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Getting back to the ‘basics’ of patient experience in 2023

The pandemic brought about seismic shifts in the healthcare industry that, today, are still impacting how clinicians and patients interact with each other—and with healthcare as a whole. Patients are the center of healthcare, and creating a positive patient experience is always top of mind. But organizations, facilities, and caregivers are struggling to find their footing after the past few years. With unprecedented turnover in all areas of healthcare, refocusing on improving the patient experience, and establishing a foundation for future positive patient experiences, is tough.

How to build patient trust by prioritizing empathy

A positive patient experience starts with building trust. We need 100% trust in healthcare—which is no simple feat. To build patient trust and a positive patient experience, clinicians and caregivers must quickly establish a personal connection supported by a feeling of competence in their role. Doing this doesn’t take long—in fact, it takes under a minute to provide Compassionate Connected Care®. In high-pressure environments, where employee burnout is up and violence in the workplace is increasing, forging and fostering human connections is an imperative—not a soft skill. But it’s not the only important piece of creating a positive patient interaction and experience.
In March of 2020, I was diagnosed with breast cancer. There’s no history of breast cancer in my family, so when I felt a lump in my breast, I assumed it was a cyst and not much to worry about. At the time, my job was demanding and I traveled frequently, which made scheduling a mammogram low on my list of priorities. After many months of ignoring the lump, I finally had a mammogram and biopsy. I wasn’t concerned and waited for the call to tell me next steps for the treatment of a cyst. After weeks, I had not heard anything. When I reached out to the clinic, they apologized and said they had lost my phone number. They asked me to hold for the radiologist—who turned out to be a friend from college. We spent 20 minutes catching up on the past 25+ years, laughing and reconnecting. He absolutely established a personal connection. Then he simply stated the facts: “Hey, bad news. You have cancer.” Time stopped, and I could feel the floor drop away.

Why healthcare workers must use Compassionate Connected Care

What came next was a well-intentioned attempt to make me feel better about the situation. He told me that even though I had a less common type of cancer, this was routine. I would need a simple procedure followed by a few weeks of radiation. It was “nothing to worry about.” Unfortunately, that's not what happened. Although today I am doing well and happy to be back to my regular routine, my treatment was far from what was described and, in fact, was something to worry about.

It's not enough to connect personally with patients. We must connect in an empathetic way and be mindful of the weight of our conversations, the need for a pause to consider what's happening, and, at times, even using humor when it’s appropriate. We must be mindful, ensuring we are humanizing healthcare—not by trying to make someone feel better in the moment, but by letting them know we are in this together, and we are here for them, no matter what.

We must be mindful, ensuring are humanizing healthcare—not by trying to make someone feel better in the moment, but by letting them know we are in this together, and we are here for them, no matter what.”

Jami Momberger
Senior Associate, Strategic Consulting, Press Ganey

COVID-19’s long-lasting impact on patient experience

During the height of the pandemic, healthcare workers were overstressed and scared, patients were terrified, and families were unable to visit loved ones in the hospital or accompany them to appointments. Building personal connections in an empathetic way is hard enough during normal times. During a global pandemic it requires a heroic level of empathy. Amazingly, many clinicians dug deep to connect personally with patients and families. They put themselves in their patients’ and families’ shoes when it was harder than ever to do so. Despite long, grueling shifts, emotional and physical exhaustion, missing their own families, and the pain of loss and uncertainty, caregivers continued to show up for patients, going above and beyond in the face of great adversity.

The pressure to consistently lead with empathy—combined with exhaustion, compassion fatigue, and everything else that COVID-19 brought—took a toll. Many of those heroic healthcare workers couldn’t sustain the physical and mental load anymore, and their mass exodus from healthcare left organizations scrambling to fill positions.
The nursing workforce in particular has struggled to rebound from pandemic-related challenges. The so-called “great resignation” stripped many healthcare organizations of high-performing nursing talent. The current turnover rate for staff RNs is over 27%. Those who were trained during the pandemic—i.e., who did their clinicals virtually, who entered into the practice when families and loved ones couldn’t visit in person, who began their careers when so many people had to rely on ventilators to survive—had very different patient interactions with patients than clinicians who were trained prior to the pandemic, or those being trained now. While younger and early-tenure nurses are the most likely to leave, there’s a new gap in nursing leadership, and organizations have big shoes to fill.

Despite long, grueling shifts, emotional and physical exhaustion, missing their own families, and the pain of loss and uncertainty, caregivers continued to show up for patients, going above and beyond in the face of great adversity.”

