the original question to the entire group; ask: “How did you feel? What are some of the things you wrote down?” You may want to clarify that you are looking for their feelings or their emotional state rather than symptoms.
As people shout out their responses, record them on the flip chart and repeat them out loud for the group.
Once the group has listed out their feelings, ask them to share what they needed; say: “So if this is how you were feeling, what did you need?”
As people shout out their responses, record them on the flip chart and repeat them out loud for the group.
Summarize: Read the two lists back to the group and say: “These are our patients. When they come to us, they are feeling like this, and these are their needs. We need to keep this in mind at all times and remember how they are feeling and what they need.”
I have done this exercise with audiences ranging from senior leaders and physicians to frontline staff. Regardless of title or life experience, the answers people commonly give are that they felt scared, frustrated, overwhelmed, and confused. They often express that they felt vulnerable, tired, and alone.
When identifying what they needed at the time, answers are typically compassion, attention, empathy, reassurance, relief from pain, and information to help them understand their condition and treatment.
I love to do this exercise with healthcare professionals because it gets them back to the essence of the patient experience and reminds them that this is the state of mind of many of their customers. These emotions and needs are at the core of the patient experience. As healthcare providers, you need to keep this in mind as you care for them and as you prepare them to leave.
Identifying and addressing these feelings and needs are among the most important aspects of patient care. And just because someone is being wheeled over the hospital threshold as a discharged patient doesn’t mean that those needs stop. A carefully timed and purposeful discharge call can go a long way in helping the patient feel reassured and confident about healing and care.
Think Back Exercise
Think back to a time when you were ill. It could be as simple as a bad cold or as complicated as a surgery or recovering from an injury. How did you feel? List all the feelings that come to mind.
What did you need? Again, think of that time when you were ill. What did you need?
Reason #2—Improve clinical outcomes and reduce readmissions
Another key reason hospitals implement PD calls is to improve clinical outcomes. You want to make sure that patients understood their discharge instructions and what to do next. PD calls help to validate patient comprehension and follow through of the instructions. They also give the opportunity to reinforce teaching.
When people are in a hospital, they often become very compliant because they feel vulnerable and out of their comfort zone. In fact, many people become highly compliant just to get through the ordeal and out of the hospital. But, once patients get back home in their familiar environment, a false sense of security often takes over. In such cases, and especially if patients are feeling better, they become convinced that things aren’t so bad, and they can resume normal activity.
Once a patient is feeling better, the less motivated he is to follow up on the discharge instructions, including medications and physician appointments. Or, if there’s been rehab or some other follow-up care needed, he may rationalize that it isn't really necessary. After all, the patient feels fine now.
This mindset, or false sense of security, is one of the most important reasons for making a PD call. First, the call continues the great care that you gave while the patient was in the hospital. Second, it reminds the patient that just because he is home and, perhaps, feeling better, it doesn’t mean he should ignore the treatment plan. This type of reminder improves clinical outcomes.
Improving clinical outcomes has additional implications in today’s reimbursement environment. Readmissions are costly to payers and disruptive to patients. But now, readmissions of a specific diagnosis-related group (DRG) have financial ramifications. The CMS have begun monitoring specific patient cohorts, which are currently being tracked on the CMS Hospital Compare site. The first three DRGs listed under evaluation for readmission rate include heart attack, heart failure, and pneumonia. The CMS will use a severity-adjusted methodology to calculate what is deemed an excessive readmission rate for each organization evaluated. Then, based on the calculation for excess readmissions, each organization could be penalized a portion of its reimbursement in the event of excess readmissions.
I won’t pretend to be an expert on the reimbursement aspect of either the readmission rates or Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and I highly recommend that you familiarize yourself with the CMS calculations and regulations. Keep in mind that these maximum penalties are going to continue to grow over time—up to 2 percent in fiscal year 2014 and 3 percent in fiscal year 2015—and they’re going to continue to add more patient groups to those that are already being tracked for avoidable readmissions. In the future, additional DRGs that could be added include COPD, bypasses, angioplasties, and other vascular procedures.
Reason #3—Deliver service recovery
The third essential reason many hospitals conduct PD calls is to implement service recovery measures. It’s been established that inpatients are a captive audience. While they have options for which organization to visit in their time of need, and they are certainly more educated about expectations in this electronic age, the majority of inpatients are only seeking care out of necessity. Furthermore, they come through a hospital’s doors in a heightened emotional state and are filtering their perception of service through a subjective lens. Quality is in the eye of the beholder.
Despite good intentions in your customer service delivery, some service issues are inevitable. Issues may vary in scope and size, but they are guaranteed to influence a patient’s experience and how she views your responsiveness to her needs. In a hospital setting where patients and their families interact with dozens of your team members across multiple departments and shifts, you may not even realize what messages are being sent to them or how they are received, let alone when something goes wrong.
Although many organizations try to find service recovery opportunities during rounds, some patients report being hesitant to vocalize concerns due to fear of retribution from the staff. Whether real or perceived, patients may not want to discuss service issues until they are no longer in your care.
If a patient is satisfied with his experience, it is likely he will tell two to three of his friends and family members about it, leading to positive brand reinforcement and the increased likelihood for loyalty and referrals. However, if that patient feels you did not handle a service issue in an appropriate or timely fashion (maybe it wasn’t addressed at all), it is almost guaranteed the patient will tell beyond two or three people about it. At that point, without even realizing there was a problem, you stand to jeopardize future business with the patient again and everyone he shared his bad review with. And consider the negative potential of online social networking media, spreading news like wildfire.
Placing PD calls provides
