Carla Daley Shehata, director of clinical operations for Regent Surgical Health, discusses seven of the most common patient complaints in an ASC, as well as how to prevent them.
1. Poor explanation of fee and benefits. Ms. Daley Shehata says patients can become frustrated when they expect their portion of the payment to be lower than it actually is. She credits this misunderstanding to several factors: patients' poor understanding of how their insurance works, miscommunication between the payor and the patient and changes in the patient deductible. She says while ASCs may not be able to affect the information the patient receives from the payor, they can take more time to explain what the patient will owe. "I think we need to talk to them in [clearer] terms, rather than our healthcare language," she says. "It's a lot more than some people can handle."
2. Long wait times. Patients are generally asked to arrive at the ASC an hour prior to their procedure, and if a physician is late or a previous case is delayed, they can end up waiting for longer than they expected. For a patient who is nervous and may not have eaten recently, this can increase stress levels and make the surgical experience seem more daunting. Ms. Daley Shehata says while ASCs may not be able to control physician emergencies or unexpected complications with other cases, they can take steps to calm a patient down. "I think keeping the patient informed calms them down," she says. "A lot of times, if we know [about the delay] early enough, we'll ask them to come in a little later for their comfort." If the patient is already at the ASC and will have to experience a wait, talk to them about the delay and apologize for any discomfort.
3. Lack of information from anesthesia providers. Ms. Daley Shehata says many patients feel they don't spend enough time talking to the anesthesiologist prior to surgery. "People are nervous, and anesthesia is the main reason for most of their fear," she says. "They really need someone to talk to them and explain things to them, not just check their heart and ask if they have any questions." She says this can be a challenge when cases are turned over quickly, but anesthesiologists should take the time to sit down with patients and address any fears.
4. Few instructions prior to surgery. Patients often feel they do not receive enough information prior to surgery, Ms. Daley Shehata says. This can include instructions about stopping medication, eating or drinking or even directions to the facility. Some patients will also forget they need someone to drive them home from the facility. While most ASCs call patients prior to surgery to explain these requirements, Ms. Daley Shehata says patients can forget the information if they're preoccupied or nervous. She says ASCs should also give patients a pre-op instruction brochure that explains how to prepare for surgery. "We also have websites that we ask them go to if they have a computer and feel comfortable visiting the website," she says.
5. Failing to understand surgeon's explanation prior to surgery. Patients may not understand the repercussions of their surgery before it happens, Ms. Daley Shehata says. "They'll feel like they didn't understand they would have to take four weeks off work, or they didn't understand they would have to go to rehab or how much pain they would be in," she says. Again, it helps to document this explanation so the patient has written instructions to refer to.
6. Miscommunication between surgeon and family members after surgery. Since many patients will be unable to take instructions after surgery, the surgeon must often communicate with family members about post-discharge care. "When a surgeon comes out in surgical scrubs, all they're really hearing is that [the surgery was] good or it was bad," she says. Even if the surgeon communicates the necessary information about the procedure and post-discharge information, the family member may not be able to remember what exactly was said. The nurse taking care of the patient and the patient's family needs to be sure to ask if they need further information or explanation. The ASCs must also distribute instructions about wound care, driving ability and other factors on paper for the patient to refer to later in their recovery.
7. Request for privacy. Especially in smaller ASCs, patients can feel that their privacy is violated when they are separated from other patients by a curtain. Ms. Daley Shehata says patients have complained that they have to discuss their medical history within earshot of other patients or that they are wheeled into the OR in front of other patients. Ms. Daley Shehata says Regent endeavors to upgrade new ASCs by placing physical walls between cubicles, but that may not be possible for an existing ASC. If structural changes are not feasible, remind your staff to speak to patients quietly about personal information and remind patients that the ASC tries to respect their privacy. Many complaints can be pre-empted with a considerate word about the ASC's efforts to keep personal matters confidential.
Learn more about Regent Surgical Health.
