Anthony Orsini, D.O.

Patient Satisfaction is one of the hottest topics in medicine today, significantly affecting reimbursement, compliance with treatment plans, clinical outcomes and even the risk of mal- practice lawsuits. (1-4) In order to survive in today’s patient- centered, competitive healthcare system, it is essential for any healthcare provider to achieve and maintain high patient satis- faction scores. The overall patient experience is so important that in a recent leadership survey, 90% of top-level hospital executives have identified enhancing the patient experience as was one of their highest priorities. (5)

But what is the main driver of a patient’s overall satisfaction? Contrary to common belief, it is not the aesthetics of the hospital nor the amenities offered. It is not the food or even actual wait times. (6) According to Press Ganey, the nation’s leading provider of patient satisfaction surveys, the ability of a clinician to communicate and build rapport with his/her patients ranks consistently as one of the top predictors of patient loyalty and therefore patient satisfaction. (7)

This should not be surprising. Patients value the interpersonal aspects of the clinician-patient relationship, such as communication, compassion and the overall sense of being treated with respect. Unlike decades past, today’s patient will often favor a physician with a good bedside manner over one with a reputation for being an excellent clinician. It is therefore imperative that all physicians, nurses and team members learn how to build relationships with patients by communicating effectively.

There are many communication techniques that a healthcare professional can learn to help form relationships with their pa- tients, even in a very short period of time. The easiest skill to learn and perhaps the most important of all communication techniques is to simply SIT DOWN.

Sitting down and having a conversation with a patient sends the non-verbal message that their provider is not in a hurry and genuinely wants to hear what he/she has to say. It tells the patient before a word is spoken, that their clinician is genuinely interested in him/her as a person and is not anxious to rush out to the next patient. Sitting down is the first step in forming a relationship and the bedrock of which compassionate communication is built.

Although multiple studies have validated that a seated posture enhances rapport and evokes a sense of interest, compassion and increased satisfaction, any astute observer would note that this practice is rarely seen in a hospital setting. Providers fear that sitting down will slow them down. This, however, is not the case. A 2012 study by Swayden et al. compared patient perception of provider time to actual time spent at the bedside. Researchers found that although physicians spent slightly more time in the room standing compared to sitting, the patient’s perception of time spent in the room was significantly longer when the physician sat down. In addition, patient comments were positive 95% of the time when the clinician sat down compared to only 61% positive comments when the provider stood. This study further emphasizes the importance of non-verbal communication. Although a physician may not feel personally rushed, the act of standing during an encounter creates the misperception of hurriedness. Providers therefore should no longer fear losing time by sitting. (8)

To further confirm the relationship between sitting and the overall patient experience, Lidgett et study the effect sitting down has on patient satisfaction scores. In the “Commit to Sit” study, researchers found that simply requiring nurses to sit with patients at least once per shift, contributed to an increased perception of compassion by patients and families resulting in a significant improvement in patient satisfaction scores (9)

So whether you are a physician, nurse or other healthcare pro- vider, the next time you visit a patient’s room SIT DOWN. You will build better relationships, improve patient satisfaction and save time.

References:

1. Jha A, Orav EJ et al. Patient’s perception of hospital care inthe United States. N Engl J Med 2008; 359:1921-1931
2. Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open 2013;3:e001570. doi:10.1136/bmjopen-2012- 001570
3. Huntington B, Kuhn N. Communication gaffes: A root causeof malpractice lawsuits. 2003 April. 16(2): 157-161
4. Litman R. Physician communication skills decrease malpractice lawsuits. 2009 73(10) 20-21
5. From Deloitte The Value of Patient Experience 2016. https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-dchs-the-value-of-patient-experience.pdf
6. Press Ganey. Increased value in the emergency department: Using data to drive improvement. 2015. http://images.healthcare.pressganey.com/Web/PressGaneyAssociatesInc/%7Ba605f55a-ed21-4b76-920f-01ed3fd0f466%7D_PG_ Emergency_Department_WP.pdf
7. Press Ganey Pulse Report Perspectives on American Healthcare. 2011.
8. Swayden K, Anderson K et al. Effect of sitting vs. standing on perception of provider time at bedside: a pilot study. Patient Education and Counseling 2012;86:166-171
9. Lidgett Cari. Improving the patient experience through a commit to sit service excellence initiative. Patient Experience Journal 2016; 3: Iss.2, Article 11

Disclosure: Dr. Orsini is president of BBN, the organization he founded in 2012 that offers training services to educate professionals in the art and science of compassionate communication.