Commentary by Michael Burgess
The Affordable Care Act has introduced not only an expansion of insurance coverage to the uninsured but has launched a transformation of the entire health care system with incentives to improve outcomes and the quality of care. Reform is literally changing the culture of doing business by hospitals, doctors and health care providers. Payment reform is being linked to better outcomes such as reducing hospital re-admissions.
Patient satisfaction is now one of the key measures that reflects outcomes. Hospitals have begun hiring “patient satisfaction officers” to undertake major initiatives to improve communications with patients and to solicit feedback. In addition to the hospital experience, transformation includes better care coordination and post hospital care to prevent unnecessary re-admissions.
A key to the success of all these efforts must be the involvement patients, their families and caregivers. Hospitals and doctors are fairly new to this “customer service” approach. And, even with the transformation underway, efforts involving patient satisfaction and communication are not as robust as those efforts actually involvement direct medical care. Indeed it is overwhelmingly clear that the knowledge and awareness of patients, families and caregivers have not kept up with the dramatic transformations going on in health care. Patients may have heard of the changes and received communications from providers but, by and large, “health care literacy” among patients remains low. They do not understand, the nature of the changes and what the impact will be on them as patients and what role their families and caregivers will need to assume in care coordination. Without this communication and understanding, health care providers run the risk of patients and families cynically thinking that all changes are tied to costs and savings rather than better coordination and outcomes.
It has been clearly shown though that more substantive change and success comes from maintaining very close and continued dialogue with patients. Health providers including doctors, hospitals and home health providers need to do more than just communicate instructions, they need to open a dialogue with patients, particularly older persons and those with limited English to understand what potential problems there are to a successful outcome. Indeed, greater communication is key to success and health providers need to work with community based groups representing patients and families to increase their health care literacy.
Here’s a great article in the April 24 Albany Times Union on patient experience and satisfaction from Dr. Michael Brannigan of the College of St. Rose in Albany