The obstacles and stressors of seeking medical treatment are plenty. Everything from social stigmas about accessing mental health services to socio-economic issues creates barriers to receiving medical care in the first place. Oftentimes, there are patients who have food, home and safety insecurities, and yet they still manage to make it to their appointment with us. Our patients don’t typically feel well when we encounter them, and most don’t really want to be seeing us or be in our offices at all. Many are acutely ill and are struggling on a daily basis just to meet their basic needs. Some patients need a little help, while some need a full array of services.
For a moment, put yourself in the mindset of someone with all these needs. What happens when they arrive at their scheduled appointment 15 minutes late and we tell them that they can’t be seen?
As healthcare professionals, we are here to holistically help our patients heal. Holistically means we are treating the whole person, considering mental and social factors, rather than just the physical symptoms of a disease. While medications and therapy may be a large part of the equation to reach the ultimate solution, the experience the patient has during their interactions with us is another important component of the formula for their success. This is the patient experience.
The Beryl Institute defines the patient experience as “The sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.” (The Beryl Institute, 2021)
A broader definition from The Agency for Healthcare Research and Quality (AHRQ) states: “Patient experience encompasses the range of interactions that patients have with the health care system, including their care from health plans, and from doctors, nurses, and staff in hospitals, physician practices, and other health care facilities. As an integral component of health care quality, patient experience includes several aspects of health care delivery that patients value highly when they seek and receive care, such as getting timely appointments, easy access to information, and good communication with health care providers.” (Agency for Healthcare Research and Quality, 2021)
Here is a short example that highlights the impact of the patient experience.
There was a male adolescent patient that was struggling with his mental health and had a history of self-harm in the form of cutting. The patient finally started seeing a therapist. The first several appointments with the therapist went well. At the fifth appointment, the patient arrived on time for the appointment and sat in the lobby for about 15 minutes. As the patient’s anxiety grew during the wait, he called the provider’s number to receive an update on timing. The provider was at home. She had forgotten about the appointment. The appointment was rescheduled for the following week. At the rescheduled appointment, the provider had forgotten to write the rescheduled appointment down and was already with another patient. Being “forgotten” twice by his therapist left the patient feeling angry and unimportant. The therapeutic relationship had suffered irreparable harm and was not salvageable at this point. It was 18 months before this patient engaged with a mental health professional again. This real-life example shows the effect of the patient experience on engagement in care.
According to the Agency for Healthcare Research and Quality, “Patients’ experiences with care, particularly communication with providers, correlate with adherence to medical advice and treatment plans. This is especially true among patients with chronic conditions, where a strong commitment from patients to work with their providers is essential for achieving positive results.” (Section 2: Why Improve the Patient Experience?, 2020). There are numerous publications that demonstrate that patients with a better experience are more highly engaged in their care and are more likely to be compliant with their treatment plan.
In short, we aren’t fully helping our patient heal if they have a bad experience with us. And if, for whatever reason, that isn’t a compelling enough argument to prioritize patient experience, then consider the financial implications of a bad patient visit. We all know the old adage that a person with a bad experience will tell ten people and a person with a good experience will tell three people. Now, with social media, the number of potential future patients that a bad story can reach has grown exponentially. A poor patient experience isn’t just bad for that patient’s health. It’s also bad for the bottom line.
So we know what patient experience is, and we know it is important. Now how do we put it into action?
First, consider this. On a typical medical, visit our patient will interact with at least ten different people, all with the opportunity to create a positive patient experience or, on the flip side, to be the cause of a poor patient experience. Some patients may also have a case manager and a social worker added to the mix of touch points. It is imperative that each of our team members understands what we want our patient experience to be and the burning platform of why it needs to be that way. As leaders, we have to talk about the why, the who, the how, the what, and the where of the patient experience as often and in as many settings as possible.
What part do you play in the patient experience? We have to think outside of ourselves and our myopic view of our role and really look at how our actions impact the patient. Below are a series of questions to ask yourself and your staff to create a better patient experience:
Are you part of the scheduling team? Trying to get the patient scheduled for an appointment as soon as possible? How do you let the patient know that you understand their needs?
Are you the receptionist, the front desk associate who is likely the first person the patient sees when they enter our facility? How do you make the patient feel welcome and cared for?
Are you the medical assistant who is greeting the patient in the lobby after they have had to wait and are irritated? Are you walking the patient to the exam room? As you walk, are you walking side by side, talking, creating a relationship? Or are you ahead of the patient just letting them follow you?
Are you the provider who is making great eye contact with the patient? Or are you looking at the floor with your arms folded across your chest? Is the computer between you and the patient?
Are you an administrator who is completing patient and staff rounds and simply walking through patient care areas without talking to the patients and staff? Do you have patient experience survey data? What are you doing with the feedback? Does it sit in your inbox or on a shelf? Are you sharing the data and having constructive conversations regarding process improvement? You can’t manage what you don’t measure. We know this and yet we often fail to measure or then when we do, we check the box and move on and fail to communicate. If you aren’t surveying, you should be. If you aren’t communicating the results, you are failing your staff, your providers and, most importantly, your patients.
In all health care, our every action, inaction, tone of voice, word choice, facial expression and our body language must match our mission. We must treat each patient with the compassion and empathy that we would use if it were our loved one receiving treatment. We are treating a whole person, and not a diagnosis.
As the AHRQ definition states, there are many factors and components that create the patient experience. Our next article will discuss the impact of staff engagement and how to drive positive impact on the patient’s experience.
In the meantime, if you have questions or would like support improving your practice’s patient experience, our team is here to help.
Pattie Clay is a Senior Advisor and Management Consultant in MMG’s Healthcare Advisory Practice. Pattie has more than eighteen years of industry experience and a proven track record as a senior leader in the health system environment. MMG is a national provider of consulting services and back office administrative support to independent and system owned physician practice groups. Additionally, MMG has been formally recognized as a multi-year Northeast Ohio Top Workplaces award winner.