AHRA: For patient satisfaction, focus on right-brain skills

2013 06 17 13 24 57 113 Washington Dc 200

As the delivery of healthcare shifts to value-based service, radiologists and their practices can't neglect patient satisfaction. To achieve service excellence, it's wise to highlight right-brain skills, according to a talk at the AHRA annual meeting in Washington, DC.

"The reimbursement model is changing from volume to outcomes, and patient satisfaction is increasingly important," said presenter William Johnson, system director of patient experience at Memorial Health System in Springfield, IL. "But there are opposing forces at work during a patient encounter. The left brain is the clinically oriented delivery system and the right brain, the emotionally oriented patient."

Why the focus on patient satisfaction? Not only is it the right thing to do, it has been correlated to at least seven positive factors for radiology practices, according to Johnson:

  • Improved quality and safety outcomes
  • Improved patient clinical outcomes
  • Better market share and competitiveness
  • Improved financial performance
  • Improved Consumer Assessment of Healthcare Providers and Systems (CAHPS) performance (a program developed in 2002 by the U.S. Centers for Medicare and Medicaid Services [CMS] and the Agency for Healthcare Research and Quality to gather and publicly report data on patients' perspectives of hospital care)
  • Alignment with CMS and Joint Commission standards
  • Increased employee satisfaction and retention

Mechanics vs. 'humanics'

Johnson said that a typical patient healthcare encounter has two components: the delivery of the service and its quality. Another way to put it is that the actual healthcare service translates to "delivery of care," while the quality of that service translates to "delivery of caring," he said.

"Service delivery is left-brain oriented, made up of policies and procedures, delivery algorithms, care pathways, and ways to measure the quality of patient outcomes," he told session attendees. "Service excellence is right-brain and deals with patients' expectations, perceptions, and experiences. It's mechanics versus 'humanics.' "

Radiologists and their practices continually work to improve the delivery of care, but if they want to improve the patient experience, they need to strengthen the delivery of caring culture. Both the mechanics and humanics of healthcare delivery come together to influence a patient's experience, Johnson said.

Service delivery factors
Mechanics Humanics
  • Appointment availability
  • Ease of scheduling
  • The facility's appearance
  • Ease of finding the facility/office
  • Ease of intake process
  • On-time performance
  • Result turnaround time
  • Telephone etiquette
  • Ready and understandable information about the visit/procedure
  • The facility's appearance: a clean, comfortable waiting room, for example
  • Patient escorts
  • VIP check-in
  • On-time guarantee
  • Postvisit email or text

Of the two categories, the humanics factors are the strongest drivers of patient satisfaction, according to Johnson.

"When patients talk about the quality of their care, they consistently refer to the quality of caring they received during the encounter," he said. "Technical and diagnostic skills are important, but patients don't access them as quickly as they do the quality of interactions between themselves and caregivers."

What is unsaid -- and said

Nonverbal behaviors affect patients' experience, Johnson said. Practice staff must consistently convey compassion, empathy, interest, and friendliness to create positive patient experiences.

"Actions speak louder than words, and when radiology practice staff makes eye contact, smiles, and listens well, it communicates the practice's attitude toward its patients," he said. "Patients and their families hear our words, but they feel our attitudes."

One way to assess these nonverbal factors is to give patients a survey after their visit that invites them to rate the encounter. Practices can then use that information to address a practice's "delivery of caring" skills.

But verbal behaviors are equally important, according to Johnson.

"Express appreciation during conversations," he said. "Speak warmly and slowly, and listen deeply."

Radiologists and administrators can create actions plans to change both the verbal and nonverbal culture of their practice, Johnson told attendees. But these plans have to be explicit: Don't assume staff members know what to do. And translating an action plan into a change in practice culture requires at least five steps:

  1. Provide effective staff training on intellectual and emotional levels.

  2. Assess staff knowledge of caring skills. If your staff members can't identify patient satisfaction behaviors, they won't do them.

  3. Provide leader role models of the new behavior. By role modeling "delivery of caring" behavior, practice leaders strengthen their own skills and build credibility with staff.

  4. Observe staff. Don't just train, demonstrate, and then walk away. Reinforce behavioral expectations during staff observation, and acknowledge when staff meet these expectations.

  5. Coach staff and offer feedback. Continue to support staff with consistent observation, feedback, reinforcement, reward, and recognition.

Changing a practice's culture to improve patient experience requires effort and dedication, Johnson concluded.

"In order for training to be effective, it must include both intellectual and emotional levels," he said. "And when you see results, that's the time to intensify the reward and reinforcement process."

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