Being a patient or having a loved one in the hospital can be an overwhelming and sometimes bewildering experience. We are at our most vulnerable state and look to physicians and nurses to understand and resolve problems that may have no easy solutions.
In today’s changing healthcare environment, with greater consumerism and pressure to increase patient satisfaction scores, hospitals are trying to become more patient and family-centered. They are working to ensure that all staff members and their operations are focused on the needs and concerns of patients and their families.
Before becoming a patient, I assumed that all hospitals were naturally patient and family-centered. After all, isn’t their mission to serve and take care of the sick? But all hospitals do not operate that way, and hospital administrators are beginning to examine their people, processes, and systems from a patient’s perspective. Similar to a business striving to become more customer-centric, hospitals are beginning to listen to the input of their customers as they do business with the hospital.
Given the complexity of healthcare and the ever-increasing demands on providers, I recognize that there are no simple solutions for a hospital to become more patient and family-centered. However, here are a few basics to determine how well the hospital is doing:
1. Access—How easy is it to access the right provider in a timely way? Can you find the direct phone number or navigate the website easily to get to the right place? For those who call, do you reach a recording with multiple prompts or a live voice who can direct you effectively to the correct person or department? If English is not your primary language or you are hearing impaired, are there processes to assist?
When arriving at the hospital, is parking easily accessible and available? Is there wheelchair assistance? Are you and your family greeted warmly by the reception and admissions staff and welcomed to the hospital as valued ‘customers’ upon arrival? Or are you required to take a number, similar to renewing a driver’s license at the MVA? Are wait times reasonable and delays explained? If directed to another area of the hospital, is the wayfinding signage clear and helpful? If you get lost, does any employee of the hospital take the initiative to stop and give directions?
2. Building Patient-Friendly Systems—New systems are being created for scheduling appointments, patient education, communicating with physicians, and monitoring progress from home. With the proper time for implementing and upgrading software and training, these can be useful tools for communicating with you and your family members.
Hospitals are continuing to implement electronic recordkeeping systems. Sometimes these systems are met with resistance by providers because they take time to learn and adapt to the new technology. However, these new systems can help ensure documentation and improve communication that can benefit both you and the provider. Having access to the system from home–or from anywhere with a mobile device–can provide greater clarification and understanding of your condition after the visit. These systems can also help facilitate more straightforward tasks, such as prescription refills.
3. Cross-Functional Coordination—Frequently,multiple specialties and different departments are involved in a patient’s care. While many clinicians operate effectively within their own departments, sometimes communication across specialty areas is problematic. You may assume that the various members of your care team are all on the same page, but they may not be. Contradictory messages from different providers can lead to confusion and, at worst, conflicting treatment and possible medical error. The attending physician should take the lead in coordinating your care to ensure proper handoffs across departments and consistent communication among team members and with you. Your care team should consult with each other in person or by phone when there are differences of opinion or no clear solutions to a problem. Proper coordination with primary care physicians and other providers outside of the hospital is also critical so that the care can be followed up and monitored at home.
4. Dignity— Every individual working at the hospital—physicians, nurses, housekeeping staff, cafeteria and nutrition workers, administrative staff, etc.—has an important role in showing dignity, respect, and empathy to patients and family members. Working in a hospital environment can be difficult and stressful; hospital employees are often exhausted mentally and physically after a long shift. Yet healing others is a high calling and much is expected. You or your family members may be hearing a devastating diagnosis for the first time or be facing a high-risk surgery. And because a hospital is not your normal environment, you may feel especially intimidated and ‘out of your element.’ As you place your life in someone else’s hands, you deserve to be treated with respect and dignity at all times, even if the eventual outcome may not be positive. A kind word and a caring touch can be most welcome and appreciated.
5. Engagement—Patient engagement is a key element of patient and family-centered care. Patients and family members are often reluctant to ask questions and assume that the ‘doctor knows best.’ You may have concerns, such as “How am I going to pay for my medicine?” or “Who’s going to take care of my family while I’m in the hospital?” and providers should encourage you to share those concerns. Getting to know you as a person, in more depth, can help in the determination of the appropriate treatment, help make the hospital stay more comfortable, and ensure that the appropriate resources are provided to support your concerns. A simple question from a clinician, such as, “What do I need to know about you as a person in order to provide the best possible care?” can make a significant difference in the quality of care and your overall experience.
6. Follow Up—After a surgery or significant procedure, following up with you is essential to ensure compliance, to monitor the recovery process, and to help reduce readmissions. During the discharge process, many patients can’t wait to get out of the hospital and go home. You may be given all your prescriptions and sign papers, but not fully understand or remember the medications and the home care that is required. If you have family members or friends that can assist you, do they understand the home care that is needed? Does the attending physician provide a cell phone number and/or email address if necessary?
Medicine is as much an art as it is a science and all procedures don’t go as planned. When things happen that are unanticipated (which happens in every line of work), do the hospital and the provider(s) stand behind their service and work diligently to correct the problem? Are your problems acknowledged and addressed in a timely way? Do they openly explain to you what is being done to correct the situation and continue to engage you in the next steps?
Becoming patient and family-centered is an ongoing journey and requires an organization-wide effort. Many hospitals are doing an excellent job and going far beyond the ABC’s listed above. As a patient, I truly appreciate the dedication and commitment to this goal.
