- Dr. Rainu Kaushal – Chair of the Department of Healthcare Policy and Research at Weill Cornell Medical College and Physician-in-Chief of Healthcare Policy and Research at NewYork-Presbyterian/Weill Cornell Medical Center
- Moderator: Joyce Lagnese, Esq.
http://nxthealth.org/), an organization that seeks to impact healthcare via research and design, gave guided tours of the space. Highlights of the Patient Room of the Future included its sleek design, hidden storage spaces for supplies, sharps containers, and tablet technology, overhead lighting that could project clouds or rainbows (for serenity, to entertain kids), blue tooth and wifi capabilities so patients could access apps and education tools, a patient lap desk with a tablet screen embedded in it as well as side controls during meal times, and a convenient charger pad to wirelessly charge mobile phones. The bathroom was especially impressive, with features like moveable walls to make room for caretakers (or equipment like wheelchairs), hand rails and shower tools designed for stability and ease of use by caretakers and patients, a toilet with deluxe comfort features and the potential for bio-sensor technology, and a side table for personal items or use as a diaper changing station.
The lively panel discussion brought to light many pearls of thought when it comes to patient engagement, experience, and safety.
On communicating with patients:
The panel spoke about the importance of language, communication, and understanding. Dr. Kaushal, “We as the doctors need to try to understand the patient and and we as patients have to try to explain who we are to doctors”. Ms. Corina emphasized that it’s not about intelligence or acronyms (that both doctors and patients probably don’t know anyway), it’s not even just about health literacy, but communication and meeting people where they are. Dr. Duroseau echoed these sentiments, “The provider needs to make a connection with the patient in a language he/she can understand. It has to be language specific and age specific. Not one size fits all. You really need to understand who that patient is”. He punctuated this by telling the story of two patients, Patient A and Patient B, getting sutured in the ER. Patient A, who is told that some of the sutures may come out during the healing process (and no need to worry), will have a different experience and perception of care received than say Patient B, who isn’t given any advice or instructions.
Dr. Kaushal told the story of a patient who was hospitalized for newly diagnosed diabetes. Every day a nurse came in to show the patient how to inject insulin. She would draw up a syringe and inject “insulin” into an orange. The patient was discharged but came back several days later, with extremely high sugar levels. It turns out that the patient would inject insulin into an orange and then eat the orange.
Communication is a 2-way street. It’s about talking and listening, and more importantly it’s about understanding, regardless of literacy or education level.
On patient engagement:
For quality healthcare, the patient has to be at the center. Patients have to be integral partners. Dr. Kalnicki made the point that non-patient-centered care doesn’t exist. Patient engagment is important because a more engaged patient helps us prioritize what is important to them.
On the patient experience in NY:
Ms. Lagnese presented some information on healthcare in NY. When it comes to disease metrics, NY leads other states, but when it comes to patient satisfaction measures which includes communication with care providers, ability to ask questions and getting them answered, NY lags behind. NY does very well when it comes to metrics and technical aspects but there is work to be done in non-technical measures. Again, communication is key. It must also be noted that there is a direct correlation between patient satisfaction and liability.
On what healthcare can learn from other industries:
A lot can be learned from other industries, the hospitality industry is a great example. Dr. Kalnicki mentioned that the root of the word hospital is “shelter for the needy”. It’s about bringing back humanism to medicine and focusing on the patient experience and the healthcare experience.
On the role of technology in healthcare:
Technology is a tool and we’ve seen it used in the form of patient portals, social media support groups, and electronic hospital records. However, it’s not a panacea and cannot stand alone. Dr. Kalnicki said that we need “both the technical and the non-technical… alone, it’s like a great painting without a frame”.
Dr. Kaushal spoke about data vs. knowledge. What electronic medical records sometimes lose is clinical context, the “A” for assessment that is part of the clinical SOAP note. There is a richness in the thought process and the assessment. Access is not enough, you have to understand the value and clinical context of data.
Dr. Duroseau spoke about the need for leadership that understands both worlds (both tech and non-technical).
On pilot programs in place to enrich the patient experience and improve safety and outcomes:
The panelists spoke about different programs that are helping to improve the patient experience. One is the use of simulation labs to help teams work on decisionmaking and team processes inclusive of multi-disciplinary rounds. A second program was based on the fact that a majority of patients who are discharged from the hospital cannot identify who their primary doctor was, as they are often seen by residents, specialists, and allied health, so an online list was created, where care team members and patients could see a list with the names and photos of all caregivers. A third program was a formal caregiver support center where training was provided by volunteers who would adopt a caregiver, teach them tasks and provide resources that would be helpful post-discharge, inclusive of going over medications, cooking classes, guiding shopping lists etc.
It is clear that design, patient-provider input, communication skills,technology, and innovative ideas and programs will play a major role in improving the patient experience in NY. There is a lot of work to be done, but the future looks bright.