What can Healthcare Communication learn from other Industries?


Date: 16th Aug, 2016

Spoke Person: Rohit MA, Managing Director, Cloudnine Group of Hospitals

India’s healthcare is criticized for it’s poor patient-provider communication. As unique a sector as this is, there are some useful engagement lessons that can be imported from other customer-centric industries.

Communication Gap

In today’s healthcare space, most healthcare providers (HCPs) face the competing challenges of minimal time for patient interaction and variable expectations. Ineffective communication is immensely widespread and can have dire consequences. Healthcare providers do not spend enough time talking with the patient. There are complaints that practitioners do not provide patients the opportunity or time to explain their issue, which often results in incorrect diagnosis and leads to patients not having enough information on their medical condition. HCPs neglect making sure that patients return from hospitals with clear instructions. Hence many patients tend to forget what they are told, leading to non-adherence and sometimes fatal outcomes. Furthermore, poor provider-patient communication is one of the prime reasons for medical errors. This culminates in a huge number of missed opportunities to deliver higher-quality and more cost-effective care. There is a plethora of examples from research which echoes this.

“Sharing of information and solicitation of outcomes are largely left within in the confines of the medical community with no proper guideline on how one can opine freely and thereby limiting consumer access,” says Rohit MA, Managing Director, Cloudnine Group of Hospitals.

Another issue is the lack of transparency in communication; from explaining information about diagnosis, treatment, follow-up in non-medical jargon to sharing the financial estimate. HCPs are blamed for focusing heavily on clinical aspects of treatment and ignoring their role as health educators. Despite this fact, communication training for clinicians and other healthcare professionals historically has received far less attention than clinical tasks.

Why Borrow?

Achieving the objective of enhancing quality, cutting down costs and improving patient experience can only be done with a significantly altered and superior communication strategy. While grappling with communication imperfections of our healthcare system in recent years, experts have started comparing healthcare to a variety of other customer-centric industries to pick best practices and operational models. Some innovative providers have even borrowed from best practices in other industries successfully. Though healthcare is a unique and distinct industry, some foreign lessons are beneficial even to us. Here are some communication lessons healthcare can import from other industries.

Lessons from Hospitality:

There are many touch points that that hotels consider, which hospitals lately have also incorporated. Lessons like providing a warm welcome, attending to the expressed and unexpressed needs of guests and cultivating a culture of five-star service can easily be adoptedby hospitals to make the patients feel more comfortable and at ease.

To minimise surgery anxiety, University of California San Francisco (UCSF) launched a pilot project where they send every neurosurgery patient a “preoperative expectations letter” (just as a luxury hotel sends all guests a pre-arrival letter) that is specific to their attending neurosurgeon and tailored to the surgery they will have. It is helpful to provide patients with as much information as possible regarding their upcoming admission, so that they know what to expect.

Zygourakis et al. complain that unlike hotels that review guests details beforehand and welcome them with “Welcome. We were expecting you,” hospitals know far more details about their incoming patients, yet have them sign in (often multiple times at multiple desks), wait hours in the admissions area, and typically greet patients with “Name and photo ID, please.” With the amount of information that hospitals have about their patients and their own waiting times, room availability, and physician availability, much could be done to improve this check-in process. Further, he says that a critical aspect of a patient’s hospital experience is their communication with physicians. A gesture as simple as the physician sitting down instead of standing at the bedside has been shown to make a difference. Patients think you spend 40 percent more time with them and appreciate the visit more. Just as the hotel industry provides customer service training to all team members, all hospital staff must be included in measures to improve satisfaction.

Hospitals are reinforcing increased provider-patient communication by employing chief patient experience officers, “hailed as the new executive must-have,” or medical communication specialists to improve overall patient experience. Henry Ford West Bloomfield Hospital in Michigan recently hired a former Ritz-Carlton executive as its CEO. The newly built hospital boasts private rooms, a chef, a concierge, and weekly classical concerts, all concepts adopted from the hotel industry. Massachusetts General Hospital has also implemented lessons from the Ritz-Carlton in order to create a “patient experience”. Many hospital executives are enrolling in to the Ritz Carlton Leadership Centre to bring their culture to their setting.

