When most of us think about health care’s Triple Aim, I’d venture to bet that improving quality and reducing costs are the first two aspects that come to mind. Although patient experience has traditionally played third wheel, the movement toward population health management has brought it directly into the spotlight.
As providers know all too well, satisfying patients is much more easily said than done. And let’s face it—The odds are already stacked against providers, because most people go to the hospital only when they are sick or injured, and they’re looking to physicians, nurses, and other clinicians to make them feel better. Those providers that provide services for patients who have high-acuity conditions or who are experiencing great stress or depression start even further behind the eight-ball.
Nonetheless, through Medicare’s value-based purchasing program, 30 percent of a hospital’s payment will be based on patient satisfaction. And in this world of transparency, patients have more and more options of where to receive care. The reality is that health care is becoming a service business, and providers need to approach how they deliver care in that manner.
So what if patients were … happier?
There’s a growing body of evidence suggesting happiness not only influences the patient experience, but also serves as a protective and predictive health factor, both in individuals and communities. According to a recent study from the University of California, Los Angeles, people who are happy are likely to have healthier immune systems than are those who are unhappy. Happiness is also associated with lower heart attack rates and longer, healthier lives overall.
San Francisco-based Dignity Health is putting this theory to the test. To them, happiness is an attitude, not a situation. Earlier this year, the health system launched Hello Humankindness, a campaign founded on a novel premise: If we’re happy, we’re likely more satisfied and healthier.
Hello Humankindness strives to “champion humanity” by providing health care “with a little more care.” Its website, www.hellohumankindness.org, features video clips and stories about random acts of kindness—everything from a perfect stranger covering the cost of another’s cup of coffee, to the donation of a kidney by someone who is only a generally acquaintance of the patient. The campaign invites anyone and everyone to tell their stories of kindness.
Studies have shown a patient’s experience is influenced most by interaction with provider employees, most notably nurses and physicians, underscoring the need for these individuals to have strong interpersonal skills. With this finding in mind, Dignity is training each of its 56,000 employees to be more effective and attentive listeners to patients and families. Employees are being educated not to pass a lit call light without stopping to help the patient.
A Better Experience
Anyone who has cared for a child knows that children are happiest when they are doing something that interests them. Lying completely still in a tunnel for up to two hours is not at the top of the list—unless they’re watching “Despicable Me.”
At Mission Children’s Hospital in Asheville, N.C., children wear state-of-the-art “pediatric goggles” that allow them to watch movies during MRI scans. Technicians also can interact with them using the goggles, further making the procedure less scary and more relaxed. This approach increases MRI accuracy and reduces the need for sedation. In fact, at Cincinnati Children’s Hospital Medical Center, the use of these goggles led to a 35 percent reduction in pediatric sedations.
Of course, there’s no happiness associated with medical emergencies, especially in the pediatric population. Such emergencies are terrifying for children and their families alike, often requiring weeks away from home. The Hollywood, Florida-based Joe DiMaggio Children's Hospital, part of Memorial Healthcare System, is confronting this fear head-on.
For pediatric patients and their families, the facility not only features state-of-the-art pediatric technology and world-class care, but also includes classrooms with a full-time teacher for kids to keep up with their school curriculum; daily movie screenings; a play area for children with disabilities; and a residential clown.
Joe DiMaggio Children's Hospital also engages families and patients through advisory councils, allowing for direct input and influence on policies, programs, and practices. It comes as no surprise that the facility has consistently ranked among the top 5 percent of the nation's leaders in patient satisfaction.
Improving the patient experience—and effectively managing population health—requires the right care to be delivered at the right time and in the right place. Increasingly, this requirement means providing care outside of a traditional care setting.
For example, Mercy Health in Cincinnati has introduced a coordinated care program that works in both inpatient and outpatient settings. Care management team nurses communicate with patients at home and through regular phone calls, providing coaching as needed. The nurses also teach health education classes and refer patients with mental health and life management issues to behavioral health counselors for additional assistance.
Mercy Health has found that the best means of treating a patient may have nothing to do with clinical care. In some cases, improving patients’ mental outlook could be all that’s needed to keep them from being admitted. For example, when Mercy Health nurses discovered that one of their patients with a chronic condition had no furniture at home, except for a bed, the organization supplied the patient with a chair, promoting mobility while allowing her to look out the window and gain a different perspective.
At the end of the day, we need to leverage every opportunity we can to manage the health and wellness of a population successfully. Exploring innovative solutions as to where, when, and how to deliver care is central to this approach.
In some cases, the best way to treat a patient may have nothing to do with traditional clinical care; instead, the best cure could be to help the patient improve his or her mental outlook.
In “Travels with Charlie: In Search of America,” John Steinbeck wrote, “A sad soul can kill you quicker, far quicker, than a germ.” Personally, I find the point of view espoused by Hello Humankindness to be a healthier alternative: “Humanity holds the power to help people heal.”
Michael J. Alkire is COO, Premier healthcare alliance, Charlotte, N.C.
Publication Date: Tuesday, November 19, 2013