Patient Satisfaction “A” Team Effort Tony Volpe, MD Medical Director of Professional Liability & Risk Management Melissa Pickelheimer, RPLU Operations & Underwriting Officer – PLPP

Patient Satisfaction….. EVERY MEMBER OF THE MEDICAL TEAM PLAYS A ROLE

A patients perception IS their reality Consider this….. Dissatisfaction occurs for many reasons unrelated to direct patient care A patients perception IS their reality

Perception vs. Expectation Influencing Expectation Minimum Expectation To be listened to To be cared about To receive clear & understandable information Treat patients as you would like to be treated

Satisfied Patients Will….. Follow Treatment Recommendations Follow Referral Recommendations Remain Loyal Patients File Fewer Malpractice Claims

Sources of Dissatisfaction Prolonged Waiting Times

Sources of Dissatisfaction Prolonged Waiting Times Isolation in the Exam Room Lack of Understanding Diagnosis & Treatment Plan

Sources of Dissatisfaction Prolonged Waiting Times Isolation in the Exam Room Lack of Understanding Diagnosis & Treatment Plan Difficulty in Obtaining an Appointment Billing Disputes Complaints Not Addressed Timely

#1 Source of Dissatisfaction Staff/Physician Attitudes & Communication

Attitudes & Communication Can be: Verbal Written Behavioral Body Language Mannerisms

Attitudes & Communication Employ active listening skills Ask probing questions to ensure patient understanding Encourage patient participation Avoid interrupting patient Body Language Lean forward Avoid crossing arms or other negative signs

Attitudes & Communication Employ Active Listening Skills (con’t) Be attentive to the patient Never appeared to be hurried Maintaining eye contact Avoid external distractions Be empathetic & supportive Address concerns or anxieties Be sensitive to what the patient isn’t saying

Attitudes & Communication Avoid Medical Jargon Use simple terms Typical patient education levels grade 8 Encourage patient feedback Reflective techniques Summarize and Repeat Essential Points

Telephone Communication Consider this… Patients introduction to the practice Patients rate communication as yardstick of quality of care

Telephone Triage What’s on your Menu? How do you use the Hold Button? Why are Repeat Calls an indicator? Who is Monitoring your phone etiquette?

Telephone Call Mgt Algorithm Patient call Automated Phone Tree Emergency- 911 Doctors Office Appointment Medication Laboratory “0” for real person Specified Staff Action

Human (criteria to guide/triage) # for Emergency Services Telephone Call Mgt Algorithm Patient call Human (criteria to guide/triage) Emergency Poison Control # # for Emergency Services Specified Staff Routine Urgent Physician Policy Laboratory Appointments

Measuring Patient Satisfaction Patient Satisfaction Surveys Tracking Patient Referrals External Evaluations Internal Evaluations Tracking/Trending Complaints

Patient Satisfaction Surveys What they can do: Identify ways of improving your practice Quality Issues Access Issues Interpersonal Issues Demonstrate that your practice is interested in quality and in improving Identify dissatisfied patients for follow up

Patient Satisfaction Surveys Types In Office Given at patient check in (consistently) Provide drop off box Mail Sent immediately following visit Allows for anonymous response Provide self addressed envelope Telephone Call within a defined period of time Allows for further probe if issues are identified

Patient Satisfaction Survey Example Thank you for completing this short survey. Your answers will help us serve you better. How long have you been a patient here? o 1st visit o Less than 1 year o 1-3 years o Greater than 3 years   Strongly Agree Agree Disagree Strongly Disagree Not Applicable It was easy to schedule a convenient appointment. o The staff was courteous and helpful. The time in the waiting room was reasonable. The forms were easy to understand and complete. The waiting area was comfortable. The physician gave me his/her complete attention. The physician answered my questions clearly. I was satisfied with my visit with the physician. I was satisfied by the follow-up appointment scheduling. I was satisfied with contacting the office by phone. I received the results of my labs and/ or tests in a timely manner. I am satisfied with the quality of care I received. I would recommend the physician/office to friends. What can we do to make your office visit better?

Event Management Investigate Coordinate communications Resolution Who How Coordinate communications Post adverse event enhanced communication Resolution Disclosures “I’m sorry” vs. “I’m responsible”

Event Management How to reduce events: Establish realistic expectations with patients Provide ongoing training to staff Evaluate operations and establish best practices Preview patient charts the day before Discuss scheduling with staff & physicians Use tasking lists to improve efficiency

Physician Perspective Every member of the medical team plays a role in patient satisfaction Staff influence on patient satisfaction makes physicians job easier Establishing realistic expectations for patients allows them to be met

Physician Perspective Dissatisfaction + Adverse Event = CLAIM “Sorry we’re behind.” “What else can we do for you.” “Would you like to re-schedule?” Can diffuse a difficult situation

Medical Malpractice Perspective 40% of Med Mal cases in the U.S. are groundless Recent Ohio Department of Insurance Report 80% of claims reported in Ohio close without payment to plaintiff Average cost to defend $35,603 per claim Total defense expenses $103,033,668 Increase of 37% from prior year Average payment to plaintiffs $315,635 per claim Total payments to plaintiffs $235,463,393 Increase of 10% from prior year

Medical Malpractice Perspective Patient Dissatisfaction = Patient Motivation to File Lawsuits Aggravation Factor Poor Communication Lack of Information Lack of Developed Relationship ANGER Physicians & Staff IMPACT Risk Factors

Questions??