Patient satisfaction

PATIENT SATISFACTION DR. N. C. DAS

WHAT IS PATIENT SATISFACTION To provide patient-centered care creating a culture that accepts people for, who they are and where, they are in life cycle, by meeting their needs at that point ,with the health system’s mission to care for the body, mind and spirit of patients. Patients are the foundation of our medical practice, it is very obvious that they must be satisfied while in or out of the Hospital.

CHALLANGE FOR HEALTH CARE Often long-term duration of interaction Heightened emotional levels - anxiety, fear, pain Purpose is to meet needs Aim is to reduce demand via effectiveness Wide and increasing gap between professional competence and patient understanding Public and private sector competition Open but blurred demarcation between patient and practitioner Ambiguous outcomes for patients and professionals Extraordinary experience rare and intense emotions difficult to describe (personal/abstract) can cause positive/negative care evaluation

OBJECTIVE OF PATIENT SATISFACTION Health Care Institutions are primarily patient centric. Patient Satisfaction is the strongest determinant of hospital functioning. Ultimate goal of the hospital is satisfaction of its customers. Not only to satisfy and cared-for patients and families, but also a positive outcome for your staff, your community and your organization’s health. Patient Satisfaction depends on workers motivation, dedication and duty towards the patients.

WHY PATIENT SATISFACTION Increased lay knowledge and taboo Increased awareness of professional fallibility and diagnostic uncertainty Rise in scepticism about medicine/science Awareness of wider influences on health Shift in focus from acute to chronic conditions Wide variation in clinical practice Pressure to increase accountability Pressure to democratise public health systems Shift from objective to subjective medicine Pressure of CPA

PRINCIPLES OF PATIENT SATISFACTION 1. QUALITY OF CARE: The quality patient experience doesn’t happen by accident but by standardized practice. A consistently great patient experience is not a matter of attitude, awareness or positive intent but a matter of design and continuous quality improvement. 2. MANAGING ANXIETY, FEAR AND PAIN: “ Anxiety is the rust of life, destroying its brightness and weakening its power.” (Anon) Patients are highly anxious. To create an exceptional patient experience, we need to focus on preventing or lessening anxiety for patients and families. 3. BETTER COMMUNICATION: Some emotions don't make a lot of noise. If we don’t communicate our caring, patients and families might think we don’t care.

4. PERSONAL ATTENTION: Patients and families want personalised care and service . 5. STAFF ACCOUNTABILITY: All staff must be accountable for their role like: Clear responsibility Clear performance Sound measurement and feedback Courageous conversations Consequences reporting 6.SOUND ORGANISATION CULTURE: The more strongly your hospital’s culture supports the quality patient experience, the more sustainable are impressive levels of patient satisfaction. Effective long-term strategies inevitably involve a fresh look at the hospital culture and how it drives or restrains your patient experience vision.

TEN PILLARS OF PATIENT SATISFACTION Leadership Vision and Commitment Process Design and Continuous Improvement Employee Engagement and Empowerment Accountability for all category of staff Monitoring and Feedback Vertical and horizontal Communication Staff Development and Training Reward and Recognition Service Recovery Dissatisfaction to satisfaction Patient Focus and Sustainability *(Wendy Leebov 1984, “The Ten Pillars”)

MEDICAL PRACTICE IN THE PAST MEDICAL PRACTICE

MEDICAL PRACTICE TODAY MEDICAL PRACTICE

HOSPITAL CUSTOMER HOSPITAL CUSTOMER Doctors Nursing Staff Paramedics Others Nursing Orderly Sanitation Staff Patient Relatives Visitors Agents Vendors Community as a whole

TYPES OF CUSTOMERS 1. Difficult to deal with : Demanding, annoying, unrealistic, loud and objectionable. 2. Desirable: pleasant, easygoing, intelligent, accommodating and knowledgeable 3.Others: timid, questioning, unprepared, lacking in knowledge and uncertain about what they want or need. Hospital has to handle them all

ADVANTAGE OF PATIENT SATISFACTION PATIENT SATISFACTION: Greater profitability. Improved patient retention and patient loyalty. Increased patient referrals. Improved compliance. Improved productivity. Better staff morale. STAFF SATISFACTION: Reduced staff turnover. Improved collections. Greater efficiency. Reduced risk of malpractice suit. Personal and professional fulfillment. THE PROCESS OF ENSURING PATIENT SATISFACTION: Patient Satisfaction =TQM (Total Quality Management)

ADVANTAGE OF PATIENT SATISFACTION PATIENT SATISFACTION MORE NAME- FAME – REPUTATION GOOD PERCEPTION GOAL ATTAINMENT RE-VISIT HIGHER EXPECTATION

DETERMINANTS OF PATIENT SATISFACTION CUSTOMER SATISFACTION EXPECTATION PERCEPTION AT EXIST AFTER EXIST AT ENTRY DURING STAY

DETERMINANTS OF SATISFACTION EXPECTATION SATISFACTION PERCEPTION CLINICAL Correct Diagnosis Adequate Care Prompt Treatment NON- MEDICAL Appropriate Physical Facility Functional Service Component C. BEHAVIOURAL To be listened to with patience To be cared about To be sympathetic to the cause To be informed clearly and under stand able language Patient Expectation Level Attained Health Status of the patient Socio – Economic Status Level of Education Past experience in the same or other hospital Patients own experience Experience of relatives and visitors Word of Mouth Advertisements of facilities Financial Schemes

EXPECTATION To have clinical core competence. Good clinical diagnosis Full confidence Rational therapy Evidence based practices Early cure Adequate care 2. Reasonably good physical facilities Approachable location with good parking facility Child friendly environment, cleanliness, facilities for recreation (library, toys, music, TV etc.) Proper place for eating Enough space for various facilities. Impart health education: handouts, video examples.

