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How to Integrate the Patient Voice into Healthcare Decision-Making

Healthcare entities need to identify useful strategies to incorporate the patient voice into their practice improvement and decision-making efforts.

patient voice healthcare decision-making

Source: Thinkstock

By Sara Heath

- Adding the patient voice into healthcare decision-making is a critical aspect of practice improvement. With the healthcare industry becoming increasingly more patient-centric, more organizations are focusing on improving the patient experience. Considering patient viewpoints is an essential strategy for patient centricity.

The growing role of patient as consumer is driving this shift. Patients are paying a larger share of their healthcare expenses themselves, giving patients more power in the healthcare encounter. If a patient has a negative hospital experience, she may not return to that specific facility in the future.

Organizations are therefore focusing on how to create positive experiences. As the drive for improving the patient experience continues, organizations are realizing that they need the patient voice to inform improvements.

Organizations cannot assume that they know what patients want in healthcare. Numerous studies have suggested that patients and providers are not on the same page when it comes to patient satisfaction and the patient experience.

Entities must tap different methods for incorporating the patient voice into healthcare decision-making. Practices can accomplish this by consulting patient and family advisory committees, consulting patient satisfaction and complaint reports, and looking at online patient reviews.

Patient and family advisory councils

READ MORE: How Patient Advisory Councils Drive Patient Experience Efforts

Patient and family advisory councils (PACs) are excellent tools for integrating the patient voice into overarching hospital decisions. These councils can help influence certain hospital policies that can in turn affect how patients and family caregivers interact with the hospital.

Organizations looking to implement a PAC must first work on patient and family member recruitment. It is essential that PACs include a diverse array of patients and family caregivers to receive input from different types of stakeholders. PACs must also contain different but complementary personality types that will work cohesively during PAC meetings.

Once the PAC has been selected, organizations must ensure that PAC meetings are seamless and productive. Meetings should have a set agenda and a clear moderator to keep participants on topic.

Meeting moderators should nurture PAC projects, collect patient feedback, translate patient experience into projects, and identify projects that may not be feasible. Moderators do not always need leadership experience and may use this role to develop better management skills.

Once the PAC has selected and informed organization-wide projects, the PAC must clearly communicate goals and success measures to providers. This will facilitate better provider buy-in and help explain what role providers play in practice improvement.

READ MORE: 3 Ways to Incorporate Patient Preferences into Healthcare

Likewise, spreading PAC awareness will also create provider buy-in. When providers know about the PAC and about the body’s overarching goals, it will be easier for providers to keep patient needs at the center of all improvement activities.

Patient satisfaction surveys

Healthcare organizations can also collect patient sentiment through satisfaction surveys.

All healthcare organizations receiving reimbursement from CMS must complete the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys. CAHPS surveys help inform some CMS payments to different organizations, including but not limited to hospitals, nursing homes, and family practices.

While some organizations may use their CAHPS results to inform better organization decision-making, others also choose to implement their own patient satisfaction surveys. These targeted surveys are useful for collecting more specific information unique to the individual practice.

For example, a hospital working on an initiative to reduce opioid prescribing while maintaining a positive care experience may deploy a survey that asks more questions about pain management.

READ MORE: How Hospitals Can Raise Patient Satisfaction, CAHPS Scores

Healthcare organizations should use multiple different measures to assess patient satisfaction, according to a 2014 study published in the journal Patient Experience.

“Measuring patient experience can be accomplished using mixed methods, quantitative, or qualitative approaches,” the researchers said. “The strength of the mixed methods design lies not only in obtaining the ‘full picture,’ but in triangulating (i.e., cross-validating) qualitative and quantitative data to see if and where findings converge, and what can be learned about patient experience from each method.”

Healthcare organizations can better target their practice improvement efforts by collecting patient satisfaction data. Backed by relevant data, these efforts will be more likely to positively impact how patients interact with their care.

“Eliciting feedback from patients and engaging them in their care and health care delivery affords an opportunity to highlight and address aspects of care experience that need improvement, and to monitor performance with regard to meeting patient experience goals in the delivery of care,” the research team said.

