How do facilities measure patient satisfaction and quality of care in the changing healthcare landscape?
Physicians are focused now more than ever on value of care over volume.. One would assume that the largest facilities would be the ones best equipped to provide the highest value to the highest number of patients, however, the evolution of technology and the changing healthcare landscape has armed smaller facilities with the ability to thrive.
Ten years ago, when medical imaging first became digitized, the focus was all on the volume of exams. It was how our work was being measured. As has changed to accommodate the changing health system, the conventional wisdom of volume over value from the pre-EHR, pre-digital days, has become outdated.
To say the U.S. healthcare system is in a volatile state would be an understatement. Hospitals are closing and merging across the country, accountable-care organizations are now the standard, regional health organization systems are uniting health facilities across the country, and the Affordable Care Act is now in full effect.
The state of the David and Goliath in the medical imaging world.
Group size of a health facility is no longer as important as it used to be. Mergers in the U.S. are creating facilities with the size to handle large populations and offer advanced health services, however, with with the mergers come the legacy—technology, infrastructure, bureaucracy, and organizational structure—that often can hold back facilities from adopting disruptive practices and technology.
Meanwhile, small facilities and practices remain agile, able to provide more attentive, high-value care. A small facility with superior technology (integrative non-imaging clinical data, order entry algorithms, and enhanced communication tools) can serve a patient population as well as, or better than, a larger, more traditional system.
The world through the eyes of a David-sized medical facility.
As an example of this, my hospital, Chinese Hospital in San Francisco, is the smallest consultative medical imaging group in the city with two full-time and three part-time radiologists.
By conventional wisdom, we should not exist. We are the last independent hospital in the area with 54 beds, and 200 beds is next smallest facility. Everyone talks about size, and assumes a small facility doesn’t have the expertise. But providing the best care is individualized; we must look at what tools and capabilities each individual possesses. Our facility has continued to thrive because we work in this mindset. We hire the professionals with the appropriate capabilities, and arm them with the tools to do their jobs as effectively as possible.
The unifying question that challenges large and small facilities.
Whether you work for a David or Goliath, there is one common challenge that we all face—what is satisfaction, and what is quality? It’s difficult to say what it is or how to measure it. What the medical professionals say satisfaction and quality mean will likely differ from what the patients say. Did they have a good experience? Do patients look for good bedside manner? Or, do they want the physician to be efficient and effective with little communication?
These are questions the medical professionals and facilities will be working to answer for years to come because the future of our industry depends on it. The groups that adopt and are disruptive—and these can be both small and large facilities—are the ones that are growing the most. These are the facilities that will define satisfaction and quality, and provide the best value of care to its patients.