5 Healthcare Executives Discuss Maintaining Patient Relationships after Treatment: An HCE Original Report

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healthcareix-itunes-artworkRecently, HCE asked five healthcare executives the following two-part question: What are you doing to maintain patient relationships following treatment? And how does the hospital-patient relationship influence brand building?

Here is what they had to say:

Brian S. Bizub, Chief Executive Officer of Palm Beach Orthopaedic Institute, PA, in Palm Beach Gardens, Fla.

“In light of Obamacare and decreasing reimbursement and increasing regulatory requirements, it can be a challenge to give the patient the time and respect they need to build a healthy relationship with their physician office,” Bizub said in an email. “Many articles have been written about enhancing the physician-patient relationship, but what keeps patients coming back in the Baby Boomer era is the interaction of the staff from valet parking to collecting money at the end of the encounter.”

Bizub takes a three-pronged approach to addressing patient relationships post-discharge: customer service, staying on time, and providing follow-up.

Key to customer service is “ensuring the staff has the proper education, guidance, and resources for a positive experience with every patient… In my opinion, if the staff can connect with the patient by giving eye contact, introductions, and even providing a compliment over just handing a bunch of paperwork to them, that’s the beginning of the experience.”

Being respectful of their time is also important, he said. “A change of mindset is necessary from ‘They need me more than I need them’ from the front-desk staff to the physicians. Today’s patients are much savvier regarding their choices in healthcare providers. The Internet has opened up doors where patients can research physicians, physician practices, quality, bedside manner, and qualifications.”

All of this leads into follow-up, of course, which can include newsletters, thank-you notes, reminder cards, and providing education materials on your organization’s website, Bizub said.

“In orthopaedics, sending out a newsletter on a seasonal basis with information relating to accidents and preventative measures for sports or activities for the season has been found to be extremely beneficial. Ultimately, the patient’s overall experience is what keeps the patients involved in the physician’s practice. I look at all of our patients as my marketing staff. They are the salesmen and women that I could hire.”

However, this follow-up is not limited to his staff, he hastened to add. “I personally call every patient back regardless of the content of the message. It is important as the CEO to understand what is working and not working in the practice. A posted number allows the patient to call anonymously to the CEO and provide their experience, interaction, or advice because they are not afraid that it will interfere in their care.

“Long-term success comes from relationships and not interactions and encounters.”

Dr. Kishore Ranadive, Chief Executive Officer of Orlando Heart Specialists in Orlando, Fla.

Because most of Dr. Ranadive’s patients suffer from chronic heart disease, he said many of them are with him for a long time. As one of only six clinics nationally to have been awarded the 2012 Bridges to Excellence Cardiac Practice Recognition by the American College of Cardiology (ACC) and the National Center for Quality Assurance (NCQA), Dr. Ranadive emphasized the need to be meticulous with the data your organization is producing.

“The only way to prepare ourselves for a value-based system is to show your data, and one of the things we’ve been meticulous about is looking at our data, because that’s the only way to say you are better than someone else or you need improvement when your numbers are not what they should be,” he said.

Having adopted EMR 10 years ago, Ranadive said he and his team rely heavily on the information the EMR collects.

“EMR is not just a record keeper. It’s a report generator.”

However, he said it’s most important to secure the patient’s buy-in with you and your organization. If they don’t trust you, then you won’t get the outcomes you desire.

“A lot of these problems with cardiac patients are often not symptomatic, but are silent diseases that require a combination of medications that patients are less likely to take if they don’t trust you.”

Beyond open access and follow-up calls, Ranadive said two years ago Orlando Heart Specialists embarked on group sessions designed to educate patients on preventative care, diet, and nutrition.

“Success in delivering your optimum care is to make the patient feel that it’s a pleasant experience and that it’s not really like going to a doctor.”

David Kent, Chief Operations Officer of Cancer Treatment Centers of America at Southeastern Regional Medical Center in Newnan, Ga.

“We have an institutional philosophy that says, ‘Once you’re our patient, you’re always our patient.’ And that means even after you’ve completed therapy,” Kent said.

Following treatment, each patient is referred to CTCA’s survivorship program, which is led by a team of physicians and advanced practitioners. The purpose of the program is to help patients deal with the aftereffects of the disease and what it has done to their bodies.

