December 12, 2018
Sustaining Great Patient Experience - Art or Science?(Article in Healthcare Radius, November 2018)
As hospital operators we always struggle with the question – What does a patient want? All of us have attempted to guess the answer to that question and have been successful at satisfying majority of our patients, but not all of them. If the solution works for most why doesn’t it work for all? Are we really addressing the needs of the patient or taking a shot in the dark which works most of the times? Is science the answer to ensure every patient goes out satisfied or is it the art in the hands of the set of people who handle the patients which ensures success?
Although physics has little to do with human behaviour but I strongly believe reactions are motivated by Newton’s Third Law – Every Action has an Equal and Opposite Reaction. Patients who appreciate or are disappointed with a hospital are made to feel that way by the actions of the care givers themselves. Simply put the more you invest in converting transactions into relationship the stronger the chance that it will nurture well!
Additionally, after the initial few years of growth every hospital feels the need to revitalise its offerings so that the growth continues in the same trajectory and the patients continue to choose them over their competitors but is that really possible? The answer lies in sustaining the original brand ethos which usually loses its sheen due to accelerated growth and success. Organizations which keep their basics close to their heart and develop a model that ensures each patient goes through a unique yet repeatable experience irrespective of the overall pressure on the hospital, are the ones which leave a mark and deliver a magical patient experience…each time.
If you study the trigger points which influence patient experience they can broadly be categorized into 6 themes based on their expectations which are varied and makes it even more difficult to create an environment which suits every patient. However, the foundation to creating a good experience for the patients is to first address their fears. Hospitals are not the best possible environment for anyone to choose and since they need to be in one it only creates discomfort and fear of the unknown.
To build control over delivering consistent patient experience it is wise to breakdown the patient’s journey into the various touch points which influence the patient and his/her family so that focusing on those themes would deliver an enriching experience.
1. Communication – It’s a known fact that the key to a successful relationship is effective two-way communication whether it is a marriage or a business transaction. Tailor made communication on the treatment options ensure that the relationship between the patient and the hospital remains strong and respectful. The patient or his/her family simply expect that the doctor, nurse and the support service staff maintain an effective communication flow to avoid confusion and apprehension. Patients and their family members often feel that while the patient was to be convinced for the need of the medical intervention the doctor was accessible and spent enough time but as soon as the surgery/procedure was done the follow up communication was reduced to once or twice a day rounds and/or interaction with the junior doctor on the team. As leaders we need to ensure that there is a culture of open communication which runs throughout the organization thus making it a way of life for internal as well as external customers.
2. Waiting Time – whether it’s a hospital or a restaurant, no one wants to wait no matter how good the result is going to be. Despite the fact that successful hospitals are thronged by discerning patients the common grudge is long waiting time. Waiting time for consultation, lab and radiology test results, admission, doctors’ rounds and discharge are the most common pain areas for patients and almost all the hospitals have attempted a structured intervention to control these aspects. It would be fair to say that there is a still a lot expected by the patients and their families.
Hospitals have moved towards adopting the process improvement tools as well as Lean implementation to ensure that the waiting time at various touch points remains under control and is acceptable to the patients, but the dynamics of the business requires heavy investments and focus.
3. Transparency – Health related expenses are always unplanned and uncalled for which itself stresses the patient and his/her family, in addition if the estimates shared at the time of admission are not honoured it becomes a sore point and creates dissatisfaction. Transparent counselling of expenses prior to any planned admission and immediately at the time of admission incase of emergency can save the patient from unnecessary stress. Healthcare costs are on the rise and the cost of skilled manpower and investment in CAPEX pushes the price to the patient upwards making the treatment package expensive. To add to that if the outcome of the patient’s treatment does not come out to be as per the plan there is bound to be dissatisfaction and bitterness between the hospital and the patient (including his/her family)
4. Clinical Outcome – Being core to healthcare and the most important differentiating factor for anyone to choose one hospital over another, this aspect needs the maximum focus on a continuous basis. Mostly patients follow the big names in specific specialties and the strongest medium, despite the growing media reach, is word of mouth popularity which is usually based on first hand experience. Clinical outcome is the basic reason for any hospital to become the first choice of patients because that’s the bottom-line for all treatment seekers.
5. Predictability in service – Strong processes and training can ensure repeated delivery of high-quality service standards. While all the organizations have created new benchmarks of service in hospitals it is the dependency on skilled manpower which creates variability and delinks patients from being loyal customers.
6. Empathy – to my mind Empathy wins hands down when it comes to delivering genuine patient experience. Ironically, this is getting extinct and the patient interactions are becoming mechanical and transactional which is leading to nothing but distrust. My personal experience tells me that while the margin of error exists in healthcare the only balancing act remains whether the treating doctor and the hospital staff genuinely stand with the patient and his/her family throughout their journey. Empathising during the tough phase of an individual goes a very long way and creates ambassadors of the hospital outside and creates stickiness between the patient and the hospital.
All along we know of the themes above however, it’s the delivery of these and in the right mix which makes the job tough. We have hospitals which do better than the others and if look carefully it is their ability to manage the above traits better which makes them look better than the rest. As we progress these will become the key differentiating factors and maybe the measuring scale for patients to choose between hospitals.
Lastly, while it looks scientific that these themes can be mastered it is the execution on ground in a high attrition environment which makes the reality disbalanced. That said our journey to master the right balance and deliver a wholesome experience to all the patients walking through the doors every time is what makes the leader’s job exciting and challenging at the same time.
Chief Operating Officer - Columbia Asia Hospitals.