“Patients and their family caregivers are constantly assessing their risk, so information that’s going to help them understand the own risks and the benefits of accessing care is important to provide.” — Kellie Goodson, MS, CPXP, Vizient performance improvement director
Not only has the COVID-19 pandemic disrupted the many ways that care is delivered, it also has had a significant impact on the attitudes of patients and caregivers about their health care. A new Vizient report shows that patients are constantly weighing the risks and benefits to remain safe from the virus when deciding whether and where to have procedures, screening tests, check-ups and vaccinations.
“The personal risk analysis is constantly on the mind of patients,” said Vizient’s Performance Improvement Program Director Kellie Goodson, MS, CPXP, who led an eight-month program to listen to the attitudes and concerns of patients to help hospitals and other providers. Goodson said the concern about exposure to COVID-19 resonated throughout the pandemic and contributed to attitudes about which were the safest settings and types of care.
The report, Connecting With Patients During COVID-19: Perspectives on Safety, is summary of focus group discussions and pulse surveys conducted by Vizient from May 2020 through January 2021.
The latest survey, conducted in December 2020, included approximately 600 respondents. Additionally, Vizient hosted four focus groups that included 24 patients from 11 Vizient-member health care organizations to gather perspective on their experience engaging with providers during the COVID-19 pandemic.
Patients still prefer visiting their physician’s office to receive care
The traditional physician’s office was where patients and family caregivers said they felt most comfortable receiving care during the pandemic. That was true across all demographic breakouts—age, gender and geographic location. The emergency department, a freestanding urgent care center and retail clinics were not considered safe by more than 50% of the respondents.
The physician’s office was also the preferred location to receive vaccinations. Nearly all patients and families surveyed who indicated they would receive a COVID-19 vaccine said they were either very likely or somewhat likely to be vaccinated in a physician’s office (97%).
Weighing the risks and benefits was also evident when focus group participants were asked if they wanted a COVID-19 vaccine. Some indicated they were at low risk for exposure to COVID because they don’t go out very often and they perceived getting the vaccine to be riskier. However, the vast majority of those surveyed (87%) indicated that they were interested in the COVID vaccination and 56% of those said they would get the vaccine as soon as it was available. Participants over age 45 were more receptive to getting the vaccine right away compared to younger ones.
Patients’ perception of safety declines for elective procedures
In May 2020, about 60% of patients and caregivers surveyed felt safe or somewhat safe coming in to have an elective procedure. That percentage climbed to a high of 80% in September, followed by a steep decline with the surge of COVID-19 cases across the country. By December, only 50% indicated they were comfortable having a procedure.
“First and foremost,” Goodson said, “patients wanted to know how, in detail, the facility would keep them safe and if they would come in contact with COVID-19 patients.” Older participants expressed the most concern about exposure to the virus.
While most hospitals posted messages and videos on their website and sent notices to patients explaining their safety protocols, it may not have been enough. The research indicated that patients wanted a personal conversation with their doctor with details about what the facility was doing to ensure their safety and when they should receive care. When it is time for a screening test, such as a colonoscopy, or receiving vaccinations, the same principle about communication applies, said Goodson. “Generic statements through the patient portal or email will only get you so far.”
Patients are enjoying the expanded option for telehealth visits for minor illness
When seeking care for minor illnesses, telehealth remains the preferred setting. Most patients and their family caregivers who were surveyed had positive feedback about telehealth visits when a physical exam was not needed, and the majority (66%) want telehealth to continue even after the pandemic. In all age groups, even those over age 75 indicated they wanted the option of telehealth to continue.
“Physicians need to be open to doing that. In the process, they will create loyalty with patients that will outlast the pandemic,” said Goodson. She added that patients indicated they don’t want telehealth from just any provider, they want the virtual visit with their existing providers.
Restrictions on family at bedside may be delaying decisions to seek care
Patients and families indicate that restricting the presence of family and caregivers is a major barrier to accessing care and should be re-examined, especially for specific patient populations and care settings.
“At first, people understood the reason behind the restrictions. However, the patients and family caregivers we spoke to wanted health systems to reconsider the visitation restrictions so that those who need someone to accompany them or be at their bedside can have them there,” Goodson said. Besides being an important emotional comfort, she points out that family members looking out for patients at the bedside can enhance safety—preventing falls, for example, and making sure dressings are changed on time, among other things.
Listening to patient insights can increase loyalty and trust
A key message from the eight-month project is that patients want a voice in their care and a good relationship with their doctors. They appreciate it when their doctors respond quickly to their questions and reach out personally to recommend treatments and screenings. They also want to know what steps their provider has taken steps to keep them safe from COVID-19.
“Leading health systems that are engaging patients and family members in advisory councils are seeing value and are reaping the benefits of it,” said Goodson. Listening to those insights can help providers increase loyalty and trust, enlisting patients to be partners in their care and providing confidence that the health care system is looking out for their best interests.