Conducting hospital satisfaction interviews across six states. Initial comments.

Communication plays such a huge role in overall patient satisfaction. There are so many valuable uses for telemedicine. You would think that hospitals, knowing how important their HCAHPS scores are would re-evaluate their patient processes and take advantage of the ability of telemedicine to put care team members in front of their patients—at their most mentally vulnerable times: pre and post discharge—in the comfort of their own home.

We tend to shower information on patients (and family members) when they first come into the hospital, we use medical terms throughout their stay and then overwhelm them again when it is time to be discharged. For most patients, thoughts at both these times are distracted; they are still trying to get their heads around the diagnosis, care needs, and logistics. Their eyes glazed over as they take in vast amounts of information. No wonder patients and family members often ask redundant questions.

Care teams believe they are doing a good job in their communications with patients yet fail to understand the psychological effect of being newly diagnosed, in a hospital (a foreign land), and losing individual power.

Patients have a difficult time processing information, they are super-sensitive to anything negative and their thoughts often go off track. Patients are fearful, many are overwhelmed with their diagnosis, yet they are really trying to understand. Hospital workflows are unknown to them, anyone in scrubs is seen as a provider, which is why they ask techs medication questions.

Side note: they are also fighting to stay as positive as they can and yet we use terms that sound negative to them and their loved ones (e.g. for LVAD patients we refer to our care team as the patient’s Heart Failure Team). But, imagine being a heart patient and hearing “heart failure team” referred to on a daily basis.

When patients are discharged they are again mentally vulnerable. They are trying to figure out how they are going to manage at home, pay the bills, take care of the kids and a hundred other things. Yet, this is when we give them lengthy, critical discharge information (e,g, home care instructions and medication needs), and discuss follow-up visits. Again, they only hear a portion of what is communicated.

Our failure to evaluate our patient communications from the patient’s psychological perspective is disheartening.

Why do we not use telemedicine, whenever possible, in the home pre and post discharge? Why not allow them to be in the comfort of their own homes to learn what to expect at the hospital… from admissions to being placed on the floor, seeing a physician, introducing their care team, information about the procedure, side effects, potential adverse occurrences, etc.?

Other industries know the value of sharing “what to expect.” If the patient is an emergency case, providing a communication service to family members (caretakers) via telemedicine would still be highly valuable. Why do we not use telemedicine to review discharge instructions, review medications, share educational material, and answer questions about care concerns?

I would love to hear that many hospitals ARE doing this, and surely those that have progressive leadership are combining telemedicine communications with discharge services and home monitoring, but most aren’t. Surely the ROI would be seen in higher HCAHPS scores, and more importantly in the improved patient experience.

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P.S. We cannot disconnect from our patients simply because we are desensitized to the novelty of being a hospital patient.  Nor can we be flippant when patients show discomfort or modesty because we have “done this hundreds of times.” (If the man wants a male nurse, get him a male nurse for Pete’s sake.)