Hi, and welcome to my blog! I'm Susan E. Mazer -- a knowledge expert and thought leader on how the environment of care impacts the patient experience. Topics I write about include safety, satisfaction, hospital noise, nursing, care at the bedside, and much more. Subscribe below to get email notices so you won't miss any great content.
July 7, 2017
Since it moved to value-based purchasing, the U.S. healthcare industry has been focusing on the patient experience, trying to measure it using 31 questions on the HCAHPS survey.
What we’re ignoring, however, is the day-to-day challenges that patients are dealing with in their lives and the social determinants that influence their relationship to the healthcare system.
For example, if you have a minimum wage job without benefits, will you get poor service and only the bare minimum treatment because you cannot pay? Or, if you are no longer sober, will people only see you as a person with a drinking problem? And, if your English is not perfect, will some people assume you are not here legally?
In a recent post on HIT Consultant, Abhinav Shashank, CEO & Co-founder at Innovaccer Inc., argued that the critical nature of social determinants fully informs value-based care. He identifies five major groups of factors: economic stability/instability, educational level, social and community context, access to healthcare and health literacy, and the neighborhood and built environment.
It’s the lived experience of patients that makes them informed, misinformed, or uninformed about their own health. Poverty, unemployment, underemployment, educational deficiencies, and lack of opportunity can all lead to poorer long-term health outcomes.
Patients with injuries, chronic conditions, cancer, or strokes may feel resigned to whatever is happening to them, rather than being empowered to affect their own future. The implications of being ill or hurt are broad, not only for patients but also for their families.
Because of this, the patient experience sits embedded in all the issues that impact people’s lives. It doesn’t happen only when someone is sick enough to seek care.
The patient experience is also related to the environment and circumstances in which the illness or injury occurs. It is affected by everything and everyone that precedes a hospitalization.
Is it possible for a patient experience to be so powerful, that the walls created by social determinants begin to open? That there is continued engagement initiated in an ER visit, hospitalization, or an appointment with a primary care physician that can be nurtured and sustained over time?
Clearly, patients come into the hospital knowing something. But they leave with a different set of understanding about themselves and others, their bodies, and their vulnerability.
How can we empower patients to move into positive, responsive places? How can we embrace them in ways that they realize they do have some control over what happens to them?
I think it starts with loving kindness. Nurse Theorist Jean Watson, Ph.D., says that human caring begins with extending loving kindness and equanimity to self and others.
Loving kindness to patients is not simply “being nice.” It is more than extending “common courtesy” and richer that being “respectful.”
It is the experience of human-to-human interaction that is authentic, meaningful, compassionate, and concerned. And, it is about valuing the humanity of patients in such a tangible way that patients can take their sense of wholeness into recovering at home.
I began with asking what the patient experience is really about. Perhaps, the best answer is that it is about everything. And, everyone who comes in direct or indirect contact with patients and their families can be agents of positive change.
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