THE QUALITY - CO$T CONNECTION

Tips to make your hospital patient-friendly environment

Potential areas of concern addressed

By Patrice Spath, RHIT
Brown-Spath & Associates
Forest Grove, OR

What can possibly be more frustrating than walking into a hospital and being treated poorly?

Poor treatment might come in the form of a receptionist who takes too long to acknowledge a patient's arrival because he or she is too busy laughing and joking with another employee. Or what about those overly complicated registration procedures that often confuse patients rather than help them feel at ease?

One of the many key responsibilities of a health care facility is to provide top-notch, high-quality service to its patients. Whether the patient interacts with the provider by phone or in person, the interactions should be patient friendly. Being patient friendly requires more than a smile and a pleasant manner. It requires that physicians and staff demonstrate a caring attitude to patients throughout the entire health care experience.

First impressions are often formed in the outpatient departments. That's where the majority of the hospital's customers receive services. For this reason, all outpatient areas should be routinely evaluated to determine where customer service improvements are needed. Potential areas of concern are discussed below:

The reception desk

Reception desks are the first point of contact for most patients. Their first impression, formed in the reception area, influences their attitude toward the entire organization. However, reception areas often are busy places; reception staff deal with queries that come in by phone and in person and also must welcome incoming patients.

To make sure someone is available to greet patients properly, it may help to separate the reception area and the task of welcoming patients from the registration area. If separating the areas is not possible and registration staff are too busy to provide a personal touch, volunteers could help with greeting and providing basic information to patients. It can be very useful for these volunteers to learn about the various hospital services so they have a better understanding of patients' needs.

Outpatient diagnostic departments

In outpatient diagnostic departments the waiting areas should be warm and comfortable, preferably with plenty of space. Upon arrival in the outpatient area, the patient should be told approximately how long they may have to wait. If there will be an unexpected long delay, patients need to know as soon as possible so they can rearrange their schedule or take care of other matters such as childcare or work arrangements. Waiting times should be monitored in all areas.

Patients coming to the hospital for outpatient procedures or diagnostic studies may be very nervous about what will happen. It is important that they are given information about the procedure, how long it may last and the effects it may have. The hospital should make available well-written patient information leaflets that include the following important information:

  • How long the patient will need to spend in the department.
  • What advance preparations the patient should make.
  • Whether patients may suffer any side effects.
  • Whether patients may need someone to accompany them — they will need to know this in advance.
  • Whether patients will be able to return to work immediately after the test or procedure.

Many patients feel self-conscious, insecure, and vulnerable during an invasive diagnostic test or procedure although they may not wish to admit to these feelings. It is important that staff are sensitive to this and that steps are taken to preserve the dignity and privacy of every patient.

Patients should not need to wear flimsy or ill-fitting gowns in public areas. A secure area should be provided for patients to store their clothes and other personal belongings. Changing rooms should be big enough for elderly or infirm patients to manage satisfactorily and should have doors wide enough for wheelchair access. If the changing area is too small or if it is necessary for the patient to change in the procedure room, use screens to provide a more private area.

All staff should avoid talking about other cases, individuals or clinical matters when patients are within earshot, or during a procedure. Discussions between staff should be kept to a minimum. It can be unsettling for patients undergoing a procedure to think that the professional's mind is elsewhere.

During outpatient procedures and diagnostic tests there may be several health care professionals (physicians, technicians, and nurses) providing services to the patient. Consistent communication between team members and the delivery of clear information to the patient is essential.

It is important to avoid giving patients or their relatives conflicting information and advice. Consider setting up standard protocols to ensure that everyone communicates the same information to the patient. For example, a protocol in the radiology department would state how long after any examination the report will reach the referring physician and how that physician will then contact the patient. Everyone should agree on the post-procedure instructions they will give patients to avoid conflict and confusion.

A real test of your environment is through the views of your patients. They have information that no one else can give you. Here is a patient satisfaction survey that could be used in the radiology department or adapted for use in other outpatient departments. You do not need to carry out large surveys of all diagnostic and procedural areas; it may be just as useful to focus on a certain area for a period of time and then conduct a survey in another area. Most patients will be pleased to be consulted about their experiences and happy to contribute to improving services for others.