Patient-Centered Care Runs More than Skin Deep

June 29, 2017

A flutter of the drapes causes you to stir, bringing into focus a rippling of light and shadow along a mahogany paneled wall. Your eyes drift across the lavish décor of your suite and slowly come to rest on a crumpled mass of pale green sheets lying on a futon couch nearby. Almost immediately the cheerful hum of Vivaldi’s Four Seasons fills the room, followed by the soft patter of footsteps.  “How are you feeling this morning Mr. Banks?” A familiar voice intones. “I’ve brought you the Sunday Times; shall I put it on the night table?” “I’m feeling much better this morning Tanya, thank you for asking. Ah, yes, on the table is fine.” “Are you ready for your breakfast? We have fresh fruit and Yogurt parfait for you and a ricotta and tomato breakfast burrito for Mrs. Banks…she went out for a short walk in the gardens you know.”

As you reach for the newspaper a jolt of pain strafes your left leg, a vivid reminder of what you went through just twelve hours earlier.  “Mr. Banks, it’s good to see you’re awake.  Dr. Smith strides through the room holding a clip board and surveying your bandaged leg.  Your knee replacement surgery went just as planned.  As long as you do your exercises and follow Tanya’s instructions you’ll be out of here in no time.”

From Hospital to 5-Star Hospitality

If the previous scenario sounds to you like a bizarre episode of The Suite Life of Zack and Cody meets General Hospital, you are not far off. While some of the best hospitals in the world are utilitarian in their design – often for very important reasons such as infection control or large patient volume, a growing number1 of hospitals are shedding their cold impersonal aura to compete for consumers with amenities and services more akin to a Four Seasons Resort than a typical hospital.

The Apollo Hospitals Group in India2, for instance, in addition to their regular hospital rooms, also feature lavish suites that can house wealthier patients in luxury with personal attendants, interpreters, a well-stocked pantry and dining table. Hospital rooms in Dubai will soon come with touch-screen entertainment and communication systems that allow patients and companions to watch TV, play games, order meals, request extra pillows and even call for an interpreter.3  At a Medical Center in Denver, delivery rooms have private bathrooms with Jacuzzi tubs, birth balls, rocking chairs, squat bars, and flat-screen TVs. After giving birth, mothers can enter one of facilities six luxury suites, where they're offered the services of a private chef.4

Defining Patient-Centered Care

But while all these perks and amenities are nice – and patients certainly like them, are they a true reflection of patient-centered care?

Patient-centered care can be defined as a healthcare setting in which patients are encouraged to be actively involved in their care, with a physical environment that promotes patient comfort and staff who are dedicated to meeting the physical, emotional, and spiritual needs of patients.5

In other words, patient-centered care goes far deeper than aesthetics, perks and amenities, nor is it characterized by individual programs or initiatives. Instead, it is driven by the core values and attitudes behind the implementation of such programs. According to Planetree, the global leader in advancing patient centered care, “Patient-centered care is about engaging the hearts and minds of those you work with and those you care for. It is about reconnecting staff with their passion for serving others. It is about examining all aspects of the patient experience and considering them from the perspective of patients versus the convenience of providers. Ultimately, it is about a collective commitment to a set of beliefs about the way patients will be cared for, how family will be treated, how leadership will support staff, and how staff will nurture each other and themselves”6

The benefits of patient-centered care

The basic premise that patient centered care is integral to the overall quality of care received by patients has been established for quite some time. But can positive patient experiences lead to better clinical outcomes?

Several recent studies suggest they do:

  • A review of over 306 hospital referral regions indicated that hospitals with lower overall ratings by their patients also tended to have lower technical quality measures 7
  • An article published in the New England Journal of Medicine suggested that hospitals with high levels of patient reported ‘care experience’ provide higher quality clinical care across a range of conditions.8
  • According to an article in the Health Services Research Journal, higher patient ratings of experience of care have been associated with lower mortality in patients with acute myocardial infarction.9
  • In a study of 927 US hospitals, strong relationships between patient experiences and technical measures of quality and safety were noted including better patient experiences being associated with lower infections due to medical care.10

There is also a growing body of evidence that patient-centered care improves financial performance. According to a recent report by Accenture, a well-known strategy and consulting organization: “A superior customer experience doesn’t just strengthen patient engagement — it also correlates to 50 percent higher hospital margins.”11 In 2016 Deloitte reported:

  • Hospitals with “excellent” HCAHPS patient ratings between 2008 and 2014 had a net margin of 4.7 percent, on average, as compared to just 1.8 percent for hospitals with “low” ratings.12
  • Hospitals with better patient ratings earn disproportionately more revenue per patient day than those with low ratings13

Studies such as these and others are slowly but surely opening the collective eyes of the healthcare industry to the health and financial benefits of focusing on patient-centered care.

What is the takeaway for healthcare providers targeting medical travelers?

There is nothing wrong with offering traveling patients and companions lavish hospital suites and gourmet cuisine – if you have the resources and that’s what your patients are asking for (you may also need to consider more affordable options for other patient groups), then more power to you. Glitzy facilities and 5-star pampering can certainly enhance the medical travel experience.

[1] https://www.nytimes.com/2016/08/02/business/making-hospitals-more-like-hotels.html?mcubz=2&_r=0.

[2] http://timesofindia.indiatimes.com/india/Some-hospitals-beat-five-star-hotels-in-luxury-and-tariffs-too/articleshow/34701940.cms

[3] http://www.thenational.ae/uae/dubai-health-authority-gives-patients-entertainment

[4] https://ca.style.yahoo.com/blogs/parenting/most-luxurious-birthing-suites-america-160300064.html

[5] Charmel, P., Frampton, S., “Building the Business Case for Patient Centered Care.” Health Financial Management Association. March 2008.

[6] Patient-Centered Care Improvement Guide. Planetree and the Picker Institute. http://www.patient-centeredcare.org

[7] Wennberg, J., Bronner, K., Skinner, J., Fisher, E., Goodman, D. “Inpatient care intensity and patients' ratings of their hospital experiences.” Health Affairs 28.1 (2009): 103-112., quoted in Luxford, K., Sutton, S., “How does patient experience fit into the overall healthcare picture?” Patient Experience Journal, Vol 1. (2014).

[8] Jha, A., Orav, E., Zheng, J., Epstein, A. “Patients' perception of hospital care in the United States.” New Eng J Med 359.18 (2008): 1921-1931. quoted in Luxford, K., Sutton, S., “How does patient experience fit into the overall healthcare picture?” Patient Experience Journal, Vol 1. (2014).

[9] Meterko, M., Lin, H., Lowy, E., Cleary P. “Mortality among patients with acute myocardial infarction: The influences of patient-centered care and evidence-based medicine.” Health Services Research 45.5 (2010): 1188-1204. quoted in Luxford, K., Sutton, S., “How does patient experience fit into the overall healthcare picture?” Patient Experience Journal, Vol 1. (2014).

[10] Isaac, T., Zaslavsky, A., Cleary P., Landon, B. “The Relationship between Patients' Perception of Care and Measures of Hospital Quality and Safety.” Health Services Research 45.4 (2010): 1024-1040.

[11] A ccenture: Patient Engagement: Happy Patients, Healthy Margins

[12] Deloitte: The Value of Patient Experience: Hospitals with better patient-reported experience perform better financially. 2014.

[13] Ibid.