Benefits of Encouraging Patients to Speak Up About Their Care

After gathering data from 10,000 patients hospitalized at eight locations in Maryland and Washington, D.C., researchers concluded that “patients frequently experience problems in care during hospitalization and many do not feel comfortable speaking up.” They found that 48.6% of patients experienced a problem, and of those, over 30% “did not always feel comfortable speaking up.”

The study, “We want to know: Patient comfort speaking up about breakdowns in care and patient experience” (published recently in BMJ Quality & Safety),  has implications for overall patient safety and satisfaction:

• Patient safety / The study’s authors say, “Creating conditions for patients to be comfortable speaking up may result in service recovery opportunities and improved patient experience.” As reported by Healthleaders’ Chris Cheney, “Patients are uniquely qualified to raise concerns about care because they are present for the entire episode of care.” Without candor from patients about their full experience, quality improvement efforts by physicians, hospitals and health systems can miss key opportunities.
• Patient satisfaction / Kimberly Fisher, MD, the paper’s lead author tells Cheney, “The most common type of problem that patients report is inadequate communication—they didn’t get the information that they wanted, they didn’t get their questions answered, or things were not explained to them in a way that they could understand.” In addition to the obvious patient safety concerns of this dynamic, the experience directly impacts patient satisfaction. In his article for Healthleaders Cheney points to one of the study’s key findings: “Patients who were not always comfortable raising concerns gave lower ratings for nurse communication, physician communication, and the hospital overall.”

According to the researchers, there are a couple of ways physicians, hospitals and health systems can make patients feel more comfortable sharing their experiences:

• Conversation / Fisher says, “Directly asking patients whether they have any concerns and conveying a sincere desire to hear from patients is essential in encouraging patients to speak up.” She recommends active, face-to-face outreach instead of more passive means like “just setting up and publicizing mechanisms—websites, phone numbers, or email addresses.”
• Response / Cheney points out that “earlier research has shown … hesitancy to speak up linked to several factors such as an expectation that complaining will not make a difference.” Healthcare organizations must be prepared to respond to feedback and may benefit from showing how they use the information not only individually (i.e. working with patients one-on-one to address issues) but also more universally by demonstrating the impact patient feedback has on overall improvements at their facilities.