Aiming for Optimal Vs Positive Patient Experience-If We Can Get Real, We Can Get Better!

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Granted there are some truly joyful times for patients and families that involve hospital or other healthcare experiences. nurse, doctor patient

Mr. Smith, your brain tumor is benign.  We should have no trouble removing it and you’ll be 100% fully recovered in a few weeks!

Mrs. Jones, your new baby boy is perfectly healthy and weighs 7 lbs 6 oz!

Mr. and Mrs. Brown, your son was in a car accident and is getting an Xray of his left leg.  He may be on crutches for a while but he’s going to be just fine.

We want to help and boy doesn’t it feel good when we can.  But sometimes, even with the best of care, positive experiences may be unrealistic.

Mrs. Smith, I’m sorry, the cancer has spread.  The colostomy will help to minimize pain for a few months, maybe longer.

Mrs. Jones, we need to get your baby boy into surgery right away, his heart is not working properly.  OR team surgery

Mr. and Mrs. Brown, your son was in a serious car accident and is in emergency surgery right now.  I’m going to see what I can find out for you. 

As with the distinction between bully and bullying, language is important.  Sometimes, projected anger or intractable grief may filter into surveys setting doctors, nurses, and organizations up for feedback that is misplaced.  As we continue to develop patient survey tools and best practices for patient experience, doesn’t it make sense to acknowledge that sometimes no matter what we do there will be tragic moments.  Bearing witness, silence, a gentle touch are helpful gestures that will minimize suffering and show compassion.  This, would lead to optimal patient experience, but not positive.

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2 Responses to Aiming for Optimal Vs Positive Patient Experience-If We Can Get Real, We Can Get Better!

  1. Hi Jim,
    Thanks for your feedback. I know you do a lot of work with employee surveys and wonder if you have additional an additional question or two you might frame for HCAHPS?

    I think part of the problem or maybe THE problem is that healthcare has become such a big and fragmented business machine and there is such an emphasis on $$$ that survey feedback is used to compete with other hospitals or to reprimand staff. I find these outcomes a little skewed b/c we go into the process without full understanding of problems and a clear intention that includes compassion and minimizing suffering. It get’s complicated! 🙂

    You might like this other post that raises questions about noise levels, another survey question.

    If we are going to create healthcare systems in the US that focus on health and care, we should most definitely include patient voices in the process. I think an approach that keeps these ideas in mind will help empower patients/consumers AND healthcare professionals and lead us to the best care possible.


  2. Jim Murphy says:

    Beth, you have made an important distinction very well. Communication is not a simple thing that can be captured by “yes-no” questions or Likert scales.

    If one considers the HCAHPS survey questions, they rate three communication variables: courtesy and respect, careful listening, and explaining things well enough to be understood. Those are very important, but minimizing suffering and compassion are obviously not included.

    Surveys capture impressions and are inherently superficial. So as you note, too much attention on such evaluative measures can actually take us away from primary question of “what are we trying to do”.

What are your thoughts?