03 Dec Do We Really Want to Know About the Patient Experience?
While the healthcare industry is focused on measuring outcomes, we have also reduced the human outcomes to multiple choice tests.The 31-question HCAHPS survey is supposed to cover the most relevant issues that make up a patient experience. Multiple Choice.
The surveys are sent out randomly within 24 hours following discharge. So, everything as interpreted retrospectively. Probably most people who take these tests guess at the most likely approved answer rather than what is actually true. And, what may be true to what happened is now fading in a recent past that one would rather forget.
Most patient satisfaction surveys should be included in this discussion, since they do not necessarily tell us what, if anything, we could do to get a different answer. Because of that, it's critical to fully understand the limitations of HCAHPS scores and patient satisfaction surveys as far as what they actually reveal about what happened to anyone.
During my own stay at a hospital in Southern Nevada last July, the minute to minute lived experience was hardly reflected in any survey. In fact, after receiving numerous calls from the hospital and physician groups and refusing to take a survey, I finally decided to tell the truth. This is how the call went:
Caller: Hello, is this Susan Mazer?
Caller: I am calling from Dr. X’s office wanting to find out how you are and how you found your care at the hospital.
Me: Actually, I am doing well, but I was most frustrated by the care at the hospital. The physician’s care was good, but the pain medication was dosed out according to some schedule he used that was unrelated to how I was feeling. Then, the antiemetic — I was suffering from nausea without relief.The doctor finally changed the meds, but it took almost five hours to get the drug to me. Oh, the other thing is that I could neither eat nor sleep, and nothing was offered to help me sleep. Given that I was in the hospital for 10 days, not sleeping was contributing to my misery. Then, when I returned home, my medical records included four pages from another patient’s lab report. What about my privacy and that of the other patient?
Caller: Hmm. Thank you for telling me, but I am at a call center in Seattle and I really cannot do anything about this but see if I can report this to my supervisor who may tell the doctors.
How satisfying was that? If the goal is to hear a patient’s concerns and fully understand what really happened, then call centers with employees whose job is just it is to call but not to care, are failing. And, personally, it was more exhausting to relive the drama (since I was asked) than it was worth. Nothing. Nothing happened. Nothing. Nada.
I did receive several calls after that one. The HIPAA compliance office called about the privacy issue and told me things like this “sometimes happen” and will be reported. No shock. Not even upset came from his side of the discussion. No apology either.
I have never heard a word since. The physician never again contacted me through his calling service or in any other way.
The real question in front of all of us when we ask, “How was your experience?” is do we really want to know? And, if we want to know and are given intimate insights into the real life and suffering of a patient, what are we going to do about it?
Patients and customers (I do not see them as the same) know far more about what happens to them than any of us who may be caring for them. The questions that always remain on the other side of answering any kind of survey is whether it was a waste of time, whether what happened to us matters to anyone, and whether any positive change will occur as a result of our efforts.
Susan E. Mazer, Ph.D., is the President and CEO of Healing HealthCare Systems, producers of The C.A.R.E. Channel. A knowledge expert and thought leader on how the environment of care impacts the patient experience, she blogs at healinghealth.com.