How Are You Improving The Patient Experience?

The patient was saying all the right things, but something about the way she was acting seemed off. Turn on your observers, thought the receptionist. It's the motto of every staff member who works in the same-day surgery unit at the University of Chicago (Ill.) Medical Center. They're taught to notice a patient's nonverbal cues and demeanor, to listen to voice inflection and read body language.

That training helped the receptionist sense the patient's uneasiness. "You appear a bit nervous," she said. "Is there something I can help you with or is there something on your mind?"

The patient appeared grateful, relieved even, and revealed that she was apprehensive about the nerve block she was about to receive.

Ah, that's it.

The receptionist smiled, said she understood and immediately went back to alert the charge nurse of the patient's concern. The nurse came to the waiting room, sat with the patient and her husband, described in detail how they'd place the block and answered every question the couple had about the process.

"You could see the patient's shoulders relax and she smiled for the first time since arriving," recalls Sunitha K. Sastry, MPH, CPXP, director of the patient experience and engagement program at University of Chicago Medicine. "Her husband was leaning in and really tuned into what was going on."

The entire episode contained the essential elements — a take-charge mentality, empathy, compassion and clear communication — that contribute to a positive patient experience, which has never been more important in this era of value-based care.

Patients have access to incredible amounts of information about their procedures. They feel empowered to choose where they'll go for surgery: a competing facility across town, across state lines or across the border. They expect to be cared for with compassion. They expect their surgeries to go as planned and they demand excellent outcomes.

"In a consumer-driven market, which is what health care has become, you need to build a strong relationship with patients and their families," says Ms. Sastry. "That requires achieving excellence in every experience with every patient, every day. It's a tough nut to crack, but that should be the goal."

You're with patients for a matter of hours on the day of surgery, so establishing a meaningful bond with them must begin with the first phone conversation. Yes, you must communicate and receive important clinical information during pre-op phone calls, but avoid ticking off a checklist of questions. "Make an effort to put a personal spin on the conversation," says Ms. Sastry. "Even something as simple as commenting on the weather or asking about weekend plans can spark a conversation."

Patients often receive the first impression of your facility when they're surfing the web to learn about the procedure they're about to undergo or the facility where they'll have surgery. Is your facility's website easy to navigate? Does it provide essential information for patients, including staff and physician profiles, and educational material about the procedures you offer?

What about the tangible aspects of surgical care — opioid-sparring techniques to manage post-op pain, first-stick success during IV starts, active warming measures, and the use of antiemetics and alternative therapies to prevent PONV — that send patients home happy and healthy? They're all essential factors in achieving quality outcomes, to be sure, but they're only a segment of the overall surgical experience.

"We all do those things, don't we?" asks Stacey Decker, MS, BSN, RN, CPAN, vice president and chief nursing officer at Integris Lakeside Women's Hospital in Oklahoma City, Okla. She suggests you ensure your staff is doing them effectively. Accentuate the positive. For example, update your team on the number of normothermic core body temperatures measured in PACU instead of informing them at a staff meeting of how many patients they failed to properly warm over the past month.

"When you share leading metrics instead of lagging metrics," says Ms. Decker, "you provide information they can use to improve patient care."

Kindness. Understanding. Comforting. Those are the words the patient who was nervous about the nerve block ultimately used to describe the care she received.

"It's so important to acknowledge and share with staff the positive feedback you receive from patients," says Ms. Sastry. "That's ultimately why you do what you do."

Ms. Sastry acknowledges that compassion fatigue is a real concern, and it's difficult to make a connection with every patient in the outpatient setting, where time pressures are constant and case volume is key, but she continues to be inspired by patients who take the time to share how much they appreciate the kindness and compassion they received during their stay. Remember, too, that you're caring for people who are hurting and frightened of the unknown, who'd rather be somewhere else.

"We love to hear from patients who say we treated them as a person, not a procedure," says Ms. Coulter. "In surgery, it's not always about the wow factor. It's more important to alleviate patients' fears and make them feel as comfortable as possible." OSM