“The use of core patient-reported measures of patient experience as part of a systematic measurement and performance monitoring in health care settings would markedly improve measurement of the ‘total’ patient experience and would heighten our understanding of the patient experience within and across settings,” the team added.

Patient complaint forms

Patient complaints can be equally as revealing as patient satisfaction forms, research has shown. Understanding what a patient did not like during the care encounter can help healthcare organizations determine their next steps in improving the patient experience.

A 2017 study published in the Joint Commission Journal on Quality and Patient Safety showed that assessing patient complaints is an essential window into what patients truly want during a care experience.

“Complaints offer distinct perspectives that compliment data available in safety reporting systems,” the researchers explained. “In addition, information reported to Patient/Family Relations is uniquely focused on the patient perspective. Sharing this information with clinicians and hospital leaders provides an important opportunity to address problematic aspects of patient-centered care delivery.”

An assessment of patient complaints at Dana Farber Cancer Institute showed that patient-provider relationships and the patient-centeredness of care could be more important than care quality and safety.

Forty-one percent of patient complaints pertained to patient-provider relationships. Eighteen percent related to humanness and caring, 15 percent related to communication, and 5 percent related to patient-staff dialogue.

“These attributes are a reminder that patients need comprehensive and correct information but also expect that it be delivered with care, respect, and sensitivity,” the researchers reported. “The records we reviewed confirmed that even one negative, unkind, or disrespectful encounter can fundamentally alter a patient's perception of care.”

Only 11 percent of complaints related to patient safety and care quality, but these complaints were categorized as high severity.

These results show that patients are more concerned with how their care was delivered than the actual outcomes. Although patients do expect quality healthcare, that quality is for naught if providers are not empathetic and with good interpersonal skills.

Additionally, these results show that healthcare organizations should incorporate patient complaint assessments as a part of their organizational improvement plans.

“On a broad level, evaluating rates and types of complaints across institutions may offer opportunity for quality benchmarking and evaluation of institutional performance over time,” the researchers concluded. “Individual centers can identify areas where the care experience is lacking by evaluating complaints, not only as single issues to be addressed on an individual basis but also as aggregate data revealing opportunities for improvement.”

Online patient feedback platforms

Online patient feedback and provider review platforms also offer troves of patient satisfaction information. Online websites such as Yelp, HealthGrades, Vitals, and ZocDoc can reveal patient sentiments about their healthcare experiences.

More patients than ever are using online provider review websites. In 2015, nearly one-third of patients were leaving online provider reviews, according to a study from the Journal of General Internal Medicine. By 2016, that number increased to 59 percent, according to a separate survey from Software Advice.

Patients place a lot of stock in these online provider reviews. The Journal of General Internal Medicine report found that patients trust Yelp reviews more than they trust reviews left on a provider website.

Thus, it is critical for healthcare organizations to take these reviews seriously. Assessing reviews left on popular healthcare websites can serve as a lens through which providers can better understand the patient experience.

However, online provider reviews can be a double-edged sword. Healthcare organizations need to develop a plan for how they manage online reviews.

Foremost, industry experts advise individual doctors not respond to comments on their own. Instead, organizations should appoint a marketing liaison to handle negative online reviews.

These liaisons should be trained in HIPAA to ensure that no responses divulge sensitive PHI or breach the law in any other way.

Marketing liaisons should be working to amend the relationship with the patient. The benefits here are twofold. First, repairing the relationship can ensure the patient will return to the practice instead of selecting a new one. Second, healing the relationships increases the odds that the patient will remove her complaint, helping to improve the practice’s online reputation.

As the healthcare industry continues to shift in a more consumer-centric direction, it will be important for organizations to frame their policies with the patient in mind. Incorporating the patient voice into healthcare decision-making will be key for accomplishing that goal.

By tapping into patient-centric resources – PACs, satisfaction and complaint forms, and online reviews – organizations can ensure that their improvement efforts embody patient preferences.

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