by Kellie Goodson, MS, CPXP
Director, Performance Improvement Programs
10/28/20

The perceptions of patients regarding the safety of elective procedures has steadily improved since May, as shown in Vizient’s updated report Connecting With Patients During COVID-19. However, this has not translated into increased utilization of health care services.

Not surprisingly, the biggest concern of patients and families continues to be catching COVID-19 while accessing care. Because of this nervousness, health care consumers may not behave the way we expect. They might say one thing but do another – or more specifically, they might say “yes, I feel safe accessing care” yet they will not actually seek care. According to the findings of Strata Decision Technology’s National Patient and Procedure Volume Tracker, “Essential care [volumes are] back to 2019 levels but electives [are] still lagging.”

Vizient® and Sg2® have been connecting with patient and family advisors (PFAs) from member organizations  across the country during the last six months to learn their perspectives about the safety of health care services, specifically elective procedures, and how they will make decisions in the “new normal.” These PFAs participated in a series of activities—one webinar and two surveys—to give us their thoughts regarding their health care delivery preferences in relation to the COVID-19 pandemic. We have learned much from them.

PFAs are patients and family members who have received care at health care organizations and who partner with them to improve health care quality, safety, and the patient experience. Health care administrators, clinicians, and staff engage PFAs through Patient and Family Advisory Councils (PFACs). More than 120 PFAs participated in the latest activity, a survey conducted in September.

So, what have we learned? We learned it is imperative to leverage the voices of patients and families as we try to improve the utilization of health care services because we cannot speculate about patient behavior during this unprecedented time. Health care organizations that engage PFAs/PFACs in strategic planning understand this deeply. PFAs told us that:

  1. Personal perspectives affect their decision-making. Their perceived risk of exposure to COVID-19 versus the benefits of receiving care largely determines if or when they will access care.
  2. Setting matters. Patients and families feel safest visiting their doctor’s office over the ED, urgent care, and retail care settings. PFAs surveyed indicate that they desire virtual scheduling with no waiting room exposure along with traditional face-to-face provider visits.
  3. Telehealth is preferred. Clearly, telehealth is the preferred method of receiving care, but not necessarily from new providers. Patients and families want their existing doctor to provide these services.
  4. Communication matters. For patients and families to feel safe receiving in-person preventive screenings (e.g., mammography, colonoscopy), they want to hear directly from their existing doctor–not from hospital marketing, media sources, or their friends/family–but directly, and personally, from their doctor.

A “one size fits all” approach will not help people recognize when they should access care. Patients need to fully understand their own personal risks and benefits of a given procedure; they do not want to be put into a box with other patients who happen to be the same age or have the same diagnosis. They want open, honest, and frequent communication that is tailored to their condition and delivered by their doctor.

Health care organizations that provide services which keep patients connected with their doctor and minimize their exposure to COVID-19, such as virtual visits and remote patient monitoring, can create a competitive advantage. Furthermore, honoring the relationship between a patient and their doctor builds trust and may accelerate the utilization of elective health care services in the short term as well as create loyalty that lasts far beyond the COVID-19 pandemic.

Photo of Vizient's Kellie GoodsonAbout the author. A thought leader in the areas of patient and family engagement (PFE) and health equity, Kellie Goodson has implemented Vizient performance improvement networks on those topics as well as co-led national Affinity Groups for the Centers for Medicare and Medicaid Services. She led the Patients First project, a multiyear analysis of hospitals leveraging and deploying PFE in quality and safety improvement. Also deployed under her direction was a multisystem program using quality improvement science to improve patient outcomes through the identification and resolution of health disparities. A certified patient experience professional, Goodson recently served on a National Quality Partners Action Team to Co-Design Patient-Centered Health Systems.