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Negative Patient Experience Tied to More Surgical Complications

According to a new study, healthcare organizations should work to improve provider workflows to improve the patient experience and consequently surgical outcomes.

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Source: Thinkstock

By Sara Heath

- A new study out of UNC Health Care shows a direct link between negative patient experience reports and surgical complications.

The research team examined patient experience reports from approximately 30,000 surgical patients at seven academic medical centers across the country. The study, which was published last week in JAMA Surgery, showed that 11 percent of patients had reported negative surgical experiences.

According to the researchers, complaints were directly tied with high volumes of surgical complications, medical complications, and hospital readmissions. Additionally, surgeons in the highest quartile of patient complaints had an adjusted surgical complications rate 14 percent higher than those surgeons in the lowest patient complaint quartile.

Negative surgical outcomes can have substantial financial implications, the research team said. At the current rate, the researchers said there will be an estimated 350,000 additional surgical complications annually, resulting in $3 billion in healthcare costs.

In order to improve patient experience, surgeons should focus on patient-provider relationships and care coordination, the researchers said.

When patients have an open dialogue with their providers and feel comfortable expressing care preferences or issues, providers can more easily address safety concerns or other complaints. Building a positive rapport characterized by meaningful communication with patients can help open doors for better care outcomes, said Scott Hultman, MD, MBA, one of the study’s authors.

“Patients want to know who their physicians are. They want to have access to them, to be communicated with throughout the process,” Hultman, who is also an Ethel A. and James F. Valone Distinguished Professor of Plastic and Reconstructive Surgery at the UNC School of Medicine, said in a press release.

“These results only reinforce why we need to continue to stress communication, teamwork, and professionalism,” Hultman noted.

Better care team communication can also help prevent surgical complications and reduce patient complaints.

“Other people on the care team may have key information that needs to be shared, and they need to feel free to speak up,” Hultman said. “If your style is such that people on your team don’t feel comfortable making suggestions, then you don’t get the information you need, and the risk of complication goes up.”

According to the researchers, a majority of reported patient complaints can be corrected. While the researchers could not disclose specific patient complaints due to privacy concerns, the team said that complaints pointed to changes in provider workflow that could foster a better patient experience.

According to UNC Health Care, this is breakthrough research. Prior to the study, healthcare experts had only proven a direct link between patient complaints and malpractice lawsuits. Equipped with evidence that patient complaints also point to surgical complications, healthcare organizations can make positive changes.

For example, at UNC Hospitals, Hultman leads the Patient Advocacy Reporting System (PARS) program, which aims to assist providers who frequently receive patient complaints or have surgical complications to improve their workflows to reduce these issues.

Through one-on-one meetings with members of similar surgical care teams, providers who receive several complaints are armed with strategies to change their behaviors, ideally helping to improve their outcomes.

“One of the things people say when entering the program is despite a high number of complaints, their work quality is good, their patients love them, or they have a low number of complications,” Hultman said. “That may be true at the moment, but this study says that if you have a high number of complaints, you are going to have complications.”

Overall, this study shows how patient safety can also factor into the patient experience. Patient safety episodes can often occur when providers do not meet certain needs, such as listening to a patient complaint leading up to or following surgery.

By tracking patient experience complaints, hospitals can detect trends in suboptimal care. From there, hospital leaders can address behavior or workflow changes necessary for certain providers, ultimately leading to better patient safety and experiences.

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