Read more about patient satisfaction in the ASC:
-5 Ways to Reduce Patient Wait Times in Surgery Centers
-10 Ways to Maintain High Patient Satisfaction
-3 Ways to Achieve Excellent Patient Throughput
1. Poor explanation of fee and benefits. Ms. Daley Shehata says patients can become frustrated when they expect their portion of the payment to be lower than it actually is. She credits this misunderstanding to several factors: patients' poor understanding of how their insurance works, miscommunication between the payor and the patient and changes in the patient deductible. She says while ASCs may not be able to affect the information the patient receives from the payor, they can take more time to explain what the patient will owe. "I think we need to talk to them in [clearer] terms, rather than our healthcare language," she says. "It's a lot more than some people can handle."
2. Long wait times. Patients are generally asked to arrive at the ASC an hour prior to their procedure, and if a physician is late or a previous case is delayed, they can end up waiting for longer than they expected. For a patient who is nervous and may not have eaten recently, this can increase stress levels and make the surgical experience seem more daunting. Ms. Daley Shehata says while ASCs may not be able to control physician emergencies or unexpected complications with other cases, they can take steps to calm a patient down. "I think keeping the patient informed calms them down," she says. "A lot of times, if we know [about the delay] early enough, we'll ask them to come in a little later for their comfort." If the patient is already at the ASC and will have to experience a wait, talk to them about the delay and apologize for any discomfort.
3. Lack of information from anesthesia providers. Ms. Daley Shehata says many patients feel they don't spend enough time talking to the anesthesiologist prior to surgery. "People are nervous, and anesthesia is the main reason for most of their fear," she says. "They really need someone to talk to them and explain things to them, not just check their heart and ask if they have any questions." She says this can be a challenge when cases are turned over quickly, but anesthesiologists should take the time to sit down with patients and address any fears.
4. Few instructions prior to surgery. Patients often feel they do not receive enough information prior to surgery, Ms. Daley Shehata says. This can include instructions about stopping medication, eating or drinking or even directions to the facility. Some patients will also forget they need someone to drive them home from the facility. While most ASCs call patients prior to surgery to explain these requirements, Ms. Daley Shehata says patients can forget the information if they're preoccupied or nervous. She says ASCs should also give patients a pre-op instruction brochure that explains how to prepare for surgery. "We also have websites that we ask them go to if they have a computer and feel comfortable visiting the website," she says.
5. Failing to understand surgeon's explanation prior to surgery. Patients may not understand the repercussions of their surgery before it happens, Ms. Daley Shehata says. "They'll feel like they didn't understand they would have to take four weeks off work, or they didn't understand they would have to go to rehab or how much pain they would be in," she says. Again, it helps to document this explanation so the patient has written instructions to refer to.
6. Miscommunication between surgeon and family members after surgery. Since many patients will be unable to take instructions after surgery, the surgeon must often communicate with family members about post-discharge care. "When a surgeon comes out in surgical scrubs, all they're really hearing is that [the surgery was] good or it was bad," she says. Even if the surgeon communicates the necessary information about the procedure and post-discharge information, the family member may not be able to remember what exactly was said. The nurse taking care of the patient and the patient's family needs to be sure to ask if they need further information or explanation. The ASCs must also distribute instructions about wound care, driving ability and other factors on paper for the patient to refer to later in their recovery.
7. Request for privacy. Especially in smaller ASCs, patients can feel that their privacy is violated when they are separated from other patients by a curtain. Ms. Daley Shehata says patients have complained that they have to discuss their medical history within earshot of other patients or that they are wheeled into the OR in front of other patients. Ms. Daley Shehata says Regent endeavors to upgrade new ASCs by placing physical walls between cubicles, but that may not be possible for an existing ASC. If structural changes are not feasible, remind your staff to speak to patients quietly about personal information and remind patients that the ASC tries to respect their privacy. Many complaints can be pre-empted with a considerate word about the ASC's efforts to keep personal matters confidential.
Learn more about Regent Surgical Health.
Read more about patient satisfaction in the ASC:
-5 Ways to Reduce Patient Wait Times in Surgery Centers
-10 Ways to Maintain High Patient Satisfaction
-3 Ways to Achieve Excellent Patient Throughput