The Patient Experience Value Manifesto

Only with all parties focusing on value for the patient will the industry make progress on this front. The challenges facing the healthcare system cannot be solved by any one discipline or entity. The federal and state governments cannot legislate their way out of the healthcare quagmire, and the private sector will also have a key role in this transformation.

The following principles address aspects of the patient’s experience that might cause patients to question or reaffirm an organization’s value proposition:

1. Chief Complaint Principle: Understand the chief complaint and display a laser-like focus toward addressing it. Patients expect to be provided with the best-known (evidence-based) options for addressing their chief complaint. In other words, deliver clinical quality care in accordance with the best-known scientific guidelines, affordably and sustainably. It is difficult to acknowledge value if a patient’s chief complaint is not resolved satisfactorily. The clinical outcome associated with the patient’s primary health concern must be satisfactory to the patient, the patient’s family, or other significant representative of the patient. 2. Hassle Factor Principle: Be sensitive to the inconvenience imposed on the patient by the system of care delivery, whether or not you are responsible for the inconvenience. Inconveniences may take the forms of waiting room temperature, scheduling error, staff error, physician running late, machine or equipment breakdown or malfunction, inadequate staffing, long wait times, delays in responding to call lights, excessive noise, etc. Ideally, there should be one place to go for all things healthcare. Hassles suck the life out of providers and patients and reinforce the perception of diminished value. 3. Safety Principle: Do no harm. Avoid anything that could make matters worse, unless the patient consents. Disclose all risks fully. Demonstrate how much premium you and your organization place on patient and staff safety. Negligence of any kind, real or imagined, makes the perception of value impossible. Make a commitment to safety, as demonstrated through things like hand hygiene, hospital-acquired infections, patient falls, mislabeled specimens, medication errors, etc. Each safety

concern weakens the patient’s trust in the quality of the service and psychologically devalues it. 4. Empathy, Sensitivity, and Compassion Principle: Demonstrate empathy, sensitivity, and compassion in your decisions, choices, attitudes, and communications with patients and their family members. A lack of empathy could erode trust, create patient dissatisfaction, and impede clinical outcomes—the cornerstones of a value proposition. 5. Post-Discharge Principle: Be genuinely interested in how the patient will care for himself/herself after leaving your facility. Provide tools for self-care, and offer the patient and patient’s family information that would help prevent a recurrence. Post-discharge calls and other followup calls reaffirm the notion of value. 6. Respect and Dignity Principle: Patients also value whether the doctor treats them with respect and dignity, as manifested in how the doctor listens and cares, and treats them. A patient, by the very nature of his/her complaint, is vulnerable. Any display of condescension or failure to make eye contact can leave the patient feeling disrespected.

In most cases, when a patient feels disrespected, the psychological impact leaves that person unwilling to entertain any idea of a value proposition. 7. Attention to Detail Principle: Pay attention to detail, especially toward the noticeable and unnoticeable, the visible and invisible, the spoken and unspoken, the consequential and the seemingly inconsequential.

Obsess over the so-called “small stuff.” Failure to handle the details can cause anxiety in patients and may lead to the perception of inferior service. 8. Price Transparency Principle: Be transparent about price, costs, and charges. Hidden charges and billing errors destroy your credibility as an organization. A perceived lack of transparency erodes the acknowledgment of value. 9. Whole Person Principle: Show interest in the whole person, even though medicine requires that you address the primary complaint.

Handoffs that do not include the management of care across the continuum of care diminish the perception of value. Every patient has unique needs and characteristics. Address the whole patient, by considering everything from therapy’s effect on functional and cognitive status, as well as a regimen’s complexity, to mental health and nutritionists, etc.

Go the extra mile. Show interest in the unspoken or peripheral issues or problems, even if the patient is not focused on them. When a patient

feels that you are only concerned about your piece of the puzzle and nothing more, they develop a fragmented view of value. When aggregated, that view leaves much to be desired. 10. Trust Principle: When trust is broken, any sense of a service’s value is highly compromised. Trust is vital to the perception of value. When trust is absent, the patient is forced into high levels of vigilance or the readiness to assert his/her autonomy. Trust animates the patient’s belief in the services, which can dramatically influence the perception of value. 11. Information Principle: Never underestimate patients’ desire for information. Even if a patient does not ask questions or seems incurious, he/she is still hungry for information regarding his/her condition and prognosis. The provider’s ability to elicit questions and address even unasked questions is a plus. In the end, information is an important piece of the question, “What did I get out of the experience?” 12. Communication Principle: It is difficult to acknowledge value in healthcare if communication barriers are not addressed. Barriers could be cultural, educational, psychological, etc. Effective communication requires that the provider communicates at a level and style that the patient would understand. It is important to patients and their family members to be invited to participate in decisions regarding the patient’s health. This level of communication makes it possible for the patient to acknowledge value in the services provided.

First, seek to understand patients by finding what and how much they know about their condition. When patients believe that you understand them, they tell you everything, and when this happens, the value of your service is boosted massively. One way to reach an understanding is to listen actively. Listening is perhaps one of the greatest tools with which you must increase your value with your patients. Communication can address many unspoken needs that could potentially make the patient and his/her family members feel at ease. 13. True Cost Principle: To accurately assess value, one must consider costs that accrue to patients and their families. It is imperative to consider out-of-pocket costs to the patient and family, non-medical costs and burdens to the patient and family, and the impact of a treatment on future costs. Other cost factors include deductibles, copayments, the cost of associated supportive care, costs due to lost productivity, the cost of travel, and the level of burden on family and caregivers.