Lessons from Restaurants:

It is a well-known fact that standardisation of service has diffused from restaurant industry to many others sectors. Apart from this factor, there are many more things to learn; they take utmost care from the first point of contact; from booking an appointment, to greeting customers,creating a warm ambience and training servers to be polite and well-informed. Front of House and Back of House communication is another lesson that can ensure integrated care and eliminate communication gap. In the book, Setting the Table, Danny Meyer emphasises on capitalising on the last chapter i.e. how to turn a negative experience into a positive. What we can learn from this is that with many frequent errors in healthcare, HCPs should not give up easily and try to the last mile with small gestures to win back their patients’ faith.

Lessons from Disney

In the book If Disney Ran Your Hospital, Fred Lee proposed ways to bring the Disney culture of customer service to health care, which includes respect, compassion, politeness, courtesy and empathy. It talks about customer service to engaging “patients on an emotional, physical, intellectual, and, yes, spiritual level.” Dr. G. Swaminath, from Dr. B. R. Ambedkar Medical College, Bangalore, in his paper Doctor-patient communication: Patient perception writes, “Even for medicine, the empathic relationship is primary. Without a sense of connection and mutual understanding, physician-patient communication becomes an exchange of medical information divorced from the context and complexities of the patient’s life.”

Lessons from Aviation:

Because culture is a major driver of improving care, many organisations have adopted the aviation’s “just culture,” in which employees are encouraged to speak up about their own actions and the actions of others without fear of reprisal, thereby enabling the identification of appropriate causes of error.

Another lesson from aviation is the much talked aboutCrew Resource Management (CRM) programs that typically include educating crews about the limitations of human performance. It defines behaviours that are countermeasures to error, such as leadership, briefings, monitoring and cross-checking, decision-making, and review and modification of plans.

Lessons from Retail:

Go to Croma or Westside, you are greeted by an executive, who inquires what you need, takes you to the products, helps you choose it and bills it for you. These executives are knowledgeable and well-informed about all aspects of the products and thus help keeping an uninformed person informed. Malls have an information desk and a maps to all its retail outlets, cafes and restaurants to help lost shoppers. Same way hospitals can employ officers and kiosks to attend to the patient information needs.Another trait healthcare communication can borrow is focus on infusing loyalty through feedback and big data. Rarely, we see patients filling out patient surveys.

Lessons from Banking sector:

From the financial industry, we learned that health care must be automated. With Electronic Health Records (EHR), patients with chronic illnesses are able to track their diseases in conjunction with their providers. Collaborative disease tracking has the potential to lower communication barriers between patients and caregivers. It provides extra time for caregivers and patients to ask questions, to set up appointments, to request refills and referrals, and to report problems. “We have invested with Microsoft to enable a technology platform for better patient outcome. A lot of communication is now enabled through this platform and we are currently evaluating the impact of these measures,” says Mr. Rohit MA.

Just as banks employ executives to help their customers with paper work, hospitals too can make this a practice. There is ton of paperwork to fill for the sick and vulnerable patients such as admission form, insurance details, list of current medication and dosage and clinical test results.

Lessons from FMCG:

With the social media boom in the last decade, consumer products companies quickly realised that platforms like Twitter, Facebook and Youtube offered them a challenge and an opportunity. From simply being another promotional channel, they are engaging directly with consumers by responding to posts.

Lessons from Apple

Lessons from e-Retail:

E-retailers depend solely on technology to enhance communication; to connect and facilitate information flow. Many customer-centric e-retailers use the concept of “light out” engagement. “Lights out engagement enables patient engagement outside the clinical setting without the use of staff during the interaction creates a scalable patient support structure.” EBay is a brilliant example of this; this user-friendly platform allow shoppers to post questions and have them answered online; it sends automated emails to keep shoppers alert about their auctioned product, prompts winners via email, has a easy transaction process and asks for feedback.With this information already stored and its automation processes, a scalable operational support system is created. Healthcare communication will do well to adopt this practice to attend to patient information needs.

“Putting the customer first, every time” is why Amazon has emerged as one of the most admired companies in the world. Like many customer-focused companies, they view technology not as an end, but a means. “The health care industry has been behind the tech curve as it relates to putting the consumer at the center of care. We’ve been building, buying and installing tools and software stacks that keep the hospital at the centre of the health care universe a center that must shift to the patient philosophically and practically,” writes Ed Park, Recode.

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