Author Archive for wmills

William F. Mills, M.D., MMM, CPE, FAAFP, CMSL, is currently the senior vice president of quality and professional affairs for the Upper Allegheny Health System located in western NY. Mills is a graduate of Hahnemann University School of Medicine and completed his family practice residency at the West Jersey Health System. He is certified by the American Board of Family Medicine, and a fellow in the American Academy of Family Physicians. Mills is currently a clinical assistant professor at the School of Medicine, State University of New York at Buffalo. He is also certified in addiction medicine through the American Society of Addiction Medicine, and currently serves as a medical review officer. Prior to transitioning to full-time administrative medicine, Mills spent more than 20 years as a practicing family physician, and more than 10 years as the medical director of a residential drug and alcohol treatment facility. He also holds a Master of Medical Management degree from the Marshall School of Business, University of Southern California and is a Certified Physician Executive from the Certifying Commission in Medical Management.

Patient Satisfaction Blog Series for CRC 2012

Easier? It can make my job easier?

You are now experts at improving the three physician-specific questions on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey:

During this hospital stay, how often did doctors treat you with courtesy and respect?
During this hospital stay, how often did doctors listen carefully to you?
During this hospital stay, how often did doctors explain things in a way you could understand?

I mentioned last week that this would make your job easier. How can that be? The following are some of the benefits that come from having satisfied patients:

Fulfills patient priorities and wants
Improves professional standing
Improves compliance with recommended treatments and follow up
Reduces liability risks and costs
Improves staff retention and satisfaction
Improves physician satisfaction
Reduces unnecessary calls, returns to the ED, and professional aggravation
Improves clinical outcomes and measures

There are other benefits as well. If you think back, you can probably find an example for each of the above from your own journey in the medical profession (as either a patient or provider). Happiness (satisfaction) is contagious!

Hopefully this series has whetted your appetite to do further reading, research, and reflection on improving patient satisfaction. Although “because the government says so” may be adequate motivation for some, the real motivation should come from our desire to provide the best patient care possible. After all, isn’t that what we are all about?

Editor’s note: William Mills, MD, MD, MMM, CPE, FACPE, CMSL, FAAFP, is a featured speaker at the 15^th annual Credentialing Resource Center Symposium, May 10-11. He will be speaking on using patient satisfaction scores to drive improvement as well as how to privilege low- and no-volume practitioners. For more information, click here.

March 02, 2012 | wmills | Comments 0

Patient Satisfaction Blog Series for CRC 2012

Blah, Blah, Blah?

As I mentioned in my last post, there are three physician-specific questions on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey:

During this hospital stay, how often did doctors treat you with courtesy and respect?
During this hospital stay, how often did doctors listen carefully to you?
During this hospital stay, how often did doctors explain things in a way you could understand?

This post will deal with tips to improve your scores on the explanation question. By now, I’m sure you would make Emily Post proud of how polite you are. (For those much younger than I, she was the queen of etiquette.) I also expect you have made some brilliant diagnoses as a result of your improved listening skills. Now it is time to focus on how you explain things to patients and increase those scores at the same time. Your patient shouldn’t feel like Charlie Brown talking to his parents and just hear “blah, blah, blah,” when you are explaining important health related issues.

Patients (those are the horizontal people in hospitals) are often not at their intellectual peak while hospitalized. Remember this is our workplace—not theirs—so we need to be a little more diligent when explaining complex, emotionally charged issues. Here are a few pointers that will help you with your ability to explain what’s going on in a way that the patient may understand:

Provide more information than you believe is necessary
Provide the option of having another person in the room to hear the information, take notes, and ask questions
Encourage patients to write down their questions in between visits. This allows them the opportunity to think about the previous interactions and formulate questions that specifically address their fears and concerns
Ask patients if they need any more information

Remember that we often get caught up in our jargon and patients “appear” to understand as they don’t want to disappoint their physician or appear not so bright. Ask follow-up questions that probe their understanding. You may be surprised by how much your patient did not understand once you start asking them these questions.

So go forth and improve the satisfaction of those we serve, while simultaneously improving quality, publicly reported measures and making your job easier. I couldn’t resist. This will make your job easier. Read next week’s post to see how.

February 23, 2012 | wmills | Comments 0

Patient Satisfaction Blog Series for CRC 2012

I’m Sorry, What Did You Say?

