Patient satisfaction and improving the hospital experience is being discussed in hospital boardrooms across the country. Now that financial reimbursements are directly tied to HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey scores, there is a significant incentive to do so. A multitude of ideas are being put forward into how this can be achieved, and hospitals are investing heavily to get tangible results. Many involve complicated and expensive methods that unfortunately border on being a bit gimmicky. Examples include reorganization of medical floors and staff, computer-based solutions, pamphlets, and other free “treats.”
However, what is often overlooked is simply listening and acting on patients’ most basic complaints. Here are 5 of them; straightforward ways to give patients a better hospital experience:
1. Time with doctors and nurses. This is nearly always top of patients’ healthcare wish list. Patients simply want more time with their doctors (and so do the doctors). Time to sit down, talk through everything that’s wrong and what treatment options exist. One of the biggest barriers allowing this to happen is the sheer scale of documentation tasks that are required of doctors and nurses. This has reached epidemic proportions. Slow and cumbersome information technology plays a large part, with some studies suggesting that doctors now spend close to only 10 percent of their day in direct patient care. There is something very wrong when doctors and nurses spend 4 or 5 times more of their day in front of a screen than with their patients. We need to swing the pendulum back to direct patient care.
2. A good night’s sleep. Usually the first complaint I hear when I walk into a patient’s room first thing in the morning. Whether it’s a noisy neighbor, noisy staff or repeatedly having their vital signs taken during the night—there’s plenty to wake patients up in a hospital. How can anyone get better if they can’t rest? Sleep is, after all, when our bodies replenish and heal. Let’s tackle this head-on by making hospital floors quieter and more soothing places to be, rather than so “rough and tumble.”
3. Better hospital food. So common a gripe for hospitalized patients that it’s become a bit of an endearing joke. Whenever I hear this from a patient, I usually try to answer in jest: “Well, we can’t make hospital food too good otherwise people will not want to get better!” But all joking aside, it would be good to see hospitals serving up some delicious (and healthy) nutritious options. This doesn’t need to be gourmet upscale restaurant food, but can definitely improve with a little more thought.
4. Be clear about wait times. When hospitalized patients are waiting for tests, be it a CT scan or a cardiac stress, the times of tests are often very uncertain. This can be very frustrating for patients who often cannot eat before certain procedures. Giving a more accurate time, plus or minus say an hour, will greatly help patients and their families in knowing what to expect (it doesn’t have to be to the nearest minute). Better co-ordination, feedback to the patient’s nurse, and direct communication with the patient should be standard protocol.
5. Multidisciplinary rounding. Instead of the patient seeing their doctor at a completely random time during the day, hospital bedside rounding should be conducted at defined times with the full care team. This should include the doctor and floor nurse at the very minimum. The attending physician should lead the rounds, with the aim of having a complete and clear plan for the day in place as early as possible. This care plan and anticipated day of discharge should be fully discussed with the patient (and their family).
These five solutions are much less complicated than many of the ideas that are being bandied around by hospitals — and don’t involve multi-million dollar investments. The answers are much closer to home than we may think. To use a cliché — it’s not rocket science: We should get back to basics, start listening to what patients tell us about how they experience their hospital stay, and start to act. Solving these 5 problems alone has the potential to transform patients’ hospital experience.
Suneel Dhand is an internal medicine physician and author of Thomas Jefferson: Lessons from a Secret Buddha and High Percentage Wellness Steps: Natural, Proven, Everyday Steps to Improve Your Health & Well-being. He blogs at his self-titled site, Suneel Dhand.