(Originally posted February 18, 2018)
Doctors,
You may know about Methodist Mansfield Medical Center’s Patient and Family Advisory Council which began meeting in August, 2017. The aim of the Council (PFAC) is to enable collaboration between patients and family members (about a dozen community members), hospital leadership, and staff. PFACs allow patients and families to have a formal avenue to provide input into various processes that impact patient care and services in order to improve care delivery and meet hospital quality and patient experience target goals. In short, PFACs allow patients and families “to advocate for their care by sharing their input.”
The conversation of the January PFAC meeting centered around physician communication with discussion about the HCAHPS “physician domain” questions and the hospital discharge process. I want to share with you the comments relevant to the physician experience that came to light from the January Patient and Family Advisory Council meeting. This email and post is being sent to the entire medical staff, sub-specialists, and consultants, and I hope it will stimulate some conversation at our various department and section meetings.
Broadly two themes emerged from our January meeting:
- Patients want to know that we care about them
- They want things explained so they can understand
CARE (and RESPECT)
Right off, the community members said they wanted us to know that they are impressed by the fact that our physicians make the effort to fully meet patient’s needs and expectations, and that the community perception of MMMC has always been very positive.
That said, they want their physicians to be helpful, comforting, and understanding. When they come to the hospital they want to feel welcomed, and fully valued. For example, they don’t want to feel like they are being bothersome when they go out to the desk to ask a question.
They said that when you come in to the hospital or E.D. room, you’ve got to be prepared to spend time and answer questions. They expect their primary doctors and consultants to know what is going on. They want to know that you have read the chart or communicated with the other doctors involved in their care.
Also, one question they almost always want to know: When are you coming back? And they have a suggestion: Use the whiteboard!
EXPLAIN
Another theme involved having things explained in a way that patients and their families can understand, and they want to know what to expect each step of the way. Patients prefer to have things explained up front: “I don’t want to ask you questions…I want you to tell me exactly what’s going on.” As one member expressed: “you may do a good job, but you need to explain it so I can understand it.”
Another “huge issue” was clear communication regarding medications, especially if a patient is going home with big changes to their medication regimen. They said it needs to be explained clearly, both verbally and written, and again, they suggested using the white board.
To summarize in their words: “explain”, “show pictures”, “spend time,” “help me to understand exactly what was going on with mom’s heart,” and use simple terms like “it’s a heart problem,” or “it’s a water pill.”
PFAC, HCAHP, WTW?
These messages are very consistent with what you might hear from national patient advocacy organizations like the Southlake based Beryl Institute, and those organizations known for service excellence, like the Studer Group, or Cleveland Clinic. Importantly, these are also the themes that the Methodist system is focusing on for patient care, and that we are working on right here at Mansfield; take for example the introduction of the Physician Code, and the “Three Things” that can make a difference:
- Introduce yourself every time you see patients.
- Show patients that you listened to them and are concerned.
- Show patients that you took the time needed to help them understand.
Some issues raised by patients fall more to the responsibility of the hospital. Like improving the discharge process, connecting better with patient’s primary care physicians and making it easier for patients to follow up with them and specialists after discharge; and constantly striving to improve the patient’s understanding of medications. However, in all this, the “hospital” side of the equation needs our input and ideas.
The next PFAC meeting is in April. Members will be expecting to have some follow up and they’ll want to hear what we’ve done with this information. So, again, I hope this feedback from the community will spark some good conversation, even if it’s just in the physician’s lounge — maybe that’s the best place for it. In the meantime, try out these “Three Things,” see if you think they make a difference, and let me know.
Thanks,
Paul Lansdowne, MD