Jami Momberger
Senior Associate, Strategic Consulting, Press Ganey

During the pandemic, training on how to create a positive patient experience was not as important as the laser-focus on the primary objective: keeping people alive. Once the immediate crisis had passed, high workforce turnover created new problems in the patient experience realm—including communication issues among nurses who did their clinicals virtually and doctors who started out when many patients were on ventilators. Now, even systems and facilities known for their strong patient experience methodologies and training programs are starting over, and rebuilding from scratch.
With life returning to some level of normalcy, or at least stability, it’s time to refocus on improving the patient experience by helping healthcare workers make empathetic human connections with patients. We have seen this firsthand at Vanderbilt Health, when they committed to personalizing the patient experience and saw an increase of 50 points in their urgent care facility database percentile rank.

How to use the ‘4Cs’ to focus on improving the patient experience

Some days, no matter how passionate clinicians feel about humanizing healthcare, they may not be in a place where connection is easy. Healthcare is a high-stress, high-stakes industry. It moves quickly, and organizations often face a longstanding challenge: too many patients, not enough caregivers.

The best approach is to create standard processes focused on humanizing patient interactions that become routine. How do you greet someone warmly if you’re having a bad day? How do you make sure patients understand their treatment plan? And how do you make sure those patient interactions, and all of the others you have with them, are part of your muscle memory?

Press Ganey’s “4C model” brings intentionality into every aspect of improving the patient experience, from learning about test results from the doctor, to nurses changing shifts, and everything else in between. Healthcare professionals who integrate the 4Cs into their everyday routines are much more likely to provide Compassionate Connected Care by creating consistent, positive patient interactions.

The 4Cs are:

  1. Connect. Offer a warm welcome and begin building a personal relationship. Communicate in the most appropriate language, using an interpreter if necessary. Talk to the patient, not about the patient. Use plain language. Make eye contact. Include loved ones if they’re present.
  2. Check. When discussing the patient in their presence, make sure the patient is part of the conversation and understands the terms we use. For example, during a shift change, when the nurses perform a head-to-toe check that includes a pain assessment, the patient should be asked to evaluate the effectiveness of their treatments. Additionally, safety checks should be narrated so the patient understands what staff members are doing.
  3. Concerns. Acknowledge patients’ and family members’ concerns. It can be all too easy to follow the clinical plan during a shift, without explaining that plan to the patient using language they understand. It’s critical to bring them in, and to ask what they need or expect to happen. Agree on an action plan.
  4. Commit. Ask if there are questions or concerns and discuss any other needs. Then let patients know when you will return and offer a sincere farewell. Reaffirm that we’re in this together—that we are one team.

Bedside shift change handoff is a great example of where the 4Cs can make a difference. During bedside handoff, it’s easy to fall into medical shorthand that patients won’t understand and have a conversation about the patient, not with the patient. Using the 4Cs establishes a clear process that builds muscle memory and prioritizes empathy and Compassionate Connected Care, even if a clinician isn’t having their best day.

Imagine if my radiologist had used the 4C model. He was well intentioned, made a connection, and tried to make me feel better when he said there was nothing to worry about. It was routine. But if, instead, he worked to provide Compassionate Connected Care in a personal way, making sure to check his tone and my understanding of the situation, delivering the news in an empathetic way, addressing any concerns that would naturally arise after hearing this type of news, and then commit to a plan of next steps, but not assured outcomes, it would be an intentionally designed interaction, and the impact would have been much different.

The best approach is to create standard processes focused on humanizing patient interactions that become routine.”

Jami Momberger
Senior Associate, Strategic Consulting, Press Ganey

These simple interactions have lasting effects on patient loyalty. After several other hiccups in my care, I decided to leave this organization (a large, well-respected healthcare system). The trust had been fractured too much to continue—there were too many well-intentioned interactions with unfortunate, unintended impacts.

Helping clinicians and caregivers find positivity and intentionality in their work changes the way they show up, and how patients and families experience care. Many healthcare organizations are recommitting to improving their employee engagement—and, in turn, improving the patient experience. One example of this is Emory Health, a top healthcare organization that uses employee feedback to drive resilience, engage their teams, and bolster professional governance among staff. “Professional governance is critical to giving nurses that autonomy to be able to work on things that make care better for patients,” says Sharon Pappas, Chief Nursing Executive, Emory Healthcare. When committed, intentional, and engaged caregivers show up wanting to do the right thing with the right tools, it makes all the difference in building a positive patient experience.

Press Ganey’s strategic consulting team can help your organization deliver a first-class patient experience, equipping clinicians with practical strategies to provide empathetic and Compassionate Connected Care. Reach out to our patient experience and employee experience experts to learn more.