Healthcare Facility Systems Approach

Background

As a Chief Patient Experience Officer, the main goal of the presentation is to introduce and design a new systems approach that meets the patient’s needs, expectations, and priorities. The approach also needs to exemplify the key values, such as community pride, justice, compassion, and respect. It is important to note that the overall basis will be grounded on a patient-oriented methodological framework that enables customer experience-based focus. In other words, a health care facility will undergo major changes that adhere to general structure commercial organizations’ marketing. The latter will be essential in ensuring that patients will be attracted to the facility, and they will be drawn to it through effective marketing techniques.

Customers

The method used for identifying customers will be based on mimicking the healthcare facility to a commercial company. Any given commercial enterprise generates revenue from selling products and services to people and organizations, and thus the latter two are the ones giving money to the enterprise. Similarly, patients are the individuals who need and purchase the healthcare facilities’ products and services in order to improve their health and wellbeing. By mimicking these two different organizations and applying the commercial enterprise-based concept to healthcare organizations, one can identify that the patients are the customers. Therefore, any form of customer-oriented approach will be manifested in a patient-oriented methodological framework, which will seek to improve the overall experience among the given individuals.

Customer Needs

In order to identify patients’ needs and desires, it is important to implement the methodology that consists of two major parts. The first phase is based on referring to existing data on the factors that affect patient satisfaction with a healthcare facility’s service. The most plausible approach is to use systematic review papers that thoroughly assess a large number of studies and draws valid conclusions by filtering irrelevant information. Such a review suggests that interpersonal care, accessibility, and quality of care are among these factors (Batbaatar et al., 2017). The next step is identification through surveys using scoring and questionnaires. The proposed method will help in identifying precise patient or customer needs and desires.

Current Customer Experience Efforts

It is important to assess and evaluate the current state of the service and change it to improve overall customer satisfaction. Current Quality Performance Status is that there is no patient-oriented approach, high employee burnout, and low quality of care. In order to meet the customers’ needs and desires, the key Quality Performance Targets, such as marketing, stress, and skills, will be set as the main objectives for the improvement.

Potential for Improvement

The planned transition to a new patient-oriented model will help improve the quality of medical organizations. However, this change in the orientation of healthcare is impossible without the use of adequate standard criteria for assessing the activities of medical organizations in the context of a national patient-oriented healthcare system. The search for new approaches and ways to improve the structural and resource efficiency of the health care system, aimed primarily at increasing the availability and quality of medical care, is one of the most priority and urgent problems facing both the authorities and administration of all levels and the professional community today. As a mechanism for creating conditions conducive to the observance of the rights of citizens in the field of health care and ensuring the availability and quality of medical care to the population, a patient-oriented approach to healthcare.

Affordable Care Act

Affordable Care Act includes a number of points that link quality to payment. These reimbursement approaches are the Hospital Value-Based Purchasing Program, Medicare Advantage, and the Hospital-Acquired Conditions Reduction Program (“Compilation of Patient Protection and Affordable Care Act,” 2010). The former one, which is the Hospital Value-Based Purchasing Program, is put to assess the entire healthcare facility’s performance with bonuses, whereas Medicare Advantage is designed to provide bonuses for the Centers for Medicare and Medicaid Services (CMS) on star rating basis (“Compilation of Patient Protection and Affordable Care Act,” 2010). Lastly, the Hospital-Acquired Condition Reduction Program acts as a penalty that punishes the performing healthcare facilities by reducing general payments. In a patient-oriented medical organization, the hallmarks of which are a benevolent attitude towards the patient, the absence of queues due to the correct organization of processes and the work of personnel, high-quality medical care, the priority of preventive measures in primary health care.

ACA Incentives

Reward incentives are the Hospital Value-Based Purchasing Program and Medicare Advantage. The penalty-based incentive is the Hospital-Acquired Condition Reduction Program.

New Systems Approach

The main directions of the approach implementation include the redistribution of the workload between the doctor and the nursing staff and the optimization of the logistics of the movement of patients with the separation of flows into sick and healthy. In addition, it is important to consider the reorganization and rationalization of work processes based on the principles of lean manufacturing, the transition to electronic document management, reduced paperwork, and an open and polite registry. The main criteria also include comfortable conditions for the patient in waiting areas, the organization of prophylactic medical examinations and preventive examinations on the principles of a continuous flow of patients with adherence to the standards of admission times per patient, and the implementation of compliance monitoring. Satisfaction in general terms should be seen in a broader context. It reflects the variability of patients’ personal resources, the dynamic behavior of contact personnel, and the nature of the conditions for the provision of medical services. In addition, there are a number of variables that determine the quality of interpersonal relationships in the therapeutic professional-patient interaction.

Customer Experience

Patient-centered medicine is a new model for the planning, implementation, and evaluation of health services, which is based on mutually beneficial partnerships between health professionals, patients, and their families. Taking into account the current problems of domestic health care, the introduction of a patient-oriented model will significantly improve the quality of medical care to the population. Globally, the implementation of the principles of this model is far from complete. Purposeful work in this direction requires additional scientific research, systematization of available data, development of new legal documents. Effective prevention is impossible without taking into account the individual characteristics of the patient and the formation of long-term communication between him or her and the clinical specialists.

