisi Uroginekologi

Departemen Obstetri dan Ginekologi

FKUI-RSCM

Objectives

The participant will be able to: Describe the characteristics of the “new healthcare consumer”

Describe healthcare consumer expectations

Explain the difference between patients and customers

List two questions from an ED patient satisfaction survey

Objectives, Continued

The participant will be able to Describe how sitting down during the physician-

patient interaction affects patients' perception of that encounter

Define "scripting" in the context of an Emergency Department encounter with a patient or family

Discuss a minimum length of time a physician should allow a patient the opportunity to talk before interrupting

Describe “managing up” coworkers

Why are we here?

The New Healthcare Consumer

Today’s patient is more discerning and demanding.

She also has more access to information and a wider array of choices.

In many ways, today’s patient shouldn’t be thought of as a patient, but as a consumer.

She wants to know the quality of care provided by her doctor and hospital and how much procedures will cost.

The New Healthcare Consumer

In some cases she can find that out with the click of a mouse. A savvy Internet user, the new consumer also expects health care to adopt the same functionalities as other industries that allow her to buy movie tickets, book a hotel room and pay a bill online.

If she doesn’t like what she sees, she is more likely now than in the past to shop around with her health care dollars.

The New Healthcare Consumer:The

According to research by Press Ganey Associates Inc., people between the ages of 35 and 49—a major part of the new consumer cohort—have the lowest patient satisfaction scores compared with other age groups.

They are more likely to have health problems than younger people, so they have more encounters with health care providers.

They also tend to be more computer-literate than older consumers and are more comfortable looking for health care information.

What Do Patients/Clients Want?

The new healthcare consumer:

Wants empathy

Wants positive outcomes

Wants relief from symptoms

Wants information

Is Internet active

Is empowered

Insists on customer service

Insists on control

What Do Patients/Clients Want?

Consumers find it easy to attribute both positive and negative experiences to the hospital itself—for example, holding the hospital responsible for the behavior of those who work there.

So if bedrooms and bathrooms are not kept clean, if nurses fail to deliver medication on time, if staff physicians rush through examinations or explanations, someone in a leadership position must be held responsible for seeing that the problems are corrected.

Five Things that Matter Most to Patients

Doctors treat patients with courtesy and respect.

Doctors explain the facts in a way that patients can understand.

Doctors, nurses and other hospital staff do everything they can to help patients with their pain.

The hospital room and bathroom are kept clean.

Patients get information in writing about symptoms or health problems to look for after they leave the hospital.

What Do Patients / Clients Expect?

Retail shops, hotels and the Internet have all influenced consumer expectations about health care and, by extension, hospitals. They have primed consumers to value customer service, convenience and easy access to information.

What Do Patients / Clients Expect?

Hospitals should have better amenities

When they are staying overnight in a hospital, many patients expect hotel-like amenities.

Many hospitals are starting to implement changes that will improve the patient/consumer’s experience, including improved food service (such as improved menu options for patients), concierge services, spa treatments such as massage, and Wi-Fi connections in the hospital. A hospital that offers this type of customer service may have better patient satisfaction and loyalty than competitors without such services.

Patients’ Expectations

Expectations Experience + Needs + Communication = Expectation

If Perception exceeds expectations: Satisfaction

If Expectations are less than perception: Dissatisfaction

Patients or Customers

Patient or Customer?The “Patient- Custometer”

Horizontal – Patient

Vertical – Customer

Patient Satisfaction Surveys

Survey Questions

Press Ganey – ED Providers: Nurses

Courtesy of the nurses

Degree to which the nurses took the time to listen to you

Nurses' attention to your needs

Nurses' concern to keep you informed about your treatment

Nurses' concern for your privacy

Survey Questions

Press Ganey – ED Providers: Doctors

Courtesy of the doctor

Degree to which the doctor took the time to listen to you

Doctor's concern to keep you informed about your treatment

Doctor's concern for your comfort while treating you

The Likert Scale

1 =Completely Disagree

2 = Disagree

3 = Neutral

4 = Agree

5 = Completely Agree

The Likert Scale: Example

The staff did a good job at answering my questions.

1 = No

2 = Somewhat

3 = Satisfactory

4 = Very Good

5 = Excellent

The Likert Scale: Example

The nurse explained the procedure clearly

1 = Not at All

2 = Not Really

3 = Somewhat

4 = Yes

5 = Exceeded My Expectations

Raw Score and Percentile Ranking

Raw Score

Percentile Ranking

Comparative Databases Small ED

Small and Large ED

Network Hospitals

AHA Region

So, what’s our plan?

