No Satisfaction

“I can’t get no satisfaction,” the Rolling Stones famously crooned. Hospitals are finding ways to  improve patient satisfaction scores, but are these efforts also lowering costs and improving quality of care?

Apparently not. An article in Friday’s Hospitals and Health Networks reported on an study published in the Archives of Internal Medicine that found “happier patients cost more.”

The generated a lot of discussion at the recnet Patient Safety Congress. One critic of the article noted that it relied on data from an AHRQ (Agency on Health Care Research and Quality) household survey which was not tied to specific provider encounters.

Patient satisfaction, long a theoretical concern, has suddenly come into focus for hospitals because consumer satisfaction data will soon influence Medicare payments.

At the Congress, a RAND statistician said that (despite the recent study)  in general “a better patient experience is linked to better technical quality, better outcomes and lower 30-day readmission rates.”

Neeraj Arora, a research scientist with the National Cancer Institute, who spoke about his 20-year battle with Non-Hodgkins lymphoma, noted that patients are often looking for emotional support at a time of crisis and may look beyond clinical expertise.

Last year USA Today reported that the Disney Institute has been hired by a number of hospitals to improve customer satisfaction. The newspaper noted

Training cost ranges from about $1,300 for a few days of workshops to several hundred thousand dollars for intensive, year-long consulting work, Disney spokeswoman Stacey Thomson and hospital administrators say.

Hospitals and businesses that sign on with Disney are not necessarily looking to give their campuses a theme park makeover. Rather, the training focuses on more prosaic workplace issues, such as improving staff morale and learning to treat patients more as customers, hospital administrators and Disney representatives say.

“Patients don’t know if the MRI machine you’re using is the newest,” said Patrick Jordan, health care industry consultant for the Disney Institute. “But they can absolutely tell you the experience they had with the technician.”

It’s not just the MRI machine that patients don’t understand, it is the whole range of complicated, expensive diagnostic tests that are now available and which our risk-averse health system adopts and prescribes at will.

At some point, technologic complexity and individual service must give way to standardization to lower costs. We can look to Southwest Airlines and Toyota for examples in that area.

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