April 28, 2006

Clinicians urged to reduce patient anxiety

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Clinicians urged to reduce patient anxiety

Patients are naturally afraid – of their disease, of what might happen to them, of pain, of being treated impersonally, of their doctor.

This observation was used recently by Dan Beauchamp, M.D., chair of Surgical Sciences, to launch a presentation for physicians about patient satisfaction and the doctor's role in reducing patient anxiety. Beauchamp's talk was given under the banner of elevate.

Many Vanderbilt clinicians may already be consciously working toward elevate goals for clinical quality. Set in motion in November 2004 and led by the executive team at Vanderbilt University Medical Center, elevate is a sweeping campaign for organizational change, with the stated aim of helping VUMC ultimately attain the very summit of U.S. health care. It springs from an outline created by consultants from the Studer Group (www.studergroup.com).

The elevate steering committee, led by Vice Chancellor for Health Affairs Harry Jacobson, M.D., is now considering how best to engage more faculty physicians in efforts to raise staff and patient satisfaction.

It's thought that physicians who want to maintain or grow their practice will naturally be in tune with elevate.

“The consumer goods industry finds that 80 percent of those consumers who rate a product like a car as 'excellent' will become repeat purchasers, but those who rate a product 'very good' are only 20 percent likely to repurchase. In health care the same numbers hold true,” said Brian Dameier, a senior consultant with PRC Inc., Vanderbilt's patient satisfaction surveyor.

The message from some Vanderbilt physicians who are already in pursuit of elevate service goals is that patient satisfaction is connected with patient compliance and clinical outcomes.

“If you make a patient unhappy and he doesn't come back, he'll have to start over, which at the very least will delay the course of treatment,” said Drew Gaffney, M.D., chief quality and patient safety officer.

Gaffney stressed that elevate is different from other broad improvement efforts because it began not with a ready-made formula for the rank and file to follow, but with changes at the top of the organization.

“The people leading VUMC are the ones who've been first to adopt elevate goals and strategies,” he said.

Another likely selling point for physicians, Gaffney said, is elevate's balanced approach. It centers around three-year institutional and departmental goals for staff and faculty satisfaction, job retention, clinical quality, service, growth and finance.

“Some physicians have complained in the past that as an institution we've focused too exclusively on growth and finance,” he said.

Members of Vanderbilt Medical Group will tend to become more engaged in elevate when they begin to see data about their own patient satisfaction levels, said Kathy Matney, a coach with Studer Group.

“Physicians are very competitive and like being able to do well,” she said.

During the last half of 2005, for VMG as a whole, the strongest correlates to patients' satisfaction with their physicians were (1) overall teamwork between doctors, nurses and staff, (2) respect for privacy, and (3) doctors' explanations of medical conditions and treatment.

According to Strategic Development, Web access to satisfaction data for individual physicians will be available soon.

Matney also noted that Studer clients and clinical researchers in general appear increasingly interested in studying the connections between patient satisfaction and clinical outcomes.

Service standards under elevate are packaged in a training program put forward by the Studer Group. Many patient care staff at Vanderbilt have already undergone training. The version for physicians sets out a number of basic recommendations, such as:

• always knock and pause two seconds before entering;

• greet everyone in the room with a smile and handshake;

• take opportunities to assure patients about the capabilities of team members;

• settle into a seat while listening to patient complaints and taking histories, the better to show attention and consideration;

• always tell patients when you'll be back and how long any test or procedure will take. Faculty will be hearing more about service standards as patient satisfaction efforts gain momentum.

Faculty seeking more information about elevate should contact their department chairperson. A link to the elevate Web site is found on the VUMC home page under “faculty and staff resources.”