The Importance of Patient Feedback

APRIL 06, 2014
Ed Rabinowitz
Feedback is a critical component of successfully doing business today. If you don’t know what your customers are thinking, feeling, wanting, or needing, virtually every business decision you make can be pure speculation.
 
For medical practices, patients are your customers, and gathering their feedback is essential to improving their healthcare experience. It’s also the best way to convince healthcare professionals of the need to institute change.
 
“It’s very difficult to change physicians’ behavior when all you’re doing is telling them they need to change,” explains Robert Gamble, director of strategic practice initiatives for the Community Oncology Alliance (COA). “However, if you can paint a picture of how their patients are perceiving their care and interaction, then all you have to do is point to the picture. That can be really good motivation.”
 
Painting by numbers
COA recently developed a patient-centered oncology medical home model that emphasizes measuring, benchmarking, and rewarding positive quality, value and outcomes in cancer care. Marsha DaVita, NP, chief clinical officer with Hematology Oncology Associates of Central New York, in Syracuse, says that patient feedback has been essential in the development of COA’s oncology medical home model.
 
“Well, it is a patient-centered model, and you can’t really know how patient-centered you are until you understand what your patients’ needs and wants are,” DaVita says. “So [surveying our patients] really has been wonderful in helping guide us and understanding what patients’ expectations are. Are they understanding the information that we’re giving them? It’s just been a really helpful tool in steering our practice to be more patient-centered.”
 
The oncology group developed a 40-question survey tool that was administered, in paper form, to a little more than 3,000 patients on 2 occasions. The response rate was nearly 50%. A third survey is currently being performed in electronic format. The surveys ask questions about accessibility, ease of obtaining an appointment, receiving responses in a timely fashion, and having information explained clearly. DaVita says patients have been enthusiastic about completing the surveys.
 
“It’s always important to allow people to have free text; to just say whatever it is they want to say,” she says. “And I think we had a high response rate because people tend to develop a close bond and trust with their oncologist. It’s hard not to be extremely compassionate with these patients.”
 
Quality improvement
DaVita says that surveying patients enables the practices that make up the oncology group to compare themselves with other practices of similar size within the group, or elsewhere. They can even drill down, if they sense an area of weakness, to compare one physician to the entire practice. They’ve even been able to use information from the first 2 surveys to benchmark certain processes that they can now reassess with the third survey.
 
“It’s a wonderful tool for process improvement and education,” she says.
 
It can also impact a practice’s bottom line, directly and indirectly. COA’s Gamble says that cancer care has a story to tell. The surveys help practices tell that story.
 
“Patients are your best form of marketing,” he says. “When they go to the grocery store, or to church, they’re talking about how well they were treated by the team. And when we asked our practices if they were using the results of the survey to help negotiate bonus payments or payment reform with their payers, 30% of them said ‘yes.’”
 
Getting started
Gamble says that for medical practices gathering patient feedback, one of the first data sets they should look at is how they compare to peers in areas like practice hours or within certain populations like Medicare patients.
 
“Your Medicare population tends to be very appreciative and very compliant,” Gamble says. “So, if a practice is 75% to 100% Medicare, those scores are going to be naturally higher. So, we would recommend first looking at how the practice is doing in total scores compared to your state or the nation, and then take it to the next level, which would be how you’re doing by location, and by physician at each location. Overall scores might be okay, but when you start looking at levels, it really helps to zero in on details and focus on those outliers that are either pulling the score up or down.”
 
DaVita reiterates how important gathering patient feedback can be. For example, her oncology group learned that test results, even a lab as basic as a CBC, is consequential to many people—even when the results are completely normal.
 
“So, it creates a little more work for us, but that’s okay, because it matters to the patients,” she says. “So we give them every test result now. That’s what we’ve learned from patients. Every normal test result that comes back is a wonderful thing, and they want to hear about it so they don’t have to worry. And I think that has helped make us better.”



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