Fair question right? Who has experienced 5 HBO cancellations out of 6 or 7 on the schedule in one day? Did you feel like you did something wrong the day before? Were you off your game? Moody? Did you bring your issues to work again when you were supposed to check them at the door? Lots of questions to ponder right? Well you should ponder them, patient compliance can also depend on how well you treat your patients on a daily basis – no matter how bad they treat you. In a patients’ mind “they are sick” and you are well and they are there to be taken care of – not to be treated badly by you, especially since they have a choice of where to go and who to see. This article will explore the possible link between patient satisfaction and hyperbaric compliance as well as how patient satisfaction affects everyone in healthcare.
PATIENT SATISFACTION: Medicine has done a 180 in just a very short timeframe and more and more healthcare workers and providers are wondering “What gives”? Patient Satisfaction for one is a huge variable in the future of healthcare as well as in the financial future of every hospital in the United States. To put it simply; If your patient’s rate your hospital low on patient satisfaction, your hospital receives less money from Medicare, and in reverse – If your hospital ranks high in patient satisfaction, your hospital gets paid what it deserves to get paid (what was originally billed). Crazy right? What about those patients who are never happy? Sometimes it seems that none of them are ever happy – short answer, they are not exempt from patient satisfaction. The argument could be made that the same percentage of “Never happy patients” are the same across the board in other hospitals (governments argument – not mine). Is it unfair? Some do say it is and there are studies and articles written about how unfair it is – but let’s get real, patient satisfaction no matter how flawed & unfair everyone says it is, is here to stay. This means we ALL have to change our ways, adjust our attitudes, or just leave the healthcare field altogether.
PATIENT SATISFACTION & YOU: Yes you in the wound care and/or hyperbaric department. Patients that are dissatisfied that fill out a survey sent by a 3rd party (not your facility) can identify exactly who was rude, mean, did not explain the procedure well, registered them incorrectly, never looked them in the eye, never smiled, was grumpy etc in the patient satisfaction survey. They can point the finger at you without you even knowing it. Just like you filling out the survey at a restaurant when the food was bad and the service even worse – this is what is happening in healthcare. In one instance it is really good because it holds each and every person in the facility “accountable” for their behaviors and actions or inactions, in another instance it is bad because the folks that usually fill out surveys tend to be the one’s that are dissatisfied with the level of service or care. It seems that with the advent of patient satisfaction surveys the deck is stacked against you (the provider, the RN, the CHT) right? Let’s not lose sleep over this just yet, believe it or not there are some simple solutions you can implement to “change the culture” from within your own department – even if there is just one of you. Here are some:
- You know that the deck is stacked against you to start because usually the dissatisfied patient is the one the fills out the patient satisfaction surveys. SOLUTION: Encourage all of your patients to “Please fill out the patient satisfaction surveys”, let them know that each of them has a voice to “Change” healthcare for the better to their benefit. Ensure that they know who the 3rd party is that sends them the survey so they do not think it’s a bill and just toss it aside.
- Change your attitude towards patients. Treat every one of them with respect and dignity, imagine them as a family member (grandfather, grandmother, or even your own parents) and see how you would rate yourself or how they would rate you if they were in fact related to you.
- Act early & often. This means that when a patient is dissatisfied right now, do not let them stew and get angrier by not resolving what is bothering them prior to them leaving your facility. Get your director, program manager, or charge nurse and explain to them what happened so that the issue can be resolved right away – not a day later.
- Use AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you). Some facilities have their own versions of AIDET but the concept is pretty much similar.
- Acknowledge is simple, say hello to the patient, make eye contact and smile (smiling does not cost you anything – but failure to do so may cost you your job). Keeping your eyes on the screen and saying hello to the patient is rude and inappropriate, so is holding your pointer finger up to their face while you’re on the phone. Drop everything and speak to the human being in front of you the way you would want to be addressed.
- Introduce yourself, who you are, your position, how many years you have been doing what you have been doing and keep a smile on your face like you are glad to see them – even if you aren’t. Your grumpiness shouldnt be their problem, it’s yours and you should have checked it at the door.
- Duration speaks towards how long they should expect to be at your facility – especially for new patients. Telling them 5 minutes every 15 minutes will just undo everything you have done so use “Disney” time (When they say 30 minutes they usually get to you in no more than 15 minutes – thereby raising their customers expectations of service).
- Explanation; now comes the link towards compliance. Explaining the procedure does a couple of things to the relationship between you and the patient, it builds trust and it builds confidence. You build trust by being knowledgeable about what you are doing and saying to the patient and you build confidence in them that you actually know what you are doing and saying as well. Why is this important you say? Well if a patient does not trust what you are saying and thinks you are a bumbling idiot they more likely than not wont trust you to lock them in that chamber for two hours everyday, that is why the explanation of the procedure is everything. You cannot rush the explanation nor should you try to use big words such as “neovascularization” without knowing how to define it to the patient in simple terms, in fact everything you say to all your HBO patients during the explanation of the procedure should be broken down into understandable & simple terms. And at the end of the explanation you must allow the patient to ask you questions in order to verify their understanding of the procedure. Often times the explanation is rushed and questions are never answered which can lead to a patient being clueless the minute they start the treatment thereby possibly resulting in them getting barotrauma or worse, calling you a liar because (according to them) you never told them certain things about the treatment.
- Thank you. Is it so much to ask for you to thank your patients for coming into their appointments? At the end of the day if you do not have a patient to treat – you are just a liability (expense) not an asset to the organization and therefore thank your patients for keeping you busy and employed probably isn’t too much to ask. So make sure you thank each and every one of your patients when you have a chance.
As much as the patient satisfaction surveys are stacked against most of us in healthcare, its main purpose to bring the “Care” back into healthcare. If I got a dollar for every time I saw a healthcare provider / clinician be rude to a patient I would be Bill Gates. Being held accountable is going to be a major part of the healthcare reform that is ongoing – this is a good thing. In this day and age there is no room for rude staff members in healthcare any longer and this in the long run will make our patients happier and possibly even healthier. As a side note on how serious hospitals are taking this patient satisfaction thing; I have sat in monthly leadership meetings for many years with the CEO of the hospital going down the list of directors seeking their “poor performers” & “bad attitude” staff members and discussing the “plan” for these staff members (many of them have been let go), even some contractors have lost their contracts – all based on bad attitudes and patient satisfaction survey results despite being a profit center for the hospital. This is how serious these organizations are taking patient satisfaction.
In conclusion, I would say that “Yes” there is a possible link between patient satisfaction and patient compliance (at the very least it does help) but it is probably not the only thing that is keeping the patients coming in for their treatments or vice versa. Surely there are other factors that affect patient compliance some of which I have not mentioned in this article such as personal & financial responsibility, socio-economic, etc. With that said, the one sure thing to stay would be the patient satisfaction surveys and the ability of organizations to weed out bad behaviors within their organization to create better overall patient experiences thereby increasing patient satisfaction.