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Family Communication - The Next Frontier for Improving Patient Satisfaction?

Sunday, September 29, 2013
Richard B. Siegrist Jr., MBA, MS, CPA Scripting, hourly nurse rounding, management rounding and discharge phone calls are among numerous strategies for improving the patient experience and related patient satisfaction scores. These strategies rightly focus on the patient and can have an important impact on the patient’s perception of the healthcare institution as well as the quality of care they receive. Yet many hospitals, outpatient facilities and clinics remain frustrated that after some improvements in patient satisfaction, their scores seem to be stuck at a certain level. Is there something that is being overlooked that could make a difference? That something may very well be family communication.

The patient’s family can play an important role in how a patient perceives his or her experience at a healthcare facility, either directly through family comments to the patient or indirectly through the patient’s view of how his or her family members are treated. Family members can also play a critical role in helping patients understand their condition, encouraging patient compliance with discharge and other instructions and in preventing unnecessary readmissions.  Furthermore, in an era of potentially declining admissions, family members are an invaluable source of future business for healthcare facility. Building family member loyalty may be a key success factor for the institution.

Hospitals and outpatient facilities are employing a variety of approaches to enhance family member satisfaction. These efforts may start with a patient and family council or committee, with family members as participants to advise the institution on what they can improve. The efforts may involve various social media or other technology solutions that facilitate better communication with and among family members. CarePages and CaringBridge are two examples of patient-related website builders to connect and engage family members and friends during a healthcare episode.

Numerous hospitals have implemented surgery patient tracking boards to keep family members and friends informed of where their loved one is in the surgery process. Other institutions have implemented text messaging services such as PatientTrak, MyCareText and FamilyTouch that send messages from the patient’s care team to family members with routine status updates. These approaches represent a technological advance from the more traditional pagers that have historically been used to contact family members. All of these solutions are designed to lessen a family member’s stress and anxiety through meaningful and frequent communication.

But does higher family member satisfaction translate into higher patient satisfaction? That remains an open question as there has been little research on that connection. Patient responses to HCAPHS questions related to nurse and physician communication as well as overall rating and likelihood to recommend are likely influenced in part by the way the patient sees their family members being treated. While one could argue that patients should really care only about themselves since they are the ones with the health issue, that is not human nature.

Expanded satisfaction surveys such as the Press Ganey inpatient survey do specifically measure staff attitude towards the patient’s visitors, with the ability for patients to add written comments. In a review of those comments using sentiment analysis, approximately 6 percent of patient comments relate in some way to respect and courtesy of staff shown to visitors (i.e., family member and friends). So, it is clearly something they find important enough to comment on. The comments tend to be some of the most positive comments as measured by the strength of the sentiment expressed, further supporting the importance of the family members’ experience from the patient’s perspective.

Anecdotal comments from family members receiving periodic text message updates from the nursing staff indicate the importance of family communication done well. One patient’s daughter commented “It is a great way to keep all family members notified of the patient's condition without all of us taking up the nurse's time."

Another patient’s daughter conveyed “I live out of town so being able to receive text messages letting me know how my mom was doing made it easier to be away.”

The wife of a patient said “It calmed my nerves.”

Given the documented importance of staff communication with patients, it shouldn’t be a surprise that staff communication with family members should be highly valued as well. Just as there have been numerous innovations in the last decade to improve the patient experience, we are likely to see a similar trend in innovation in family member communication.  The end result will hopefully be a better experience for patients and providers as well as the family members themselves.

Rick Siegrist is director of innovation and entrepreneurship and associate academic director of the Master’s in Health Care Management Program at the Harvard School of Public Health. He is also CEO of Avation Health, the provider of the FamilyTouch text messaging service. He was previously the CEO of Press Ganey Associates.

Tags: communication, HCAHPS
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