• Making clear to the patient from the beginning the role of the hospitalist, their relationship with the patient’s primary care provider, and how they will be in charge of the patient’s complete care as part of a collaborative care team. This helps to reassure an often anxious elderly patient and their family;
• Regularly using aids such as explanatory introductory cards, pamphlets and business cards. Leave them on the table in the room so that family members can also see them and know the doctor who’s in charge of the care;
• Making a clear plan for the patient every day. Utilize whiteboards in the patient’s room and keep them updated;
• Developing more optimal patient rounds, including multidisciplinary rounding models to ensure that all members of the healthcare team are on the same page;
• Setting aside dedicated time for extended patient and family meetings each day, usually in the afternoons;
• Making clear that you are regularly communicating with the specialists who are also involved in the patient’s care; and
• Developing and maintaining good communication skills, always displaying empathy and compassion.
Statistics show that two of the most frequently cited patient complaints are a lack of time with their doctors and healthcare staff exhibiting poor communication skills. On a practical level, in order to maximize time with patients, hospitalists obviously need a manageable daily patient census.
Formal communication skills training is often well received by physicians, especially if feedback is given in a friendly and collegial atmosphere. It’s traditionally been an area that the healthcare profession hasn’t gotten into, and older physicians in particular are much less likely to have ever received any formal training or skills advice. Worried about pushback if you bring up the concept? Most physicians actually enjoy thinking about the topic, and are very keen to improve their skills.
Ultimately, it’s all about making the patient feel comfortable, at ease, and listened to. Some proven communication techniques that physicians should utilize include making eye contact, sitting down, and asking open-ended questions. These are very basic, but often forgotten about during a typical hectic day. They can all be taught, improved upon, and coached.
Specialists also need to step up to the mark. They need to be encouraged to maximally collaborate with the hospital doctor and to make the patient feel like all their care is being coordinated. The other touches that go into improving a hospital stay, such as regular nursing checks, being clear on wait times, and following up post-discharge with a personal (non-automated!) message from a nurse or administrator, should all be added to the mix.
Let’s remember that this isn’t simply about saying that you’ve “improved patient satisfaction” and raising survey scores for the sake of reimbursements. Patient satisfaction is really about understanding what the patient is experiencing and the emotional roller coaster that goes with being sick. HCAHPS scores, while by no means the perfect survey, may be the jolt the medical profession needs to strive for what it should have been doing all along: providing patients with a high level of customer service at a low point in their lives.
Hospital medicine doctors are best placed to engage the patient from the beginning, and by focusing on them to lead the way, organizations can soar to new heights.
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care. This post originally appeared at his blog.
