The Doctor’s Advocate | Fourth Quarter 2020
Perspectives from the CMO
Could COVID-19 Bring More Patient-Centered Care to Your Practice?
Earlier this year, my wife, Debbie, and I had dinner plans in our friends’ backyard. As the day approached and the weather turned hot and humid, our friends asked if we would be comfortable dining inside. My wife and I turned to each other: Would we? Well, maybe, but we wouldn’t hug them hello—would we?
Into this new social and medical landscape, winter brings with it an old complication: the flu. We have to ask, in the future, will we have an annual combined flu season and COVID-19 season? If so, will we still celebrate holidays with family and friends, and what will medical practice look like?
One bright spot is that in some ways, the pandemic has forced us to provide more patient-centered care. If we continue in that direction on purpose, we may see some positive outcomes for our patients and our practices.
In patient-centered care, “Patients are partners with their health care providers, and providers treat patients not only from a clinical perspective, but also from an emotional, mental, spiritual, social, and financial perspective.”1 Looking back over 2020, we can see how a positive aspect of the impact of COVID-19 may be how it has exposed us to a more complete picture of our patients’ lives. For instance, it has allowed us via telemedicine visits to make something like an old-fashioned “house call,” in which we see the home environment and perhaps interact with family members. The pandemic has also pushed patients and providers into what for many has been uncharted emotional territory.
Now, pressing ahead into positive outcomes, we can take steps to make our practices more patient centric. Consider the following steps:
Revisit Your Mission
In environments prioritizing patient-centered care, “The health care system’s mission, vision, values, leadership, and quality-improvement drivers are aligned to patient-centered goals.”1
The challenges of 2020 can serve as a time of reflection for your practice. Is it time to revisit your practice’s mission?
A mission statement can center your team in times of adversity: For The Doctors Company, keeping top of mind our mission to advance, protect, and reward the practice of good medicine has kept us focused through this stretch when medical practice, for many of our members, looks different than it ever has before.
So, if you haven’t done it yet, consider how a refresh of your practice’s mission, if appropriate, could elevate the morale of your team while elevating quality of care.
Deliver Information Quickly
“Full transparency and fast delivery of information” is a hallmark of patient-centered care.2 The U.S. has been collectively immersed in the frustrations and poor outcomes caused by COVID‑19 testing delays. Taking that as a prompt, has your practice considered how test result tracking and communication conveyed to patients could be improved? And how this would benefit your patients, as well as your practice?
The literature provides ample evidence that a high level of engagement in clinical quality reduces medical liability risk.3,4 Therefore, as my colleague Paul MacLellan, president of Medical Advantage, part of TDC Group, can attest: “Quality, safety, and risk management financially align.”
Rename the “Waiting Room”
The name says it all—and when you add a TV, you double-down on that commitment. It’s an unwise practice to contain people indoors during not only flu season, but also during the coronavirus pandemic.
Some practices have implemented cell phone waiting; others might take a holistic look at their workflow, seeking missed efficiencies. Manufacturers speak of “just-in-time” inventory—though people are not supplies, a “just-in-time” approach to patient scheduling will benefit patients and practices now more than ever.
Ramp Up Telemedicine
Depending on your specialty, you may be able to achieve more by remote consultation than you think, and doing so when appropriate reduces infection risk while increasing convenience and patient satisfaction.
Consider video visits for consultative appointments, especially with patients managing chronic conditions. Some post-op conversations can also be completed remotely, allowing patients to recuperate at home while reducing infection risk for everyone.
Some practices may want to consider asynchronous data collection for patients with chronic conditions. For example, having patients send home-recorded blood pressure or glucose readings not only gives the physician better insight into a patient’s disease status, but it also increases the patient’s engagement with the physician and the physician’s office.
That said, incorporating telemedicine into your practice does mean reorganizing workflows—and mitigating a new set of risks. For help getting started—or retooling measures taken hastily in spring 2020—see the telehealth advisories in our COVID-19 Resource Center for Healthcare Professionals or read our telehealth white paper, Your Patient Is Logging On Now: The Risks and Benefits of Telehealth in the Future of Healthcare.
Promote Flu Shots
Patient-centered care emphasizes individual outcomes, but contributes to population health outcomes—such as by making more patients feel comfortable getting a flu shot.
The Centers for Disease Control and Prevention recommends a flu shot in September or October (for maximum effectiveness through the whole flu season), while some providers in 2020 were recommending a flu shot as early as July or August, to reduce risk of co-infection with COVID-19. Many patients are reluctant to visit a clinic or pharmacy at all during the pandemic.
The flu itself can carry deadly risk,5 and those who get the flu are then at greater risk for severe complications or death from COVID-19. Moreover, flu symptoms could be mistaken for COVID-19, landing patients in the emergency department who don’t need to be there.
Remind patients that the benefits of getting a flu shot outweigh the risks. Even in December, January, and February, keep pushing patients to get their flu shots.
Look Ahead
Fortunately, patient-centered care not only improves patient satisfaction and outcomes, but it also enhances a practice’s reputation. It also results in better morale among clinicians and support staff. After all we’ve been through in 2020, that’s good news for everyone.
References
- What is patient-centered care? NEJM Catalyst. Published January 1, 2017. https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0559
- Trovato E, Lau TM, Chang L, Pechman K. Ethical issues commonly managed during rehabilitation. American Academy of Physical Medicine and Rehabilitation. Updated July 30, 2020. https://now.aapmr.org/ethical-issues-commonly-managed-during-rehabilitation/
- Diraviam S, Sullivan PG, Sestito JA, Nepps ME, Clapp JT, Fleisher LA. Physician engagement in malpractice risk reduction: a UPHS case study. The Joint Commission Journal on Quality and Patient Safety. 2018;44:605-613.
- Black BS, Wagner AR, Zabinski Z. The association between patient safety indicators and medical malpractice risk: evidence from Florida and Texas. American Journal of Health Economics. 2017;3(2):109-139.
- Disease burden of influenza. Centers for Disease Control and Prevention. Updated April 17, 2020. www.cdc.gov/flu/about/burden/index.html#:~:text=While%20the%20impact%20of%20flu,61%2C000%20deaths%20annually%20since%202010
The Doctor’s Advocate is published by The Doctors Company to advise and inform its members about loss prevention and insurance issues.
The guidelines suggested in this newsletter are not rules, do not constitute legal advice, and do not ensure a successful outcome. They attempt to define principles of practice for providing appropriate care. The principles are not inclusive of all proper methods of care nor exclusive of other methods reasonably directed at obtaining the same results.
The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.
The Doctor’s Advocate is published quarterly by Corporate Communications, The Doctors Company. Letters and articles, to be edited and published at the editor’s discretion, are welcome. The views expressed are those of the letter writer and do not necessarily reflect the opinion or official policy of The Doctors Company. Please sign your letters, and address them to the editor.
Fourth Quarter 2020
From the Chairman
COVID-19: A Call for Innovation and Leadership in Healthcare
Perspectives from the CMO
Could COVID-19 Bring More Patient-Centered Care to Your Practice?
An Ounce of Prevention
The Role of Pretest Probability in the Evaluation of Suspected Venous Thromboembolism
Government Relations Report
2020 Judicial Review
Foundation News
Dr. David Feldman Joins Foundation Board of Directors
Complimentary Telehealth Webinars
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