Physician Best Practices
Health Consumer Assessment of Health Providers and Systems (HCAHPS) collect satisfaction results based on patient visits to the hospital.
While filling out the survey, patients record their perception on how frequently surveyed topics occurred by selecting Never, Sometimes,
Usually, or Always. This handout was created as a tool to help you review Physician and discharge questions and best practices to make
the “Always” response more likely.
How does HCAHPS impact Physicians?
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HCAHPS allows potential patients to review physician scores online.
Resource: www.hospitalcompare.hhs.gov
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As early as 2015, physician relicensing qualifications may incorporate physician satisfaction scores.
Resource: http://intranet/SIOPResources/documents/ABMS%20-%20Maintenance%20of%20Certification.pdf
PHYSICIAN HCAHPS QUESTIONS:
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During this hospital stay, how often did doctors treat you with courtesy and respect?
During this hospital stay, how often did doctors listen carefully to you?
During this hospital stay, how often did doctors explain things in a way you could understand?
Best Practices to Make “ALWAYS” More Likely for Physician HCAHPS Questions:
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Introduce Yourself: by name, department, and role.
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Make Eye Contact: sit down, touch the patients’ hand/shoulder, and ask if the patient has any questions.
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Ensure that the patient is aware of the “what” and “why” of their tests, treatments, and procedures.
Be sensitive to NPO status; be realistic about likelihood of tests or procedures ordered.
Picture yourself in the patients’ shoes; look at the patients’ situation from their perspective.
Allow Time for Questions & Answers: avoid medical jargon when possible.
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Ask the patient if the plan makes sense. Do not “wonder” out loud and cause undue anxiety and tension.
Be honest about what you know – if you do not know, look it up and give answers within minutes, not days.
Be Sensitive to Patients’ Frustrations: be realistic about the likelihood of the test orders.
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To perceive concern, it must be visible to the patient.
READ Chart Communication (progress notes, etc.) before discussing the plan of care with patient/family.
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Patients respond negatively to physicians who do not make eye contact.
Sitting is perceived as a longer visit than standing.
Studies show that patients save the most troubling questions for the end of the encounter.
“Studies show 91% of patients want to be addressed by name; 78% want their physician to shake hands” (Annals of Int. Med).
Follow Isolation/Hand Hygiene Protocol by washing your hands or using hand sanitizer.
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Teaching hospitals have a big challenge to show “coordination of care” because of varying opinions of care teams.
If you are the attending team and you consult, let the patient know who and why you are consulting other teams.
Do not disparage other services, teams, or colleagues; this produces anxiety for the patient.
“Studies show 75% of hospital admits were unable to name a single doctor assigned to their care” (Archives of Int. Med, 09).
Demonstrate empathy and earn trust to create a positive physician/patient relationship.
Repeat your name/role at the end of the encounter so that the patient and family will remember you.
“Studies show the average time a physician allows a patient to speak without interrupting is 20 seconds” (Press Ganey).
Prepare the Patient for Discharge by telling the patient they will be discharged in the afternoon (2pm – 6pm).
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Avoid setting up your patients for disappointment. This is a HUGE and fixable dissatisfier for discharging patients.
“Studies show that 75% of discharges actually occur in the afternoon”.
Quarterly HCAHPS Focus
Discharge
HCAHPS DISCHARGE QUESTIONS (Never, Sometimes, Usually, Always):
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During this hospital stay, did doctors, nurses, or other hospital staff talk with you about whether you would
have the help you needed when you left the hospital?
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During this hospital stay, did you get information in writing about symptoms or health problems to look out for
after you left the hospital?
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During this hospital stay, staff took my preferences and those of my family or caregiver into account in deciding
what my health care needs would be when I left
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When I left the hospital, I had a good understanding of the things I was responsible for in managing my health
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When I left the hospital, I clearly understood the purpose for taking each of my medications.
A Standardized Approach to Make “ALWAYS” Responses More Likely:
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Acknowledge HOW the patient’s diagnosis and/or treatment may affect the patient after discharge
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Check with ALL other care teams to ensure everyone is on the same page before the patient’s discharge
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Discuss the patient’s medications/side effects and any follow-up appointments prior to discharge
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Discuss HELP with the patient, inform the patient of 74-NURSE, UMC’s 24/7 medical advice hotline
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Ask about concerns regarding discharge, address stated concerns
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Use the “teach back” method to ensure all patient questions/concerns are addressed.
TEACH-BACK METHOD
Studies have shown that 40-80% of the medical information patients receive is forgotten immediately and nearly
half of the information retained is incorrect. One of the easiest ways to close the gap of communication between
the physician and patient is to employ the “teach-back” method, also known as the “show-me” method or “closing
the loop.” Teach-back is a way to confirm that you have explained to the patient what they need to know in a
manner that the patient understands. Patient understanding is confirmed when they explain it back to you.
Resource: www.nchealthliteracy.org