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Friday, December 9, 2016

Value: The Missing Piece to the Puzzle to Improving Our Healthcare System







According to the latest news reports, National health expenditures will hit $3.35 trillion this year, which works out to $10,345 for every man, woman, and child in the United States. As a result of escalating healthcare costs, there is a mandate for all healthcare providers to demonstrate value for the services and products they provided.

Healthcare professionals are turning to each of us (the end user and consumers of health care services) to learn what we expect from the healthcare providers? What constitutes value for you in health and healthcare?  

Measuring the value of health care services is difficult as value is different for each person. This is because most people do not equate health care services the same way as we do other services. For example, if you go to a restaurant and do not get good service you probably will not go back to that restaurant. In healthcare, we (the consumer) tolerate long waits and what we may consider inferior services because we don’t feel there is any recourse. We tolerate things in healthcare, or at least we used to.

Today, consumers are responsible for more of their healthcare costs. As a result, they are demanding more from providers. They want to receive information that allows them to make decisions on care options. They also want to be treated with respect and receive timely communications about their care. They want to be valued as a person. Individuals who don't feel appreciated by members of the healthcare team are changing providers. When a person does not feel valued, they will seek out providers who they can communicate with and who shows concern for them as a person. In other words, consumers are starting to treat healthcare like other services they receive and expect more from the health care providers they choose. Those who can meet these demands will do well. Those who do not provide value in the services they provide will not do well in today value-based healthcare system.

In a post a few months ago in Nurse Advocate, titled the Waiting Game, I shared a frustrating experience I had when I was made to wait to see my doctor with no word from the staff as why or how long I would have to wait. I wrote I did not feel valued by the healthcare team at the clinic where I was receiving care. I wrote this post because I know waiting is a common problem many people experience and wanted to call out to fellow patients, caregivers, and other healthcare professionals that this type treatment is not acceptable and needs to be recognized and corrected.  One of the comments I received from the post that was eye-opening to me and showed me that we, as a customer, should expect more from healthcare providers who care for us. We all have choices as to where we receive care and should exercise our options when we do not experience the type of care we expect.   

Here is the comment: Anne, I have to wonder why you continue with a doctor who treats his patients this way. I see a fine cardiologist and never, ever wait. I even stopped bringing a book to read. I asked him why I never wait and he said because he waited once for 2 hours to see a doctor and swore he would never do that to his patients. I switched all my doctors who made me wait and found perfectly competent clinicians AND feel respected. Long waits don't automatically mean they are "good." It can mean that they are careless, unorganized or don't care. When I was pregnant, I was often the cause of doctor back-ups. My complications (which often led to miscarriages and early deliveries) allowed me preference, and I would go right in. If this is the case at your doctor, and they told you there was an emergency, it would be another story, and you might be grateful for a caring physician. If there is no reason, and we allow doctors to treat us this way, we are part of the problem.

The comment raises important points that we as consumers of healthcare should keep in mind. Our time is valuable and should be respected. Providers should keep us informed when there is a delay in an appointment time and offer alternatives if the wait is excessive. This is common courtesy that should be standard of care for all healthcare providers and organizations. 

Currently, the system is set up to meet the needs of the providers and not the consumer. This is changing, and your input when problems occur is important to share so that providers know what you expect from a provider. If we want the system to be better, it is up to each of us to make our concerns heard. Here are some the ways you can address issues and challenges when you use the healthcare system. 

·        Talk to a member of the staff in a position to address a challenge that you are facing. Most physician offices have an office manager who is in a position to hear patient concerns and take action. The office manager is usually in the background so you will have to ask to talk with the office manager. Don't be intimidated; it is like asking for a supervisor when you call a vendor on the phone, and you are not getting the information you need.
·      
       If you are a patient or a caregiver in the hospital and have a concern, ask for the Hospital Patient Advocates or the Patient Representative. Many people are afraid to tell a nurse or the doctor about a problem they are having as they fear retaliation. Today, most hospitals have Hospital Patient Advocates who are in place to address patients and their caregiver concerns or complaints. Hospital Patient Advocate is available in place to resolve issues and bring these matters to the people in charge who can correct situations.  
·       
       When you are asked to share your opinion in a survey please take your time and answer the survey honestly and make recommendations that can improve the system. Sometimes you can see a solution better than the people who work in the system.  There is lots of attention paid to patient surveys as reimbursement is tied to them. 

·       To ensuring patients and caregivers have a positive patient experience, many organizations now have put into place, a Patient Experience Officer. The Patient Experience Officer many times can be a physician or someone in a high-level position who is responsible for addressing concerns from patients and caregivers. Check to see if the hospital you use has a Patient Experience Officer. They are another good contact for you to keep in mind.

·       Many organizations have put into place Patient and Family Council Meetings. In these groups, patients and caregivers come together and share information with the principal members of the team to improve processes and services. Your opinion is critical as many times the staff at the hospital, clinic or doctor's office do not see how the system works from your point of view. 

Organizations are taking an active role in educating patients, caregivers and all who use the healthcare system on Patient Safety. Many patient safety offices and risk management professionals know that getting the patient more involved in their care is critical to decreasing medical errors.

One organization doing good work in this area is PULSE: Patient Safety, Advocacy, and Support. PULSE provides patients, and the family and friends of patients, the opportunity to partner with their health care providers, to help to ensure the best possible outcomes in a person’s medical care.

In closing, keep in mind we are all consumers of healthcare. Therefore I urge you to use your voice and be part of the process to ensure our health care system is delivering valuable services and products to all.


Have a good week!