Hospital Stakeholder Satisfaction

An important factor in changing the healthcare model to a patient-oriented option was the change in the healthcare paradigm with the appearance of obvious market features in it and the patient acquiring the role of a client, for whose choice there is a struggle in the competitive environment of healthcare providers. The patient focus in this context can be interpreted as customer focus, which is an indispensable attribute of market relations. Thus, all of the above prerequisites have led to a shift in healthcare systems around the world towards the elements of a patient-centered model. In general, it can be argued that patient-centered medicine is implemented at two levels, such as systemic and personal, and both of these levels require detailed consideration. Difficulties in implementing this concept at the system level primarily include integration and access.

Step-By-Step Plan

The problem of integration lies in the lack of universal unified implementation of the approved ideas. Thus, moving from one hospital to another, from one clinician to another, from a general practitioner to a specialized specialist, the patient risks suffering from the lack of this unification if the system is built around its components, rather than on the patient himself as to its center. The most vulnerable in this case are high-risk patients such as comorbid and deeply elderly. Patient satisfaction surveys can be difficult for healthcare leaders. In many cases, one has to deal directly with the patient, and his or her reaction may depend on the successfulness of the treatment. Patient feedback does not reflect the quality of care, as the patient is not a medical specialist. Many of the factors that increase patient satisfaction are not medical-related. There is a strong correlation between high patient satisfaction and objective criteria for effective treatment. Various aspects of interaction with the doctor and nurse affect satisfaction much more than the quality of food or the comfort of the bed.

Burnout is a state of physical, mental, and emotional exhaustion of a person caused by a prolonged stay in emotionally stressed situations. This formulation is close to understanding burnout as a chronic fatigue syndrome. This model consists of emotional exhaustion and depersonalization, which manifests itself in a deterioration in attitudes towards other people and oneself. Burnout is understood as a syndrome of emotional exhaustion, depersonalization, and a reduction of one’s personal achievements. The relevance of the health problem of medical workers is due to the fact that the quality and efficiency of their work depends not only on qualifications and material and technical equipment but also on their state of health. The importance of timely diagnosis or identification of the problem, treatment, and prevention of professional burnout syndrome of medical staff has been proven.

Communicating to Stakeholders

The patient’s family is also a stakeholder, and the perception of relatives may be quite different from that of the patient. The need to clearly identify the structural components of patient satisfaction has become an urgent task, which is also determined by the presence of an urgent need to systematize a variety of quantitative and qualitative indicators used in managing the consumption of medical services and developing, on its basis, unified methodological approaches for use in the everyday practice of modern healthcare. There is a strong link between patient satisfaction and quality care. However, there are differences between them, and it is not at all necessary that high-quality medical care provided, from a professional point of view, be accompanied by high patient satisfaction.

Quantitative Data Modality

Quantitative data modality is based on two studies that focus on communication skills and burnout. First, 1537 attending physicians underwent communication skills training, whereas 1951 did not, and the result was that the study group showed better personal accomplishment and empathy (Boissy et al., 2016). The latter changes led to the improvement of patient satisfaction and experience. The second study showed that physicians with high levels of burnout expressed worse patient care and low professionalism that resulted in less patient satisfaction and high incident rate during the procedures (Panagioti et al., 2018).

Qualitative Data Modality

Qualitative data modality is also focused on two studies that include a systematic review of interpersonal skills and marketing as patient satisfaction drivers. The first study primarily addresses the value of interpersonal and communication skills among employees in order to enhance the quality of care (Batbaatar et al., 2017). The second piece of evidence demonstrates that marketing can be a major booster of patient satisfaction (Neuwirth, 2019).

Conclusion

The primary objective of the new systems approach is to improve patient satisfaction, and thus two types of changes will be integrated. The individual-level changes will consist of communication skills improvement and burnout reduction. The systemic changes will be comprised of a pay-for-performance methodological framework and optimization of processes. The outcome will be manifested in satisfaction among employees and patients and the effectiveness of processes.

References

Batbaatar, E., Dorjdagva, J., Luvsannyam, A., Savino, M. M., & Amenta, P. (2017). Determinants of patient satisfaction: A systematic review. Perspectives in Public Health, 137(2), 89-101.

Boissy, A., Wondover, A. K., Bokar, D., Karafa, M., Neuendorf, K., Frankel, R. M., Merlino, J., & Rothberg, M. B. (2016). Communication skills training for physicians improves patient satisfaction. Journal of General Internal Medicine, 31, 755-761.

Compilation of Patient Protection and Affordable Care Act. (2010). Web.

Neuwirth, Z. (2019). Creating a new healthcare. Healthcare Success. Web.

Panagioti, M., Geraghty, K., Johnson, J., Zhou, A., Panagopoulou, E., Chew-Graham, C., Peters, D., Hodkinson, A., Riley, R., & Esmail, A. (2018). Association between physician burnout and patient safety, professionalism, and patient satisfaction: A systematic review and meta-analysis. JAMA Internal Medicine, 178(10), 1317-1331.

Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations. Jones & Bartlett Learning.

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