Mar 19, 2016
Patient centered outcomes and assessment are the evolving measure of success and value in healthcare. Patient reported outcomes (PROM), Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS )and new research sponsored by Patient-Centered Outcomes Research Institute (PCORI) formed by Congress in 2010 emphasize the focus. Patient measures are the new coin of the realm. One of the most important aspects of patient centered assessment is realizing that the perception of experience is paramount. Understanding the difference between perception and reality highlights the critical nature of managing expectations in the healthcare environment.
The following anecdote exemplifies the importance of managing expectations and the difference between perception and reality. In the imaging department, the goal is to see all patients within 5 minutes of their appointment. One patient arrives at noon having been told by scheduling that the department strives to see all patients within 5 minutes of their arrival. On any given day there can be a backup in the ER or inpatient requests for critically ill patients are high. The patient often can wait for 30 minutes. They leave frustrated, angry and send a critical letter to the administration. The same patient told nothing by scheduling is advised on arrival to the department, that they will be seen as soon as possible but that the ER is busy and critically ill patients from the ICU are coming to the department . They are told with a compassionate and apologetic tone that they may have to wait an hour. The technologists then finds the time to squeeze them in after 30 minutes. They leave the department thrilled and delighted with the service and may send a letter of praise to administration. The patients received identical care with opposite attitudes and emotions. The difference, managing expectations.
The lesson for our customers, the patients, is no different than for us personally. You hoped for a 3 carat diamond engagement ring but settled for a 1 carat ring. You bought a new boat but it was only 30 feet long not the 40 foot yacht you hoped for. You received a ten percent raise not the 20% you thought you deserved. One can make an objectively positive event appear disappointing. All these attitudes highlight the importance of managing expectations so that you and your patients celebrate the smallest victories and enjoy the smallest success to its fullest.
Too many patients leave the healthcare experience dissatisfied. Impersonal care, lack of compassion, being rushed and endless waiting often lead the list of complaints. Transparency, communication and compassion framed within realistic and achievable goals are the keys to successfully managing expectations.
The attitudes of the caregivers are immediately perceived by patients. Compassion and altruism are requisites for success. Creating a culture of compassion through experiential training allows an institution to manage expectations with resultant consumer satisfaction. Patients who have sufficient advance preparation and education are likely to have realistic expectations. Having patients communicate with other patients who have recently had a specific procedure is very valuable.
Create expectations for both your patients and yourself that allow all to be content within the framework of the experience. Institutions and providers should remember the highly stressful environment of healthcare delivery. By managing expectations, the perception of the experience can be improved dramatically. Using the tools of caring, compassion and communication, one can create the milieu for patient contentment. Now watch your HCAHPS and Press Ganey scores improve.
Nicolas Argy, M.D., J.D. Health/Business Consultant/Educator, Patient Safety, Quality, Risk Management, Public Health Advocate, Witness Prep