Tuesday, 3 March 2015

“Patient Satisfaction”- A Biomarker for Quality HealthCare !


From the Desk of Sagar Galwankar, MD

 As the world continues to invest in HealthCare and as Administrators are born to rise continuously, “Patient Satisfaction” has emerged as a Crucial Biomarker in the Diagnosis & Prognosis of Quality of HealthCare.

#PS as I call it … is indeed the Indicator which is now being used with greater intensity to grade the quality of healthcare delivery.

Across the so called “Developed” World which is “Enveloped” in its own existence #PS continues to exist and grow with scores, patterns and algorithms being built to access the end point i.e. Quality Health Care.

What is the #PS, How does it affect us, what are the things that matter the most, how do you get the maximum score, what does that relate to, how do scores translate …….

In simple terms #PS means when a patient is asked how did you like the care provided to you ….he/she should say Great/Good/Satisfactory/Not Good/Bad.

Now this end point is broken into several questions with scoring sheets, numerical grades and with complex calculations and that emerges a score which is compared to averages across the industry.

#PS can refer to a whole system Example: “Care in the ED” or “Care by an Individual physician/ Nurse”.

Administrative Leaders stress a lot on #PS. This is because of the influence of the materials and service industry where it’s the rule “customer is always right”.

I am intrigued “Is the Customer-The patient – Always Right”

Well that’s an answer which by itself can institutionalize the debate generated around it.

The world of Litigation, Regulation, Accreditation, and Consumer Rights revolves around Customer Dissatisfaction and Enforcement of Patient Rights –which by the way I support totally.

But again ………How is #PS is a crucial biomarker?

I recently read somewhere about comparison of patient attitudes in USA and South America featured around an ED visit where two patient attitudes were compared: One in USA who is upset because his ED visit took 2 hours from entry to medication filling and discharge versus a patient in South America who walked miles to get seen after waiting for hours outside a busy ED and was happy with simple pain meds and thanked the physician and walked back home.

When I review all the writing and think simply I feel it is all about relationships. In Emergency Departments there is very little time to build a relationship and establish confidence.

No matter what we do , If corporate culture has entered healthcare, if investors are reaping returns in healthcare, if there are administrators who are accountable and if patient is considered a customer and physician/nurse a service provider like Fast Food Chain or Cell Industry ……. Then #PS will not only live, but thrive, survive, advance and expand.

The Developed World is full focused on #PS but this phenomenal has yet to oblige the economies in transition.

Countries where HealthCare is considered an Emerging Market like India #PS is sparingly used and restricted to patient complaints and compliance to satisfy these unsatisfied/ dissatisfied customers.

The Investor Industry which drives accountability from administrators will soon introduce and foster the #PS Phenomenon and institutionalize it in India in a BIG WAY.

It will not be long before Administrators who are already singing the Phrases of Quality and Safety will start speaking and proctoring #PS and making their operating systems, health care, executives and physicians accountable.

It is just a matter of time!

I will say few points which affect me and my care:

1.    Patient is First, his/her welfare is first

2.    Addressing the primary concern is my focus – Pain, Fever, Bleeding , Rash are things will I address stat

3.    Humble Approach, apologize if patient had a long wait, be considerate about the complaints, privacy while examining and regular discussion with patient, relatives through the stay of patient are crucial skills

4.    Keeping patient comfortable and pleased is the key

5.    Good manners and giving full attention to the anxiety of the patient is important.

Don’t answer Phone calls when patient is with you. Apologize that phone rang and switch the call off. If you get called for a serious patient, ask patients permission and then apologize and leave and affirm that you will be back as soon as the task is over etc etc.

There are times when you perceive that patient’s complaints are exaggerated. Even if the complaint seems Exaggerated – that by itself is a symptom which has to be addressed by you.  

Pain Control is a big player in #PS. Many times in Developed World patients are prescribed strong pain control medications which can get the patient into habitual use.

Use, Overuse and Abuse are very closely related. In all these processes the healthcare provider is involved as the patient evolves.

Controlling Pain is crucial like all of many complaints.

No matter you made a correct diagnosis, no matter you gave the best treatment, if you did not satisfy the patient, then #PS suffers so do you and your future!

As the payments, performance and progress gets tied to #PS , physicians have to revisit their past training. Bedside Manners were taught to us in Medical School… #PS now continuously grades those skills.

Knowledge is Key but Strategic Techniques to customer service are crucial.

Do we need Coaching Classes for that…….better than remediation after faulting! Prevention is better than cure…….we all agree to that!

We should not forget that we the physicians call our HealthCare Lifestyle as “My Practice”. It means in true sense you as a Physician continuously Practice your way to Perfection and Progress. This is a continuous process.

The New “P” is Patient Satisfaction which if good will improve your practice, perfect you and will definitely progress you.

“It’s the little things that matter the most”!

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