As an article in Tuesday’s NY Times highlighted, Medicare is going to start looking at patient satisfaction survey results when reimbursing hospitals.
Hospital representatives quoted in the article are concerned about the negative financial impacts for things they can’t control as opposed to actual clinical quality measures (which will still determine the bulk of the reimbursement they receive). And, of particular note for those of us in MA, hospitals in the Northeast and California are concerned that their patients will “grumble” more than those in other parts of the country!
While patient satisfaction can obviously be more subjective than clinical quality, there have been similar grumblings about clinical quality measures. For a long time, and probably still today for some, infections were accepted as something that happens and can’t be stopped, and there was “grumbling” about public reporting of infection rates, not to mention reducing reimbursements when infections occur in the hospital, as Medicare has been doing for certain infections. But in recent years, there has been a lot of focused work on preventing infections and many hospitals have seen amazing results. And you have to assume that public reporting and financial implications of infections have played some role in this change. So, let’s hope that the same will happen for the patient experience.
The article mentions important innovations that can make patients’ experiences better and help to prevent errors or serious problems from occurring-such as having nurses visit rooms hourly and expecting all employees to respond to a patient’s call light. And the questions that CMS asks patients in the satisfaction surveys include topics like whether or not the patient received proper instructions on what to do when leaving the hospital. With CMS also focused on reducing hospital readmissions, a question like this really gets at whether or not a patient feels prepared to leave the hospital and continue receiving care as an outpatient. If the discharge process does not ensure that a patient is prepared to make that transition, then that patient has a higher likelihood of being readmitted.
In a nutshell, taking steps to improve patient experience will also result in improving care over all. Making care in all settings more patient-centered is one of the priorities of payment and delivery system reform.