Physicians are schooled to be data-driven, objective problems solvers. From the early days of medical school, teaching the practice of medicine has involved deductive reasoning, problem solving and using data to help drive our thought-process and make decisions.
While important, the human side of the practice of medicine—delivering compassion, comfort and empathy—receives far less attention during training than the clinical side.
Physicians are taught to do no harm, and they are trained to be detached and dispassionate in their thinking to ensure the best clinical decisions. This tradition is likely part of the reason that physicians and other health care professionals have had difficulty embracing the patient experience movement.
In fact, for many years, physicians have questioned whether improving the patient experience has any direct impact on patient outcomes at all. They and other health care professionals have contended that because clinical delivery is the most important consideration, in an environment of limited resources, we should focus on improving outcomes, not patient happiness. Some have even argued that too much attention on patient experience can have a detrimental effect on care, with one study suggesting that hospitals with higher patient satisfaction have worse clinical outcomes.
Finally, there is some clarity. In a well-designed study using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) published in JAMA Surgery, a team of researchers at UCLA evaluated 103,000 surgical patients over the age of 65 for four consecutive years. They demonstrated that patients undergoing surgery at hospitals performing in the top-quartile on the HCAHPS survey had a lower likelihood of death, failure to rescue and minor complications than patients treated in hospitals performing worse on patient experience in lower quartiles.
This study is not insignificant. An earlier study demonstrated a similar link between higher patient experience scores to lower mortality, fewer post-operative complications and a shorter length of stay, however that study was criticized for being less robust because it used administrative data.
The UCLA study, on the other hand, uses the high-quality, validated and reputable NSQIP clinical database—the gold standard for tracking surgical outcomes in the United States—to demonstrate the link between improved patient satisfaction and surgical outcomes.
To those who have been skeptical, this compelling data should finally be enough to support what we have known all along: the effort we put into such humanistic concerns as communication, teamwork and care coordination to ensure a high-quality patient experience doesn’t just make patients happier, it improves patient care and outcomes.
The patient experience is about how we deliver safe, high-quality care in an environment of patient- and family-centeredness. It is critical to recognize that to be successful in our work, we have to develop a meaningful, supportive health care culture so that our caregivers come to work every day engaged, satisfied and committed to the ideal of making sure patients are at the center of everything we do.
Written by Dr. James Merlino on Press Ganey