When focusing on treating the patient as a consumer, healthcare sometimes loses sight of a simple, valuable principle that produces satisfied and compliant patients—setting proper expectations. Dr. Larry Golson puts it this way: “Patient dissatisfaction usually involves unmet assumptions that were not delivered on. Even if you never discuss it with patients, most have preconceived ideas…. The best way we dispel unrealistic expectations, is to inform the patient of what to expect before they even ask.”1
Know the patient expectation
A recent study looked at 10 years of Grey’s Anatomy episodes and discovered that if a patient’s expectation of a trauma setting was influenced by the show, they would expect immediate surgery followed by either an almost instant recovery or death – both more television-entertainment appropriate than reality.2 “As anyone involved in the care of patients at a regional trauma center knows, real-life patients are often managed non-operatively or with operations (sometimes multiple) performed at an interval to the time of admission, and depending on the burden of injury, often require prolonged hospitalization and have disabilities requiring transfer to long-term inpatient facilities.”2
It is important to remember that patients come to care facilities with expectations that may not necessarily be realistic. One study found that a major contributing factor to a patient’s view of surgery success even a year later was preoperative expectations.3
A similar study had the same findings particularly as related to pain after surgery. Patients’ expectations of surgery were overly optimistic about being pain free and the patients measured their outcomes against their expectations.4 This shows the importance of establishing realistic expectations for patients prior to surgery.
Manage Patient Expectations
More communication and more education can help patients set realistic expectations. A patient engagement solution with education offers the opportunity for patients to learn at their own pace prior to planned procedures and admissions, throughout a hospital stay, and after discharge. The use of video also gives the opportunity to see a typical recovery process and outcome by engaging with more information and stories of other patients. Materials can also offer topics of discussion to think about and address with their care team—including expectations. Care teams can monitor education completion and video comprehension as well as schedule emails and texts to keep communicating with patients throughout the care experience.
Health literacy and education have been connected to compliance and outcomes for decades. According to a recent study higher empowerment and adequate health literacy led to patients reporting better health statuses.5 Giving patients more information—through education and meaningful discussion helps them set appropriate expectations and build confidence in their care. For example, Dr. Larry Golson’s optometry practice is careful to explain to patients that there may be an adjustment period for their new glasses and they might not have better vision right away. “Not only does this set a patient who may be unsure if their prescription is right at ease, it also builds trust between the patient and your practice.”1 These same principles can guide setting patient expectations throughout healthcare.
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- Golson, L. (2013, July 23). Strategies to keep patients happy: Prevent dissatisfaction before it occurs. Retrieved May 10, 2018, from Review of Optometric Business: http://reviewob.com/strategies-to-keep-patients-happy-prevent-dissatisfaction-before-it-occurs/
- Serrone, R., Weinberg, J., Goslar, P., et al. (2018). Grey's Anatomy effect: television portrayal of patients with trauma may cultivate unrealistic patient and family expectations after injury. Trauma Surgery & Acute Care Open, 3(e000137). doi:10.1136/tsaco-2017-000137 Retrieved May 10, 2018, from: http://tsaco.bmj.com/content/3/1/e000137
- Neuprez, A., Delcour, J.-P., Gillet, P., Crielaard, J.-M., Bruyère, O., et al. (2016). Patients’ expectations impact their satisfaction following total hip or knee arthroplasty. PLoS ONE, 11(e0167911). doi:https://doi.org/10.1371/journal.pone.0167911 Retrieved May 10, 2018, from: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.016791
- Mannion, A., Impellizzeri, F., Naal, F., & Leunig, M. (2013). Fulfilment of patient-rated expectations predicts the outcome of surgery for femoroacetabular impingement. Osteoarthritis and Cartilage, 21(1), 44-50. doi:https://doi.org/10.1016/j.joca.2012.09.013 Retrieved May 10, 2018, from: https://www.sciencedirect.com/science/article/pii/S1063458412009880
- Náfrádi, L., Nakamoto, K., Csabai, M., Papp-Zipernovszky, O., & Schulz , P. (2018, March). An empirical test of the Health Empowerment Model: Does patient empowerment moderate the effect of health literacy on health status? Patient Educ Couns., 101(3), 511-517. doi:doi: 10.1016/j.pec.2017.09.004 Retrieved May 10, 2018, from: https://www.ncbi.nlm.nih.gov/pubmed/28899712