Driving patient loyalty is a complex task, asking organizational leaders to focus on the business priority as well as patient-centered care experiences.
As healthcare organizations work to increase patient loyalty to meet their business bottom lines, it will be equally important for clinical leaders to be mindful of the patient-centered strategies that will get them there.
After all, it’s those patients and their returning business that will keep a hospital or clinic afloat. Thinking about compassionate, coordinated care will be more important than any formula to business success, according to Thomas Lee, MD, the chief medical officer at healthcare consulting firm Press Ganey.
“Healthcare is no exception in that it’s organizations are better off if they take good care of people so the people keep coming back,” Lee, who is also a practicing internist and cardiologist a Boston’s Brigham and Women’s Hospital, told PatientEngagementHIT.com.
Purely form a business perspective, chief financial officers may be interested in looking at an individual patient’s healthcare dollars spent and seeing the percentage of those healthcare dollars that are spent at the CFO’s own organization. This is a basic measure of patient loyalty, Lee explained.
But driving patient loyalty is a far more complicated task. Decades of fee-for-service reimbursement models have made it challenging for organizations to prioritize activities that promote a positive patient experience and subsequent patient loyalty.
“The reimbursement system hasn’t rewarded loyalty per se. It hasn’t rewarded loyalty directly,” Lee said. “The fee-for-service system instead directly rewards doing lots of care and procedures. You have got to do it well, you have to do it safely, you have to do it efficiently, but it just rewards activity as opposed to holding onto people and taking good care of them over time.”
Fee-for-service payment models still accounted for over half (66 percent) of healthcare reimbursements in 2017, according to a 2018 report from the Health Care Payment Learning & Action Network (LAN). And in these models, organizations are still largely focusing on what they are paid for versus what they may not be paid for directly.
“The fee-for-service system is a distraction, at best,” Lee stated. “But even under fee-for-service, provider organizations still need to hold onto patients, so there’s been increasing attention over the last two decades to understanding what drives patients’ confidence that their care is as good as it can be given the cards that they’ve been dealt.”
And by paying attention to those factors, organizations – which are increasingly engaging in value-based care – are starting to prioritize patient loyalty.
But to truly achieve patient loyalty, organizations need to figure out the different factors that influence patient satisfaction and loyalty and deliver on those.
“You can think of loyalty as a business goal,” Lee noted. “That’s one of the reasons why healthcare organizations want to measure it. But in order to be successful in that business goal, you have to be successful in accomplishing some things which are more fundamental to what we want in healthcare.”
And while industry experts will agree that shorter wait times, digital appointment scheduling tools, use of other health IT, and clinic or hospital amenities can drive patient satisfaction, Lee said loyalty comes down to more than that.
All of those things are the “what,” Lee said, referencing the “why, why, how” framework outlined in Simon Sinek’s seminal TED Talk.
And patients are less concerned about the “what.”
“Our data show that if organizations get the ‘why’ right and the ‘how’ right, they can achieve patient loyalty,” Lee stated.
“The ‘why’ means showing that providers are really there to do the right thing,” he explained. “The ‘how’ is that the care is delivered with compassion, with coordination, that there’s good teamwork and good communication. All of our data show that patients will cut organizations some slack on the ‘what,’ like how long they waited for an appointment.”
But again, having enough time to make a compassionate connection with a patient and do the work of comprehensive care coordination remain some of the top challenges in healthcare. How can organizations deliver on these goals to create patient loyalty?
“Organizations are realizing that you need cultural transformation so that caregivers are highly reliable about delivering care the way it should be,” Lee stated.
This includes reliability in key factors such as patient safety and clinical quality.
“But you want to be reliable about safety and about giving care that is compassionate and coordinated and communicated well,” he said. “You want to be reliable about the how with which care is delivered.”
“The challenge that is being addressed directly is the need for cultural transformation into being a highly reliable organization, delivering care that is consistently safe, consistently compassionate, high quality and so on,” Lee added.
This will require an emphasis on provider motivation. Organizations must help providers see their jobs as meaningful and inspire providers in identifying what type of clinician they want to be.
“For physicians, nurses, and other personnel, the way to get them to be highly reliable about being the way they should be is to help them be the way they want to be,” Lee said.
This should not be prescriptive, Lee added. Instead of dictating to a provider, Lee recommended organization leaders help providers identify the characteristics they want to embody as a medical professional. This motivational technique can consist of four key questions.
First, leaders should ask what the providers hopes her patients say about their experience when they go home. Next, leaders can ask clinicians what needs to happen in order for the patient to walk away with a positive review.
After that, leaders should ask clinicians to reflect on the challenges associated with making patients feel positively about them as providers. And finally, clinicians should think of the different care team members who will be integral to achieving this positive patient outcome and whether the team knows about these priorities.
This is where the concept of provider loyalty and satisfaction comes in. A nurse or physician who is dissatisfied with their job, burned out, or not getting what they need from their organizations will be less motivated.
“Physician autonomy is a good thing and it’s something that’s very important to preserve,” Lee asserted. “Every patient is different and there’s no quality measure that defines the right thing to do for every single patient. You need physicians to be people who are in the position to make the decision and empowered to say, ‘this isn’t the right thing to do for this patient.’”
That means organizations need to prioritize physician satisfaction and recognize their importance as members of the care team as opposed to cogs in an assembly line. This is more than just being nice to clinicians; it means ensuring they have the autonomy to do the right thing for their patients.
“We’ve got a happy overlap of goals between the true values of patients and clinicians and business values,” Lee concluded. “Everyone wants patients to be loyal because their needs are being met. That also leads to caregivers feeling more pride and being more loyal as well.”
Date: June 21, 2019