Overcoming Obstacles to Enhanced Patient Satisfaction

This is the second in a four-part series that will address four essential areas for health systems strengthening.

Following a recent training for executive hospital leaders from Nigeria Hospitals, LMG Project director Dr. James A. Rice, participated in a day of discussions about the hospital of the future and strategies Nigeria and other low- and middle- income countries will want to consider for their future vitality and sustainability.

Four random groups of executives were invited to quickly identify important obstacles to:

• Improve clinical quality
• Enhance patient satisfaction
• Increase efficiency (reduce costs)
• Enhance stakeholder engagement

The following ten obstacles should be used by health leaders and hospital executives for discussions with their physician, nurses, staff and governing body about how best to implement sensible actions that could remove, reduce or work around each of theobstacles to patient satisfaction.

Why worry about stronger patient satisfaction?

Because enhanced patient satisfaction helps earn the provider team: (a) greater political support when seeking more and better staff, equipment, supplies and facilities; (b) is an indicator that quality of care is improving which should lead to enhanced staff pride and performance gains; and (c) it is an indicator that health outcomes are likely to be better as patients are more likely to comply with prescribed guidelines and treatments by the provider staff. The following list of obstacles should be used by CEOs for discussions with their physician, nurses, staff and governing body about how best to implement sensible actions that could remove, reduce or work around each of the obstacles to enhanced patient satisfaction.

Obstacles to Enhance Patient Satisfaction

1. High out-of-pocket costs of treatment for patients raise their expectations about the quality of service that can be difficult to meet. They compare us to other service industries that are doing a better job (hotels, restaurants)
2. Patients do not know their rights, and patients and families lack easy way to complain or express their appreciation to health workers
3. We do not explain what is going to happen to patients and their families, and they experience bad transportation, poor waiting areas, rude reception staff, no-eye contact, no pleasantness and poor attitudes of senior managers and nurses.
4. Lack willingness to engage with patients, to ask for their ideas about how we can be better
5. CEOs do not manage by walking around, and hide in their office
6. Health workers and managers lack training on customer relations and service excellence
7. Health workers lack time management and culture to be on time
8. Poor facility setting and weak compensation does not encourage staff to be upbeat and professional enough.
9. Our services are too complicated and bureaucratic and that results in poor waiting by patients and wasted time by our providers.
10. We lack enough staff and money to do what we know is important.

The key for leadership success in addressing defined lists of obstacles to health system strengthening is to take the list and get your team to discuss them, refine them, then add to them. Then prioritize the list down to the top 3-5 and assign small teams to do something about each one. Develop practical actions that can yield quick wins by reducing, removing or working around each of the top obstacles. Those wins will embolden you and your staff to try the next 3-5 obstacles on the list

Three actions to consider would be:

1. Invite a customer services manager from a good hotel to help us assess our current approaches for better patient/customer service excellence and have them volunteer as our coach for service and satisfaction improvement training;
2. Develop employee award of the month for proving excellent patient services in their department or health center (even if the award is only a certificate, a day off and a dinner out);
3. Convene a small group of patients and providers to draft and then post a “Patient’s Rights Document” that defines clearly service standards for each of our service units.