Positive Patient Experience, Good Outcomes Are Top Patient Priorities

Having a positive experience as a patient, achieving good outcomes, and being seen as humans are among the priorities that are most important to patients and should be the centerpiece of diabetes and chronic kidney disease care, according to a presentation at Kidney Week 2021.

Providers know what their priorities are when caring for patients, but it's imperative that they line up with what patients want and feel, said Matt Cavender, MD, MPH, an interventional cardiologist and assistant professor of medicine at the University of North Carolina School of Medicine in Chapel Hill.

A 2021 survey by the Beryl Institute revealed some of the qualities healthcare consumers seek (1). The first takeaway, Cavender said, is that the experience of patient care is extremely important.

“They consider it to be a priority for all providers to deliver care that results in an experience [that] is overall positive,” he said.

Second, the impact on personal health and well-being and, most importantly, a desire for good outcomes are the leading reasons consumers believe that a good patient experience is important.

Third, consumers want to be seen as humans. “They want to be listened to and communicated with in a way that they can understand,” Cavender said. “They want to be able to have a conversation with their provider, to be able to express the things that are important to them as a patient, and they want the provider to listen. Additionally, they want the provider to be able to incorporate what the patient is telling them as important when [providers] come up with a treatment decision.”

Consumers see the patient experience as encompassing myriad important topics, such as safety, quality, outcome, service, engagement, cost, and actions of the entire care team. This starts from the person who checks the patient into the clinic and ends with the person who checks the patient out—and includes every staff person encountered in between, Cavender said. The experience of patients who need care from multiple areas of a health system highlights the need for collaboration and coordination of care across the continuum, he said, particularly as patients go from inpatient to outpatient or from nephrologists to other physicians in cardiology or primary care: “Patients want to be able to see there's coordination there.”

Diving into what constitutes quality in these scenarios, providers can turn to the Six Domains of Health Care Quality from the Agency for Healthcare Research and Quality (AHRQ) (2). These include healthcare provisions that are safe and avoid harm to patients and that are effective, based on sound scientific knowledge, and offered to patients who will benefit and not offered to those who will not benefit.

The quality domains also include care that is patient centered, respectful to the patient's values, needs, and concerns. Care also must be provided in a timely and efficient manner, avoiding unnecessary delays or waste. Finally, care must be provided equitably to all patients regardless of gender, ethnicity, geographic location, socioeconomic status, or other personal characteristics.

The Patient-Centered Outcomes Research Institute (PCORI) also has tackled questions of importance to healthcare consumers, Cavender said. These questions include the following:

• Given my personal characteristics, conditions, and preferences, what should I expect will happen to me?

• What can I do to improve the outcomes that are most important to me?

• What are my options, and what are the potential benefits and harms of those options?

• How can clinicians and the care delivery systems they work in help me make the best decisions about my health and healthcare?

To summarize these points, Cavender said, patients want to know answers to the following questions: What are the outcomes? What sort of lifestyle changes can I make with this condition? What treatments are available? And how is care going to be delivered?