3. Functional Service Component Honor the appointments. Appointment system should be accurate but flexible. Communicate well with them in day to day language. Medical jargon should be avoided. To listen to their problems patiently and give them enough time. Master the art of listening Show personal concern for the patient. Body language ,greeting , a good first impression of a caring physician, make it visible that we are with them in their worst times too. To explain everything about the illness and treatment.

4. BEHAVIOURAL Staff to shows care, concern, courtesy and empathy. Patients spend more time with paramedical staff Behaviour and attitude of the staff to be polite and cooperative Go beyond the rules of duty to help Handle personal and telephonic conversations Promptness in all responses During Emergency case, admissions show sympathy Provide desired information

SATISFACTION Proper documentation Good legible prescriptions, a detailed discharge summary, certificates, prompt issue of papers for medi claim Clear explanation for administration of medicine to ensure compliance. Provide hospital information brochure and to have informative sign boards. 2. Transparency in financial matters One of the major causes for dissatisfaction Proper display of routine consultation and indoor charges Should be properly informed about the expected expenditure before any procedure or admission

3. Patient’s convenience To use modern technology. Computerization and adaptation to new technology for diagnostic and therapeutic purposes. To have easy flow between various services. Patient should not be wasting time to avail of various services May I help you desk Signage and transfer facilities, trolley and wheel chairs Patient safety measures

PERCEPTION Patients own experience in hospital Early recovery and early discharge Experience of relatives and visitors Word of Mouth Advertisements of facilities Financial Schemes Citizen charter Public facilities

QUALITY MEDICAL CARE MODEL OF PATIENT SATISFACTION CUSTOMER CONTINUITY OF EFFECTIVE CARE COMMITMENT OF HOSPITAL STAFF PHYSICAL FACILITY POSITIVE ATTITUDE OF CARE PROVIDERS SATISFACTION LEVEL

FACTORS INFLUENCING PATIENT SATISFACTION PATIENT SATISFACTION APPROPRIATENESS (RELEVANT PATIENT CARE) TIMELINESS RIGHT TREATMENT/ RESPONSE AT NIGHT TIME RESPECT & CONCERN (SYMPATHY & CONSCIOUSNESS) SAFETY OF PATIENT (SAFE ENVIRONMENT) CONTIUNITY (TREATMENT & OUTSIDE) EFFECTIVENESS (CORRECTNESS TREATMENT) EFFICACY (RESPONSE LEVEL TO TREATMENT) AVAILABILITY (TREATMENT AS PER PATIENTS REQUIREMENTS) EFFICIENCY (CAPABILITY & RESOURCE AVAILABILITY)

PLACES VALUE PATIENT SATISFACTION RECEPTION COUNTER BILLING & PAYMENT TIMELY, ACCURATE BILLING FLEXIBILITY IN PAYMENT INDOOR SERVICES ADMISSION COUNTER OPD REGISTRATION INFORMATION COUNTER FACILITIES IN OPD POINTS CASUALTY & EMERGENCY Ambience of the room Privacy Quietness Comfort Level Safety & Security Cleanliness, Hose keeping Promptness of treatment Staff behaviour & concern Promptness in Care Facilities Provided Lab. Tests Transport Water Toilet Waiting Area Signage

ROLE OF PROFESSIONALS Understand the importance of patient involvement in their own health and health care, as co-producers, not consumers Prioritise what is important to patients and their informal carers, whilst maintaining a critical professional view Maintain what is perceived to be good and improve what needs improving Involve all staff from the beginning in the effort Draw comparisons over time and with other care givers Cultivate Team Climate Acknowledge Team Member Contributions Demonstrate Mutual Respect Hold members accountable for Outcomes Develop team work Culture

ROLE OF PATIENT/RELATIVES Discuss with professionals to share information and, if desired, to share decisions Cooperate with hospital staff Maintain discipline and cleanliness Seek help from voluntary and community groups, as well as provide them with feedback Suggest improvement

ROLE OF SOCIETY Voluntary and community groups can discuss with professionals their ways of communication in relation to specific conditions or population groups Provide accessible and appropriate educational resources to enable patients and their families to be involved as much as they wish to be Influence policy and planning to require patient-centred working practices

MEASUREMENT OF PATIENT SATISFACTION Various Methods are used to measure level of Patient Satisfaction. May be directly from horses mouth or indirectly from community response. Objective is to improve the facilities and performance level.

STRUCTURED QUESTIONNAIRE BASED PATIENTS SELF ASSESMENT AT DISCHARGE (Likert Scale) STAFF OPINION ABOUT PATIENT DURING STAY ANALYSIS OF LAMA CASES MEDIA COVERAGE COMMUNITY RESPONSE (INCREASE PATIENT NUMBER) EVALUATION PROFORMA PATIENT’s RELATIVE DURING STAY VISITORS BOOK EXIT INTERVIEW SUGGESTION BOX REPEAT VISIT TO HOSPITAL PATIENT SATISFACTION ANALYSIS PATIENT SATISFACTION ANALYSIS

Hospital Administration Made Easy http//hospiad.blogspot.com An effort solely to help students and aspirants in their attempt to become a successful Hospital Administrator. hospi ad DR. N. C. DAS

Patient satisfaction

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