“Holistic approach for patient satisfaction”- An innovative experiment at AIMS

Introduction:

The last few decades have witnessed fast economic growth and rapid urbanization in developing countries; this along with technological advances, including revolution in information technology worldwide has led to increased demands and new expectations of patients. Now increasingly knowledgeable patients armed with the information from media as a well as guidelines developed by health planners confront physicians with the expectation of quality care of highest standards. With technological innovations in medical field, patients have become so much obsessed and dependent on the technology that understanding the patient, his feelings and emotions has become a thing of the past. The sense of the growing gap between what patients want and what general practioners perceive as important has resulted in increased dissatisfaction of patients with the health care system.

The claim for the measure of satisfaction may be final common pathway for all health care outcomes. Over a life time, patient expectations of health care may change dramatically. Some patients may place more emphasis on technical competence where as others; fulfillment of personal needs, comfort, dignity and supportive services will be of paramount importance.

Understanding how things look through the patient’s eye should be central part of any quality improvement programme. Patient satisfaction is sometimes treated as an outcome measure i.e. satisfaction with health status following treatment and sometime as a process measure, i.e. satisfaction with the way in which care was delivered.

At Amrita Institute of Medical Sciences, satisfaction ratings reflect three variables:

• The personal preference of the patient in center of excellence
• The patient’s expectations
• The realities of the care received

About the Institution:

Inspired by her holiness Mata Amritanadamayi Devi, Amrita Institute Of Medical Sciences (AIMS) brings together a dedicated team of physicians, nurses and other health care professionals to provide the highest standard of medical treatment and compassionate care at affordable cost. They provide in a class healing environment for maximum patient comfort.

AIMS is a not-for-profit organization dedicated to establishing a center of health care of excellence and improving the well being of the community through quality programs of preventive medicine, medical education, and research. It is dedicated to establish patient friendly approach and is committed to reach out to community. Being 92% occupied each day reflects that patients are satisfied and their feedback is valued.

One dissatisfied patient who leaves a health care facility can result in the loss of $238,018 in income over the lifetime of the practice. ¹

Companies that have successfully satisfied all their client groups have increased sales by an average of 682%. ²

Missed appointments directly affect practice efficiency and the bottom line.

More than 200 Texas physicians who have never been sued for malpractice credit their flawless records to positive patient relations.

Out Patient:

The workflow of the out patient dept. has been designed to make consultations faster, simpler and as stress free as possible. As soon as the patient enter the hospital ” May I Help You” desk employees greet them and guide them to the right counter.

OPD registration acts as a triage point, manned by trained nursing staff, who listen to patient complaints and directs them to the concerned department. Custodial staff escorts each patient to respective departments by wheel chair/ trolleys.

OP’s are uniquely designed, where all ancillary departments are present adjacent to the waiting areas, hence unnecessary movement and valuable time is saved. Phlebotomy, Pharmacy and Finance billing, revisit appointment fixation, complete information to call back in case of an emergency, contacting patient movement services for comfortable escort to patients or arranging for an ambulance / taxi, can all be done at a single point in OP. A smoothly flowing appointment schedule minimizes waiting time and is a significant ingredient in our recipe for patient satisfaction and successful practice.

We accomplish the smooth flowing schedule (waiting time 5-10 mins) by:

• Not taking walk in appointments
• Leaving room in the schedule throughout the day for emergency call ins
• Allotting visit time according to the complaint
• Communicating to the patient the expectation that they must be on time
• Communicating clearly to the staff, the commitment to time schedule and gaining their cooperation
• Cross training all the staff to ensure maximum efficiency.

Referral letter is generated to the referring general practioner’s with complete treatment information about the patient to maintain continuity of care.

Medical Social workers are present in all Ops where they conduct individual counseling sessions as well as group sessions, formulating self-help group for chronic cases.

Educational resources such as video libraries and computer kiosks, interactive hands on educational displays, health and wellness classes and support groups provide information about illness and the therapeutic interventions designed to promote healing by Health Educator.

A fully networked and computerized hospital information system helps investigation reporting, prescriptions, scheduling, report generation and dispensing faster and hassle free.

Inpatient department

Physical facilities (décor, displays, cheerfulness of the facility) have been given importance in design at Amrita. Patient’s surroundings, ambience, natural lighting, ventilation and windows overlooking beautiful landscapes are also a patient satisfier. ³

There is a nursing station outside each cubicle for immediate response to patient complaints. There is Pre op and Post op segregation of patients and isolation rooms for multi drug resistant isolates and communicable diseases. Appropriate care is also taken to improve the accuracy of drug administration using at least two patient identifiers

Physician:

Committed and dedicated service oriented and professionally competent faculties have been appointed and they spend reasonable amount of time connecting with each patient as a human being.

Each floor has a Nursing Supervisor to supervise nursing and medical side of patient complaints and Floor coordinators promptly attends to the general or non-medical patient grievances. Regular nursing audits are performed in order to keep nursing competitive and up to date.

Well-trained physiotherapists attend patients at the bedside; dietary staff suggests therapeutic and non-therpeutic diets and counsels patients according to medical illnesses. Daily billing is practiced for all IP patients to maintain transparency in billing patterns, which makes patients/ bystanders comfortable to keep track of expenses.

Intensive Care units are well equipped, spacious and have comfortable waiting room. Each interventionist and intensive care nurse has been given special training on communication skills. Secluded counseling rooms are provided where briefing of family members takes place if necessary by the team of treating physicians, intensivists, nursing staff and MSW. The interventionist briefs treatment plan and progress of the patient to the attendant daily, in presence of treating nurse and MSW, which helps bystanders to get timely feedback.

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