The Department of Health and Human Services decided in October 2012 that 30 percent of a hospital's Medicare reimbursement is based on patient satisfaction. The idea behind this decision is that transparency and accountability will improve health care services overall (from The Atlantic). Top-performing hospitals even receive bonus money from the pool of reimbursements that aren't given.
The problem comes when we try to measure patient happiness using surveys. What metrics should we use? What makes some patients more satisfied than others? Should hospitals be catering to all of these different needs, or should they be focusing more on the healthcare aspect of their jobs? Do happier patients mean healthier patients? As you pursue your Master’s in Health Administration online, it’s important to consider the role patient satisfaction could play in your future career:
How Hospitals Are Improving Patient Satisfaction With Technology
Technology plays a huge part in customer satisfaction. It makes things easier for patients to connect with their doctors, understand their diagnoses, and make or change future appointments.
2-in-1 devices have become popular ways for doctors to communicate important health information to their patients. Doctors can easily use their laptops to bring up charts and diagrams and then detach them and bring the tablets right to a patient's bedside for easy explanations. This is a wonderful way to make patients feel more included and informed about their health journey.
Many hospitals and doctor's offices are now also making everything digital. Patients can make or cancel an appointment with a few clicks from a phone or computer. New patients can fill out their medical and insurance information using a tablet or smartphone rather than having to grab a clipboard from the front desk. This saves tons of time and means that patients can head straight into the doctor's office, where medical history information can be brought up at the doctor's desk.
Implementing all of these different technologies is great, but how can hospitals know if it is correlating to improved patient satisfaction?
The Government Medicare Survey
There are several different ways that hospitals can measure their patient satisfaction, but the way that matters most to the hospital's bottom line the one issued by the government. To determine whether a hospital is meeting the government's requirements for receiving Medicare reimbursements, the government has created a survey that patients fill out after their time at the hospital.
The survey that the Department of Health and Human Services uses is called the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The HCAHPS survey has 32 questions and focuses on nine key topics: communication with doctors, communication with nurses, pain management, the responsiveness of hospital staff, quietness of the hospital, cleanliness of the hospital environment, discharge information, and transition of care.
The HCAHPS also takes patient demographics and other personal information into consideration to better examine the answers to the questions. The hospital can use the survey results as a way to better understand how patients perceive them and as a tool to improve their services in the nine different areas.
How Else Can Hospitals Measure Patient Satisfaction?
While the HCAHPS is the survey that the government uses to gauge patient satisfaction, many hospitals are using other surveys throughout the year to ensure that they are meeting those requirements and are better able to tweak their customer satisfaction metrics. Several other formal surveys are offered by RAND Health that hospitals can use sporadically throughout the year to gauge patient satisfaction. Some are for patients experiencing a specific treatment while others are more generic.
For renal patients, there is a dialysis patient satisfaction survey. This survey asks how happy the patient was with their kidney physicians, the nurses and other staff at the dialysis clinic, their health plan, and what they thought of the physical environment.
There are also visit-specific surveys where a customer answers a set of questions based on a specific visit to the hospital or medical center. Patients can rate their healthcare provider, their experience that day, and the doctors and nurses they met with, and they can leave comments for improvement. This allows hospitals to see how people experience a one-off visit versus patients who are frequent visitors.
Another valuable survey is the patient satisfaction questionnaire. This survey measures 50 different items across six main areas: technical quality, communication, time spent with the physician, interpersonal manner, the financial aspect, and the accessibility of the care received. This allows hospitals and healthcare facilities to really understand the level of care they are giving their patients and how they correlate into customer satisfaction.
Problems That Arise From Focusing Too Much on Patient Satisfaction
For many, an attempt to improve healthcare has led to too much focus on making patients happy and not enough focus on making them well. The government incentive has led to nurses and doctors being forced to pay far more attention to making their patients happy, and they feel that this has taken away from what should be their main priority: healthcare.
Most questions in the HCAHPS survey address the care that nurses provide. The questions are misleading, and some have very little to do with the actual level of care that was given. Some hospitals that are doing excellent work are being punished simply because they are not catering to their patients' every whim.
In a recent essay published in The Atlantic, nurse Alexandra Robbins worries that hospitals are missing the point. As a way to keep patient satisfaction up, she says, some nurses are being required to attend nonmedical training to improve their people skills. Others are being forced to use scripts or specific phrases when dealing with customers, leading to impersonal interactions and unhappy staff.
It's important that hospitals and healthcare providers find a balance. Client satisfaction is important in any customer-facing industry, but a patient leaving happy isn't more important than a patient leaving healthy.
Educational Opportunities
Understanding patient satisfaction and how it can improve overall hospital care is becoming more important than ever. If you are interested in pursuing a career in healthcare leadership, it is a factor that will almost certainly impact your role. Learning everything you can about the factors that improve patient satisfaction can only help you as you move further down your career path.
To learn more about educational and leadership opportunities in healthcare, visit Sol Price School of Public Policy of University of Southern California.
Sources:
https://www.theatlantic.com/health/archive/2015/04/the-problem-with-satisfied-patients/390684/
What Do Patient Satisfaction Surveys & the HCAHPS Survey Tell Us?
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