Patient Experience is a rapidly growing measurement for determining provider revenue under Pay for Performance reimbursement models. It has been demonstrated that this measurement also has significant influence on patient engagement, compliance and clinical outcomes. Equally important, communication has been identified as a major contributing factor in modulating the kind of Patient Experience outcomes that are collected and analyzed by healthcare providers using system-specific versions of the Healthcare Consumers Assessment of Healthcare Providers and Systems survey (HCAHPS).
An analysis of Consumer Health Beliefs and Value Expectancy principles clearly identifies communication during healthcare interactions as a major influence on Patient Experience outcomes. Moreover, it is not only the quality of communication, but the consistency and duration across the care spectrum…hence the challenge.
No other consumer-centric system of service has as many communication “touch-points” as healthcare, no other system has as many consumer entry points as healthcare, and no other system has as many variations in the number of people communicating with the consumer as healthcare. Adding to this conundrum is the fact that some consumer interactions with healthcare providers and systems are emotionally charged.
Communication Model: Reducing Noise
The communication model illustrated above can be used to demonstrate a process that enhances interactions with healthcare consumers at each touch-point along the interaction spectrum with a focus on eliminating the kind of noise that interferes with comprehension and feedback. In some instances, noise can cause a complete “circuit break” in the communication process where no communication actually occurs. Here are a few circuit breakers:
Using medical jargon with patients instead of communicating in common-use terms
Not understanding the patient's health beliefs, expectancy, level of activation or healthcare literacy
Showing lack of knowledge regarding clinical or personal information
Not encouraging feedback during interactions (teach back)
Interrupting the patient while they are encoding a message
Poor eye contact
Body language that resonates “Let’s get this over with.”
Poor active listening skills
Improper or cultural demeaning salutation
Allowing unnecessary interruptions during interactions
Providing written information that is difficult to decode
Sequential Communication Mapping can be used to identify those “touch points” that can influence interactions with providers and systems leading to higher Patient Experience Scores. The entry points can include the following:
New non-emergency patients
New emergency patients
Existing emergency patients
Potential patients (market outreach)
Each category of patient enters the healthcare system with different Health Belief and Value Expectancy. For example, emergency patients are often focused on pain or discomfort mitigation while other categories of patients are more inclined to apply their Health Beliefs and Value Expectations toward their interactions with individuals within the organization and how the organizational behavior affect them or their loved ones. An example of Sequential Communication Mapping can include:
Patient initiated call for appointment
Office follow up call to confirm appointment and answer questions
Initial interaction with the front desk staff and security/parking attendants
Interaction with the Medical Assistant
Interaction with the MD/NP/PA team
Interaction with the Pharmacy Team
Interaction with the Lab Staff Team
Interaction with the MA to review visit summary
Receive follow up/thank you note from practice
Receive reminder for next appointment.
Provide survey on patient experience during visit
Note: The process starts all over when the patient is referred to another physician or system for specialty care.
From the Sequential Communication Mapping process, the Communication Model can be used to identify those touch points that pose a high risk for creating noise. This can be follow by assigning weighted values for each touch point to aid in data analysis for process improvement. Hence…
Noise Reduction = Increase Revenue
About the author: James P. Young, Jr. PhD
Dr. Young has over 35 years working with Primary Care and Specialty Practices in caring for patients with complex cardiovascular disease. He is a Certified Professional in Healthcare Quality, NCQA PCMH CCE, award winning Assistant Professor of Healthcare and Business Administration, and Associate Chair of the Donald W. Maine College of Business, Davenport University. To learn more contact Dr. Young at firstname.lastname@example.org.