ny trip to the doctor’s office can be filled with anxiety. When a surgery, injury, or illness requires an overnight stay, the anxiety and fear increases, as does the number of people involved in your care. Inpatient stays require coordination between upwards of 100 people and multiple teams, from doctors and nurses to therapists and case managers, custodians and food service. It’s a complicated experience for patients and their families to navigate.

The existing tools to understand and respond to the experience of hospitalized patients are limited. The standardized Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) has been used since 2006 and is designed to enable consumers to compare the quality of hospitals. Hospitals must participate in surveying their patients or face reputational and financial consequences. Five hospital groups and experts have called for revisions to HCAHPS questions and distribution processes, citing numerous drawbacks, including falling response rates and lag time to receive responses. 

We wanted to know–how do patients and their caregivers want to provide feedback both during and after their hospitalization? How do we develop a better listening strategy that doesn’t center solely on surveys?

Our goal is to quickly resolve issues for patients while they are still in our facility, create more open communication, and  receive feedback to inform improvement. 

We hear from about 16% of our hospitalized patients and only receive their feedback following their discharge. The responses are often delayed, difficult to attribute to the correct unit, and represent only a subset of our patient population. Often, the patients cite concerns that could have been resolved during their hospital stay. 

We set out to learn about the advisors' inpatient experiences and gather their input on making care requests and giving real-time feedback.  

Here’s what the advisors said 

Inpatient stays are difficult to endure for both patients and caregivers. With rotating care providers and numerous care plan updates, it can be a confusing time for all. Patients and caregivers often need clarification about their or their loved one’s health status and care plan. They also have many requests, from emergent to non-emergent, that need attention.   

In-person communication is key 

From tired caregivers to busy staff, people’s memory during inpatient stays can be fuzzy at times. If patients are too sick or unconscious, it can be difficult for them and their loved ones to understand what is happening with the care plan. Patients and their loved ones prefer in-person communication with the care team about results and care plans because it ensures the right information is communicated to the right people and clears up confusion. Having the care providers’ name tags visible with names and roles, as well as updated white boards, helps patients and caregivers know who to go to when there is an issue. 

Patients want to know how to get in touch with their team  

Historically, the only available option for patients to get help has been to press a call button that signals to the nursing team. Patients especially like the walkie-talkie function of some call lights because it ensures their request is acknowledged and being triaged by their care team. Managing expectations for response times is important. Patients understand it may take some time to have their request fulfilled, especially for non-emergencies, but they want to know how long it will take so they can adjust their expectations. More patient education around how to use the call light (where it is, expectations of response times, etc.) could be helpful. 

Clarification is needed for emergent vs. non-emergent requests 

Patients like the idea of separate communication options for emergent and non-emergent requests because they feel teams can answer more quickly in case of an emergency and less quickly in case of a non-emergency. But not everyone has the same gauge for what an emergency is (e.g. pain vs. bathroom vs. room temperature) and patients might have issues selecting the correct option because they are groggy or tired. In the event that patients have more options than just using the call light, education around when to use which communication option would be helpful.  

Giving feedback in-person is best 

Patients prefer to give feedback directly to leadership in-person. Not only is it easier, but it also enables patients with certain disabilities the same access to resolution. If patients are able to use a device, they prefer to use their own to fill out a survey from a link sent to their device. Receiving the survey upon arrival and then turning it in upon discharge would help patients know what to look for during their inpatient stay and would make them more likely to fill out the survey. Besides providing feedback, patients also want to use the survey to recognize their care teams and staff who were particularly helpful. 

Overall, patients agree that high-tech aspects of care are useful, but warrant the same amount of touch and personal attention as manual aspects. There is an opportunity to streamline care delivery and make improvements in real time through surveys and communication platforms, but patients still want access to and acknowledgement from their care teams in-person. By blending the high-tech and personal touch aspects of care delivery, we can offer a more holistic and personalized patient experience.