By Debra Wood, RN, contributor
February 21, 2013 - Health care is becoming more patient focused, with patients expected to assume greater responsibility for their health and to rate their satisfaction with their care. So what do patients value and how can nurses deliver on it?
“Patients want to be heard and be considered a valued member of their health care team,” said Sue Neville, PhD, RN, chair and associate professor of the Department of Nursing at New York Institute of Technology School of Health Professions. “Attentive listening is a crucial communication strategy that is embedded in clinical practice.”
Deb Rivituso, RN, reported that medical negligence cases often involve a lack of communication.
Safety is of primary concern to patients and providers, and clear communication is a key factor in ensuring safety.
Karon Gibson, RN, CCM, president of AmericaNurse in Romeoville, Ill., and author of the book Nurses on Our Own, added that patients appreciate courtesy, attention and the chance to be heard. “Patients want to be involved and be able to have the time to tell their symptoms unrushed and have some input into what and when tests will be done. They want undivided attention and a sincere interest.”
Patients want an experience similar to what they expect from other service industries, added Nick Angelis, CRNA, MSN, author of How to Succeed in Anesthesia School (And RN, PA, or Med School) and a nurse anesthetist in Pensacola, Fla.
“Treating patients with care and compassion does make a considerable difference,” Angelis said. “What
patients want varies greatly depending on their previous experiences with health care.”
A look at the evidence
Research bears out the importance of compassion and communication.
Communicating with Patients on Health Care Evidence, a September 2012 white paper from the Institute of Medicine (IOM) Roundtable on Value and Science-Driven Health Care, reported that more than 80 percent of people surveyed expressed the desire for their provider to listen to them, but only 60 percent indicate that happens. Less than half of the 1,068 respondents reported their provider asked about their goals and concerns for their health and health care. Patients who felt their providers listened to them and asked about their goals were 3 to 5 times more satisfied with their providers than other patients.
The IOM study also found 80 percent of patients want to hear the full truth about their diagnosis, 70 percent want to understand treatment risks.
The July 2012 report Customer Experience in Healthcare: The Moment of Truth from the Health Research Institute of PwC US in New York, indicated patients’ ideal experience is increasingly being defined by nonclinical elements, such as convenience, customer service and staff attitude, more so than they expect from other industries. In fact, consumers are less forgiving of health care providers than people in other industries. And they are willing to switch providers for a more “ideal experience.”
“The voice of the customer may be the best kept secret in health care, but that’s changing as consumers exert greater control over how their health care dollars are spent and exercise power to vote with their feet and wallets,” said Kelly Barnes, leader of U.S. health industries, PwC, in a written statement.
Getting and staying well
While good communication reflects good nursing or medical care, one cannot forget why people are meeting with a health care professional in the first place.
Sue Neville, PhD, RN, said safety is of primary concern as the complexity and acuity of care is continually increasing.
That being said, Detsky also reported that patients want to be treated with kindness and empathy, and they want hope. While in the hospital they want their own room, and they want the best physicians, based on testimonials from people they trust. They want certainty and active strategies.
The PwC report found 57 percent place a high value on the patient education they receive during a visit. And 65 percent of consumers want to exchange information through online and mobile channels of communication.
“Patients are being discharged ‘quicker and sicker’ back into the community,” Neville added. “Patients want targeted follow-up care to assist them in attaining their optimum level of health and wellness.”
Angelis, on the other hand, added that many patients want quick fixes not requiring diet or lifestyle modification.
Detsky agreed, writing in JAMA, “Patients prefer treatments that they perceive will require little effort on their part. Medications and surgical procedures are preferred over clinical strategies that involve behavioral changes (e.g., diet or smoking cessation) or exercise regimens.”
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