As I mentioned in my last post, there are three physician-specific questions on the Hospital Consumer Assessment of Healthcare Providers and Systems HCAHPS survey. They are:

During this hospital stay, how often did doctors treat you with courtesy and respect?
During this hospital stay, how often did doctors listen carefully to you?
During this hospital stay, how often did doctors explain things in a way you could understand?

This post will deal with tips to improve your scores on the listening question. Hopefully you have tried to be a little more respectful (as discussed in my last post) and have found it rewarding. So let’s improve your listening skills now.

You have probably figured out this is a perception issue, and you are correct. The following tips have been shown to improve the patient’s perception that you are listening:

Sit down during the conversation portion of the visit
Ask open-ended questions and listen with empathy
Use “reflective” listening (paraphrase, clarify, ask for understanding)
Offer a physical gesture, such as a handshake, a touch on the shoulder, or a pat on the knee
Make eye contact with the patient and family
Pay attention to the patient and not the chart or cell phone

Although these tips improve the perception that you are listening, you actually do need to listen carefully. Remember back to medical school when the wise attending said that the patient will tell you what is wrong with them if you will only listen? My experience is that they were right. How about your experience?

February 16, 2012 | wmills | Comments 0

Patient Satisfaction Blog Series for CRC 2012

Courtesy and Respect? Don’t have to; I’m the Physician!

As I mentioned in my last post, there are three physician-specific questions on the Hospital Consumer Assessment of Healthcare Providers and Systems HCAHPS survey:

During this hospital stay, how often did doctors treat you with courtesy and respect?
During this hospital stay, how often did doctors listen carefully to you?
During this hospital stay, how often did doctors explain things in a way you could understand?

This post will deal with tips to improve your scores on the courtesy and respect question. Hopefully you have bought into the concept that improving patient satisfaction improves quality. If you haven’t yet, then try these suggestions and see what happens.

Since approximately 85% of communication is non-verbal, pay particular attention to your body language. We have all been in situations where the body language was so loud, that the spoken words could not be “heard.” Clear your mind prior to beginning the encounter.

Brush up on your polite behaviors such as:

Knocking on the door before entering
Making eye contact with the patient and visitors
Introducing yourself and the members of your team
Addressing the patient by their preferred name

Do not discuss the patient in the third person when they are present. They are not just the “gallbladder in room 203” but actually a person, too.

These are just a few of the proven methods to improve patient satisfaction and your score on this question. Try these out this week; next week I’ll be sharing about listening skills.

February 07, 2012 | wmills | Comments 0

Patient Satisfaction Blog Series for CRC 2012

Pat Sat/HCAHPS/P4P – Huh?

This is the first of a series of five postings that will attempt to make sense of some the above. Patient satisfaction has risen to the top of many a list as the government and other payers are establishing pay for performance (P4P) initiatives. One of the reasons everyone is working on this is there is a clear connection between patient satisfaction and quality. Check out the New England Journal of Medicine for more information on this (2008; 359:1921-1931).

Because patients, payers, and politicians now care about patient satisfaction, the next three posts will provide tips for improving scores on the three physician specific questions on the HCAHPS questionnaire. The last post will tie it all together to show physicians and MSPs how patient satisfaction affects physician performance.

To start, what is HCAHPS? The Hospital Consumer Assessment of Healthcare Providers and Systems is a 27-question survey developed by Centers for Medicare and Medicaid Services with the following goals in mind:

To produce data about patients’ perspectives of care that allow objective and meaningful comparisons of hospitals on topics that are important to consumers
To create incentives for hospitals to improve quality of care by making public survey results
To enhance accountability in healthcare by increasing transparency of the quality of hospital care provided in return for public investment (also by making public the survey results)

Although this survey covers a number of areas, my blog posts will cover these three physician-specific questions:

During this hospital stay, how often did physicians treat you with courtesy and respect?
During this hospital stay, how often did physicians listen carefully to you?
During this hospital stay, how often did physicians explain things in a way you could understand?

Until next time, try to get your arms around the fact that improving patient satisfaction will improve quality. For many of us, this fact will be difficult to swallow, but swallowing (internalizing) this will be critical for our success in the future.

January 27, 2012 | wmills | Comments 0