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How is patient-centered care changing patient engagement?

By Kyle Murphy, PhD

- Current healthcare reform is placing a serious emphasis patient-centered care and making patients active participants in their healthcare experience. For one industry insider, the success of today’s healthcare reform hinges on the ability to engage patients in a meaningful way. “Patient engagement is critical if we are to transform the healthcare system,” says Patrick Ryan, CEO of Press Ganey.

“As you look at reform and the future of healthcare, it will be by giving all patients the opportunity to have their voices heard and engaging them in their care,” he maintains. “It has been demonstrated that patients who are engaged and communicated with regarding their care have better clinical outcomes and achieve that more cost-effectively than other patients.”

Patient-centered care cannot exist without giving the patient a voice, feedback that has typically taken the form of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPHS). These surveys, however, appear to miss the spirit of a patient-centered approach to healthcare, relying too heavily on quantitative and not enough on qualitative information.

Perhaps what’s problematic about HCAPHS is that it belongs to a different era, one which valued a certain kind of patient feedback that does not mesh with the goals of the triple aim.

“In the industry, we talk about the patient experience now,” Ryan explains. “Patient satisfaction confused people for a number of years and people would talk about it as being happiness and it’s not about being happy. It is really about the overall experience.”

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Gauging that overall experience requires a more robust type of data that is possible with a modified approach to surveying patients.

Improving on traditional patient surveys

Healthcare organizations and providers wanting to compete in an era of patient-centered are likely wondering what the steps their highly-successful peers are taking to engage their patient populations. According to Press Ganey’s CEO, the first step is rethinking their patient surveys.

“Almost 100 percent of our clients have customized surveys — we call them integrated surveys,” he reveals. “The HCAHPS questions are not sufficient to address the kind of operating processes that we’re talking about in transformations, so customization is critical in addition to the HCAHPS. The HCAHPS are asking a frequency question — did something happen, how often did it happen. Ours are experience questions — when this happened were treated with respect, were you communicated with.”

Why does this difference in posing questions matter? The answer to that question has to do with how quickly and effectively healthcare organizations and providers can respond to this kind of patient feedback. For Ryan, there is a discernable difference between overall aggregated and more detailed data.

“A perfect example is the OB/GYN unit is not performing well in aggregated data, so you then retrain everyone, you make the blankets bluer and pinker, and you involve the entire staff in that unit,” he continues. “With detailed data you can find out that it’s the weekend shift that needs to perform differently and you retrain the weekend shift and focus on those areas that actually need the work.”

What’s more, improvements to how patient feedback is collected, electronically and via mobile devices, has translated into service recoveries within days and weeks rather than months. ” By getting the data in a real-time format, there’s almost immediate service recovery that’s occurring and processes and procedures being addressed — whether it’s coaching team members or realizing process defects within the organization that can be covered,” adds Ryan.

Adapting to a national trend of patient-centeredness

As the momentum behind patient-centered care continues to grow, the healthcare industry cannot afford to ignore the needs and wants of patients. And this drive does not appear to be going away any time soon based on Ryan’s interactions in both the public and private sectors. “From a government level and from the private sector level, designing a patient-centered healthcare system is everybody’s focus,” he observes.

Recent interactions with members of Congress show a growing appreciation for an actively-involved patient population.

“Congress gets that the patient needs to be at the center of all healthcare,” Ryan claims. “Everyone that I spoke to is very interested in expanding on what patient engagement means. To a person and to a party, they appreciate that patients must take an active role in their healthcare, be involved, and be communicated with in ways that we’re just expanding to and implementing.”

If that weren’t sufficient evidence of changing times, Ryan sees a similar shift occurring among executives and leaders within the private sector as well.

“As a trustee of a medical center, a best practice is to know exactly how your patients are viewing your organization,” he continues, “and everyone who is a trustee of a medical center today wants to know, maybe as the first metric, how are we doing from a patient experience standpoint and they recognize that the patient’s voice is the strongest indicator of clinical performance, safety performance, and in fact financial performance.”

Patient-centered care is impossible without the patient’s involvement. Key to making that involvement mean something is ensuring that patient feedback becomes actionable data in the service of healthcare reform.

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