The CMS mandated HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) Survey provides hospitals with valuable feedback on the patient perception of the experience. Seventy percent of U.S. hospitals score higher than Mercy, which negatively impacts reimbursement for services and ultimately the hospital’s bottom line.
Mercy physicians are evaluating how they communicate with patients to provide a positive experience and overall satisfaction with care. Frank J. Kaeberlein, MD, chairman of the Department of Emergency Medicine, and Michael H. Linz, MD, chief of Inpatient Medicine, share the communication practices they encourage among their department physicians.
The Big Close
“The Emergency Department physician group is emphasizing what is called ‘The Big Close’ in the emergency medicine literature,” Kaeberlein says. “For all patients, it is important that they understand the elements of their visit.”
Kaeberlein recommends this practice to any physician speaking to a patient upon discharge:
- Tell them what you found and, equally important, what major problems you ruled out.
- Review and summarize any consultations and significant lab and imaging results (print the reports for home-going if needed).
- Explain the next steps, including prognosis, follow-up appointments, additional testing and treatment plans, and recommended behavioral changes.
- End with open-ended questions such as, “Is there anything else I can do for you? Is there anything you do not understand or are still worried about?”
With elderly patients, it is ideal to do “The Big Close” in the presence of their family or a support person.
The Four C’s: Culture, Communication, Connectivity and Compassion
Culture is unseen, yet present within the hospital. It influences the success or failure of the healthcare team.
“How well the ‘team’ works together influences patient satisfaction ratings,” Linz says. “Supporting one another with positive words rather than negative blame-shifting statements is key to improving patient satisfaction ratings.”
Examples include statements such as, “I called the doctor. I don’t know why he/she isn’t calling back,” verses “I called the doctor. He/she is a caring physician, and I am sure we will hear from him/her soon. Why don’t I make you comfortable.”
Patients quickly pick up on culture and react by feeling secure or afraid, Linz explains.
Communication has a direct impact on the patient experience. Many communication tools and behaviors are available to improve communication.
“Direct face-to-face communication strengthens relationships and builds trust,” Linz says. “Emails, texts, Halo and cell phones make communication more accessible, but do not replace AIDET, scripting, sit to speak, and teach-back methods.”
Connectivity is the relationship between the healthcare team and the patient. “Honesty, simplicity, listening, and a positive attitude all impact the connection between the caregiver and the patient,” Linz says. Making a positive connection yields positive results.
Compassion and empathy are the foundation of emotional intelligence. “Compassion is rooted in the mission and values of this organization as well as personal and spiritual beliefs of practitioners,” Linz says. “Physician as healer, practicing the golden rule, ‘do unto others…,’ and having a Boy Scout attitude of courtesy and respect will make a difference.”