Quality Service

The Four Key Elements of Quality Service:

Customer

Commitment

Expectations

Continuity

Patient Satisfaction Tools & Techniques

Sit Down and Listen

Sit Down and Listen

Patient satisfaction surveys ask respondents to evaluate “The degree to which the physician took time to listen to you”

Optimizing patient responses can be accomplished by increasing the frequency of specific physician behaviors: an introduction, sitting down, use of scripted phrases, and multiple encounters.

Sit Down and Listen

There are effective ways to demonstrate concern for a patient even when you’re trying to do things quickly.

How You Enter the Exam Room is Important

Walk into the room with a smile,

Apologize for the wait,

Introduce yourself to all those assembled (remember to include the family),

Shake the patient’s hand,

Call the patient by name and

When possible and appropriate, sit down.

Sit Down

Sitting down places the physician at or below eye level and reassures the patient that you are paying attention (listening)

Sitting down relaxes the patient so that he or she will communicate more openly

Now That You’ve Set The Stage, It’s Time To Listen

After a general prompt about the reason for their visit to the ED, let the patient talk for a minute without interruption – you will get information you otherwise might have missed

When the patient has finished speaking, paraphrase what they’ve said to confirm that you correctly understand their concerns

Scripting

It Helps To Have and Use Effective Communication Tools

The consistent use of conversation that has been proven successful in advancing patient satisfaction is called “scripting’

You may want to consider utilizing one or more of these phrases as part of the patient encounter

It Helps To Have and Use Effective Communication Tools

“How can I help you?”

“I’m sorry this happened to you.”

“Do you have any questions? I have plenty of time.”

“You’ll probably think of some questions. Here’s a notepad to write them down.”

“Have you thought of any other information I might need to know?”

“Come back any time. We never close.”

“I’m going to be here all night.

Check Back Frequently

Give Evidence of Your Continuing Interest in and Involvement with the Patient’s Care

Check on the patient’s progress with multiple, brief encounters.

When things are busy, at least stick your head in an exam room and let the patient know you’ll be with them soon

As information becomes available, provide an update to the patient

Service Recovery and the Blameless Apology

Service Recovery

If you have made a mistake, or the patient has perceived an error:

Listen

Apologize

Fix it

Something Extra

Follow Through

Follow Up

Managing Up

Advantages of Managing Up Self, Skill Set, Experience and Certifications

Communicate that we are health care professionals

Create patient confidence and trust in healthcare provider

Another opportunity for key words … connect the dots

Advantages of Managing Up Coworkers

Patient feels better about their next care giver

The patient feels more at ease with the handoff, thus their coordination of care

Co-worker has a head start in winning confidence

Manage Up Coworkers

“Hello Mrs. Smith. I will be going home to my family now. Ken is taking my place.

I just shared with Ken all your important information. Ken is an excellent nurse and I have worked with him for over seven years. I hear such nice compliments about him from

his patients. . .”

Advantages of Managing Up Other Departments

Reinforces coordination of care and teamwork

Positions other department well to reduce them from having to win the patient over Decreases patient anxiety and concern

Manage Up Other Departments

“Hello Mrs. Smith. I see this afternoon you will be going down to the Radiology department. Radiology has state of the art technology and a very friendly and

courteous staff. They are aware you will be down there this afternoon and are well

prepared for you.

”Advantages of Managing Up Physicians

Shows coordination of care between staff and physician

Lessens anxiety for the patient

Physicians will appreciate this being done Hardwires positive word of mouth Emphasizes “team”

Manage Up Physicians

“Mrs. Smith, I see Dr. Richards is your physician. He is one of the best. He

explains things well and is so good at listening and answering patient questions.

You are very fortunate he is your physician.”

Summary

Introduce yourself in a professional fashion Address family members - bring them into the

encounter Establish a high level of professionalism and courtesy

Provide information as it becomes available with frequent updates

Check the patient’s progress using multiple, brief encounters

Sit down and listen Manage Up your co-workers

Remember…

Patients won’t remember what you said to them

Patients won’t remember what you did to them

But they will always remember how you made then feel

Sources

“Patient Satisfaction Scores: Improving Them in Your Emergency Department” Presentation notes from a program at the ACEP Scientific Assembly, October 18, 2004, Thom Mayer, MD, FACEP.

Leadership for Great Customer Service. Satisfied Patients, Satisfied Employees. Health Administration Press 2004, Thom Mayer and Robert Cates.

Hardwiring Excellence. Fire Starter Publishing 2003. Quint Studer. “Variables Contributing to Emergency Department Patient

Satisfaction” Academic Emergency Medicine Volume 12, Number 5, Catherine A.

Marco “Towards a Bold Love for ED Systems: 25 Practical Strategies to Improve Emergency Department Patient Satisfaction”, The Press Ganey Satisfaction Monitor, July / August 2000, James A. Espinosa, MD, FACEP

Questions and Comments?