Researchers, led by Claire Senot of Tulane University and Aravind Chandrasekaran of Ohio State University, measured the effects of
two different aspects of patient care on readmissions: the communication-focused aspect, which focuses on the caregiver's ability to engage the patient in meaningful conversations, and the response-focused aspect, which corresponds to the caregiver's ability to respond quickly to a patient's explicit needs.
Their research, combined with in-depth case studies of several acute care hospitals, found that hospitals would reduce their 30-day readmission rates by 5 percent if they invested in training programs to teach caregivers' interpersonal skills and empathy to improve communication with patients, in addition to complying with evidence-based care. But hospitals that invested in monitoring systems and RFID location systems to help caregivers quickly respond to patients' requests, combined with process of care, would reduce readmissions by 3 percent.
Hospitals must walk a tightrope between improving both process-of-care measures and patient experience measures, both of which affect their reimbursements, Senot and Chandraskaran wrote in Harvard Business Review. Caregivers widely perceive satisfaction-focused measures as subjective and unscientific, and of little value in the quest to improve outcomes. Indeed, experts have raised concerns that satisfaction measures could take the focus off of tangible outcomes.
Meanwhile, many hospitals pay less attention to improving caregiver communication because of high training costs, according to the authors. They also note that technical skills take priority over patient communication at medical schools. However, improving the communication aspect is actually cheaper than improving the response aspect by about $14 per patient, according to the study. "These results have important implications for where hospital administrators should invest to improve the overall healthcare delivery system in the United States," the authors wrote in HBR.