How Do Patients Define Provider Quality?

Ask any doctor, and they'll likely admit that they're always striving to improve the patient experience, but it's not something that dominates their busy, day-to-day work. When looking at such an overarching issue in the health care realm, you can't expect medical professionals to chip away at the problem. At the same time, provider quality doesn't improve on its own. So what can the hardworking people in the industry do to balance their constant workloads with big-picture dilemmas?

Bettering the patient experience means taking an active look and soliciting feedback from those whose opinions matter most of all: the patients. In the end, you want them to feel as happy and satisfied as possible, but it's so important to recognize that those feelings aren't entirely related to health outcomes. The metrics in assessing high-quality care and provider quality are not simply defined by the speed of recovery; it's also the path toward recovery that contributes to the overall impression, which is governed by any number of elements.

How was the patient's interaction with doctors and staff? Did the patient feel listened to and a part of treatment decision-making? Is there anything -- whether a part of interactions or administrative steps -- that the patient would change? Answers to questions such as these illuminate the process's successes and pain points in the patient's eyes, generating the precious feedback needed to make valuable changes.

Defining Patient-Centered

In 2001, the Institute of Medicine outlined six key attributes that define effective health care: safe, effective, patient-centered, timely, efficient, and equitable. And while it goes without saying that provider quality is dictated by safe, effective, and efficient health care, we are still learning how to apply a patient-centered approach. Whereas the health care of yesteryear had clearly defined roles -- the doctor treated and the patient listened -- a patient-centered approach is where the care provided "is respectful of and responsive to individual preferences, needs, and values, ensuring that patient values guide all clinical decisions." Thus, to apply a patient-centered approach and be in compliance with the core tenets of effective health care, further clarity must be gleaned regarding those individual patient preferences.

What Are Your Patients Thinking?

A 2003 article published in the British Medical Journal revealed five widespread needs for an effective patient-doctor relationship: better eye contact, a partnership regarding condition and treatment discussion, clear communication that's free of jargon, more time spent with the doctor, and efficiency in booking appointments. But do all patients want these things? A highly cited study published in the Journal of General Internal Medicine actually indicates that you can't come up with umbrella patient needs, concluding that patients "vary substantially in their preferences for participation in decision-making." Accordingly, it's encouraged that providers "not assume that patients wish to participate in clinical decision-making" and "assess individual patient preferences and tailor care accordingly."

By using existing research to guide clinical decision-making, your practice will be closer to the forefront of evidence-based medicine. But what is crystal clear from the study cited above is that relying on external research to guide how we treat and interact with our patients is not sufficient. Just as we aim to apply innovative, unique approaches to care, we need to recognize our patients' individuality.

In this situation, your patient base is your best source of data. Take time to get to know their preferences. The more you discuss key pieces of the health care process, the better chance you have at enhancing provider quality and emphasizing a patient-centered approach.

Center your questions to patients around the following areas:

• Decision-making. How involved do you want to be in the decision-making process?
• Information. How much information do you want regarding your condition?
• Time. For a typical checkup, how much time would you like to spend with your doctor?
• Scheduling. How far in advance are you willing to schedule a (nonurgent) doctor appointment?
• Wait times. How long is too long to wait in the waiting room?
• Relationship. How would you define a good doctor-patient relationship?

By treating patient preferences on an individual basis and being open to making changes based on those preferences, you're following a classic patient-centered approach. But you can't make positive changes until you know what patients think. Don't rely on overarching surveys, as you'll only get mixed messages. The key to improving the patient experience is gauging -- and responding to -- how each of your patients is feeling.