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Lisa Romano RN, MSN, CNO CipherHealth

As an industry, we talk a lot about creating great patient experiences. While we have made tremendous strides around this important initiative, many patients still feel as if they aren't "heard" and their issues are not taken seriously and/or addressed. But, what if the "prime mover" to improving the patient experience was as simple as recognizing communication is an essential practice and is even a clinical intervention? When the voice of the Patient is placed at the center of care delivery amazing things happen.

Communication is as essential to healing as prescribed medications and other interventional therapies. Pain, Anxiety, Anger, Fear, and Sleep Deprivation weaken a patient's ability to heal. As negative emotions and anxiety escalate, patients channel energy away from their important healing journey. This loss of control manifests as heart rate and breathing escalate and pain intensifies. The body can enter panic mode which induces a "fight or flight" response draining precious healing resources of the already compromised individual. Patients' appetite is lessened and if food is not appetizing to them it is easy for them to just refuse. Basic healing principles are threatened: sleep, nutrition, rest and overall peace of mind.

Not surprisingly, even patients whose lives were literally saved by the care team; may report after discharge that they were dissatisfied with their care. It is hard for them to forget the state of high emotions while in the hospital. They may have been too sick to even remember the life-saving intervention, but they will remember the pain and fear during recovery that were amplified by poor communication and follow-up.

It is disheartening to the care team when this occurs, but the good news is, there are ways to prevent this from happening and improve patient satisfaction and perception of their patient experience. Some examples:

• Listen to the patient. Understand what it is important to them.
• Do what you say. If the patient communicates a concern, make sure it is addressed timely and effectively. Software tools can streamline the communication process and ensure that the voice of the patient is recorded for the next provider who cares for that patient.
• Demonstrate caring behavior. No matter how busy you are, the patient doesn't need to feel rushed. Let the patient know you are their advocate, that you care, and will make sure they are taken care of. Once the patient feels that caring message, it is critical that issue resolution occurs or they will lose trust.
• incorporate into the care plan the essentials of healing: room cleanliness, quiet environment to assist with healing sleep, nutrition that is palatable to the patient, reduction or elimination of pain, reduction of stress by giving the patient some control with allowing him or her to be heard and feeling the result of effective, timely intervention, recognition that they have care needs after discharge and that you will help coordinate a safe and reliable plan of care
• Understand their care needs after discharge and alleviate their anxiety by ensuring communication with the patient will occur even after they leave the hospital. The patient needs a lifeline to help them transition to self care.

While it can be frustrating for a hospital and health care professional to receive negative feedback from a patient, especially when they perceive a particular complaint as trivial. It is important to remember that "saving their life" doesn't equate to a satisficed patient. Whether or not a patient is satisfied is often a product of the experiences surrounding those life-saving interventions.

Considering that dynamic, how do we satisfy a patient and inspire patient loyalty? Is loyalty defined as high patient satisfaction rankings and choosing that provider again for future care needs? The reality is that healthcare is a business and the service provided must be exceptional if the hospital is to remain competitive and thrive in this challenging healthcare market.

While the majority of patients are grateful for the life-saving intervention and are forgiving of what might be thought of as the little things that weren't ideal, repeated exposure to less than ideal or having easy choices for alternate care providers makes it easy for patients to say I'm going to try a new provider or hospital. Telemedicine is an attractive option for many patients as they battle with illness, but still try to manage their daily life. Much of the frustration with care delivery begins with long wait times for initial care and inconvenience with getting appointments and then waiting once you arrive.

Providers and hospitals need to recognize that the old model of "this is my doctor and this is my hospital" are gone. Patients have choices and access to education to help them make informed decisions and be in control of their health.

We must earn loyalty through exceptional service both clinically and emotionally. We must earn that patient's trust and never lose it. We must keep them safe and make sure they feel respected as a person and that we care. When that happens, there will be no one more loyal than the person on the receiving end.

As CipherHealth's CNO, Lisa Romano, RN, MSN is passionate about improving the health of patients across the healthcare continuum. Romano brings more than 25 years of clinical practice, healthcare IT strategy, and healthcare operations experience to her current role. Prior to previous CNO roles, Romano spent 19 years as a nurse and hospital administrator at Lehigh Valley Hospital and Health Network in Allentown, PA, where she was responsible for all patient flow and transfer center operations as well as numerous quality and patient satisfaction initiatives.