CTCA also offers the Cancer Fighters program, which enlists CTCA patients and caregivers to go out into the community and talk with their friends and family about their experience with cancer and what can be done to prevent it, including the resources and screenings that are available.

The program extends beyond community outreach, though, into various levels of involvement and engagement, Kent said, including Cancer Fighters CareNet, which connects CTCA patients and caregivers with other patients and caregivers who are making decisions and seeking more information about treatment.

“Actually, a fairly large percentage of our patients come from that Cancer Fighters program,” he said. “So we really treat them as family on an ongoing basis.”

Kent’s favorite day of the year, however, is Celebrate Life, on which CTCA brings all of their patients who have reached that five-year survivorship mark back to the hospital for a party, complete with food and live music. The celebration focuses on what they have been able to do with their lives because they decided to fight back.

“We have hundreds of patients signed up for the Cancer Fighters network. We have hundreds of patients in our survivorship program. That will be thousands as we grow. Patients are absolutely taking control and giving us feedback. They’re voting with their feet on this. We put this out as a service offering and they jumped on this.”

Kent’s next goal is to reach out to communities without strong care networks, strengthening both CTCA’s impact and reaching new patients in the process.

Joe Lamantia, Chief Operating Officer and Executive Vice President of Administration

Sue Penque, PhD, ANP-BC, NE-BB, RN, Senior Vice President and Chief Nursing Officer, Patient Care Services

South Nassau Communities Hospital in Oceanside, N.Y.

With the inevitability of population health, Lamantia is focusing on South Nassau’s clinical service lines as one way of enhancing patient engagement. For example, these efforts include patients within the cardiology program who are being treated for heart failure.

Lamantia said his team educates patients about their condition throughout their stay and follows up with them 24 hours, 30 days, and then three months after discharge. But the most important component in this relationship has been the integration of home care.

Home-care personnel become involved prior to the patient’s discharge and are fully briefed on what the patient’s care team would like to achieve post-discharge.

“So when the patient goes home, the patients are hearing a lot of the same dialogue that took place in the hospital regarding their illness,” Lamantia said. “The home-care nurse is now a continued extension of the education that occurred at the hospital.”

Penque said South Nassau is also focused on communication with the patients’ physicians post-discharge.

“They are the first contact with patients that leave here so having that bridge with physicians, making sure they have discharge records, information about how their hospital stay was, is critical so they have that information when they see the patients as follow-up,” she said.

Since so many of South Nassau’s patients reside in nursing homes, Penque said she and her team have formed a similar collaborative with 12 nursing homes in the hospital’s market to keep them abreast of their efforts to prevent such issues as ulcers and falls.

Grateful patient programs are also important to South Nassau, Lamantia said. “There are patients who have suffered for a long time and now they’re healed and want to talk about it. So there’s a good opportunity to bring those patients back into the organization to have them meet with prospective patients, especially for the elective surgeries. They become champions of the program.”

For example, every other Thursday, South Nassau’s joint replacement program holds an education class for prospective joint replacement patients. During this meeting, they not only have the opportunity to meet everyone involved in their care, but they also have the opportunity to hear a past patient speak about their experiences with the program.

Additionally, South Nassau offers support groups for past patients, especially in their bariatric, mental health, and cardiac rehab programs. Last month, Penque attended the monthly bariatric support group meeting.

“They had 125 patients come to that support group,” she said. “They filled two auditoriums, demonstrating the strong ties patients feel with our hospital. These patients that had surgery five years ago were still coming on a monthly basis.”

These support groups not only offer exercise and education, but they also offer emotional support. And Penque believes it’s because of this personal connection that South Nassau has such a large market share in its region.

“If we weren’t doing this, we wouldn’t be seen as a community hospital and a hospital that’s giving back,” she said. “It’s a positive thing that we’re doing to maintain those relationships. It’s part of our mission statement to ensure that they’re maintaining their health. We don’t want patients to be coming back. We want them to stay healthy. The community sees us as constantly reaching out.”

Lamantia agrees. “I think focusing on service has always been important. Hospitals try to distinguish themselves from one another not only based upon the technology or the facilities or the investments they make in the staff, but in how the patients perceive the organization from a service standpoint.”

As healthcare executives, how is your organization seeking to maintain a relationship with patients following discharge? How do these efforts contribute to your brand building?

-by Pete Fernbaugh

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