April 02, 2019
Creating a Patient-Centric Culture
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Clinical communication is the single most important aspect of creating a patient-centric culture. No one appreciates this more than patients and families themselves, which I know from personal experience. Over the last few years of my father’s life, he was in the hospital several times. Each time, my family and I were disappointed and frustrated by the hospital’s inability to deliver patient-centric care. This experience gave me a heightened appreciation of the importance of the patient experience, and what we can do as healthcare providers to improve it.
Our frustration with my father’s care was not sparked by the clinical care itself. The hospitalists provided clinically correct care. The surgeons said and did everything appropriately. However, clinical communication fell short, which eroded our trust in and satisfaction with the care my father received.
For example, the nurse said the doctor would be right in, and no doctor came for hours. The hospitalist shared a specific plan with my family that was opposite of what the prior day’s hospitalist had said. A dinner tray would arrive, only to be followed by a nurse running in and taking the tray, stating that the speech therapist had changed his diet, but the order hadn’t gotten to the dietary department in time to send the right tray. To use an overused expression, there were too many instances where the right hand didn’t know what the left hand was doing.
From a physician’s perspective, there’s no question that increasing pressure to improve patient satisfaction scores can be frustrating. It’s easy to scoff at the accuracy and reliability of specific measures. We’ve all experienced patients and families who are unhappy with their experience, even after we provided evidence-based clinical care with good clinical outcomes.
However, as healthcare providers, it’s important that we consider the greater importance of providing truly patient-centric care. We must consider the patient and family’s perspective in all we do. We must acknowledge and respect that what they see and experience is totally different than our clinical perspective.
Most healthcare professionals, like myself, have been patients or have had family members in the hospital, and many have been dissatisfied with the care their family member received. It is instructive to realize that their dissatisfaction almost always revolves around the patient/family experience, not the actual medical care. It’s rare that a physician family member complains that the antibiotic they would have chosen was not given, or a different blood test or x-ray was necessary. In the vast majority of cases, the frustration with the care received revolves around poor communication, different answers by different providers, a mismatch between the stated plan and the actual care the patient received, or some other bad service experience. Often the family or patient leave the hospital feeling that the outcome was not ideal despite no specific evidence of poor clinical care.
The key to addressing this dissatisfaction is to work toward providing a consistently positive patient experience through improved communication. If the information provided by one hospitalist is different from that of the next, then it is not satisfactory clinical care. If the nurses and doctors are not on the same page when communicating care plans to the family, they are not delivering satisfactory clinical care. Furthermore, this issue can’t be addressed on a one-by-one, “whack-a-mole” basis. Instead, it should be addressed by instilling a patient-centric culture that permeates all hospital departments and all aspects of patient care. An emphasis on consistent interdisciplinary communication and an expectation that all patients will receive a universally positive experience must be part of the core mission of the hospital
Ultimately, to ensure patients and family members leave the hospital feeling positive about their experience, we must expand the definition of “excellent clinical care” beyond performing the appropriate diagnostic evaluation and treating the disease correctly. We must also include communication clarity and consistency, assuring that patients and family leave the hospital feeling that their care was great, that all members of the team gave consistent answers, and that the hospital truly cared that they had a great patient experience.
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