By Thomas Davis, DNAP, MAE, CRNA

You know the type of surgery that your patient will receive, you have reviewed the lab work and history/physical and you have a sense about their basic health.  It’s time to meet the patient, assess the airway, explain what you will be doing and then get the case going.   You feel as if you know your patient, but do you know who they are as an individual?

The business community has learned that regardless of the product being offered or the knowledge of the salesperson, it is the consumer who makes the decision about what to purchase or pass up.  Over the past decade, the business community has become increasingly aware of the importance of understanding consumer intent.  Simply stated, consumer intent is the desired outcome that drives the person to purchase a product.  It is the foundational reason that creates the motivation to buy the item.  You may know your patient from a medical perspective, but you don’t truly know them until you understand what drives their desire to obtain medical care and their desired outcome.

How does consumer intent apply to us as healthcare workers? After all, we are in healthcare to provide a basic service and promote wellness.  Yes, we provide essential care, however patients have ownership of their medical records and are no longer geographically bound.  Our patients are free to travel either locally or to distant communities to obtain healthcare as they desire.  As a result, healthcare delivery has become competitive, and providers must be sensitive to creating a loyal customer base that generates the cash flow required to keep the doors open.  Becoming aware of customer intent builds a foundation for a trusting relationship and promotes two-way loyalty between the provider and the patient. 

On the institutional level

Healthcare organizations want to be at the forefront delivering state of the art, evidence-based care to their population base.   Introducing new lines of care and investing in technology to support emerging programs is expensive, therefore, upper-level leaders assess return on investment before moving forward.  Gathering information about consumer intent gives important insight into what services their client base want the organization to provide.  Writing in Loyalhealth, author Brian Gresh describes how healthcare organizations are using chatbots linked to artificial intelligence to assess consumer intent.  Prominently displayed on the company website is a chatbot with the Question, “How can I help you.”  Questions from patients are submitted and AI links to evidence-based information that answers the person’s question.  In the background, the organization captures the questions that are asked and gains valuable insight related to what is on the mind of the population that they serve. 

Consumer intent on a personal level

Reviewing information gathered by the company chatbot may be interesting, however, it is up to us to connect one on one with our patients and determine not only what they want, but also why they want it.  The task may sound daunting, yet by making a commitment to connect with each patient and following a simple plan, you will be amazed how easy it is to gain insight into the patient and their family.  Let’s get started.

Develop a routine.  We are creatures of habit and are less likely to forget something when it is part of our routine.  Review your order of events for doing the pre-operative assessment/teaching and create a space to learn about the patient as an individual including their expectations related to the desired outcome.  Create and ask personal preference questions at the same point during every pre-op interview. 

Develop open ended questions.  Establish one or two non-medical questions to assess who the person is as an individual.   Writing in the Harvard Business Review, Authors Awdish and Berry recommend questions that reveal individual preferences and expectations.   Rather than opening the pre-operative interview with questions about the person’s baseline health, introduce yourself and then ask, “What is important for me to know about your health, your preferences, and you as a person?”   If you listen attentively, you will gain valuable insight about baseline health as well as expectations.  A favorite question that I ask patients as we roll to the operating room is “Tell me something about you that is not on your medical record.”  Again, careful listening will give you insight into the things that matter the most to your patient.

Hone your listening skills.  The questions in the previous paragraph are only effective if you actively listen.  Enter the conversation with a curiosity to know more about the person and a commitment to using higher levels of listening to gather insight.  Writing for The Black Swan, author Derek Gaunt describes five levels of listening:

• Listening for the gist.  In a busy, high production pressure environment, who has time to effectively listen?  When you listen for the gist, you say “ya, ya” as the other person talks and all the while your mind is elsewhere.  If you check your phone for messages while another person is talking, at best you will get the gist of the conversation and no more.  Not only is it rude, but you also cheat yourself out of an opportunity to learn about what is on another person’s mind.
• Listening to rebut.  Unfortunately, we spend too much time at this level of listening.  The entire time the other person is talking, your mind is on your reply.  When talking to patients, we don’t always rebut them, rather, we flip the conversation away from them and toward ourselves.  The patient opens the door with a statement, and you jump right in to tell the patient about your experience.  Suddenly, the patient is silenced, the conversation is about you, and you learn nothing new about the person.
• Listening to the logic.  At this level of listening the focus is on the other person and you have a sincere desire to learn what they are thinking.  Whether you agree or disagree doesn’t matter, the important thing is to learn their point of view.  Keep the conversation alive by restating what you hear and say, “tell me more about.” 
• Listening to the emotion.   When you achieve this level of listening, you are experienced at listening to what a person thinks and now you desire to learn why they think that way.  Again, use open ended statements such as, “that must have made you tense, frightened, happy…”  Then listen as they describe their feelings.
• Listening to their point of view.  It is rare that we would get to this level of listening with a patient.  At this level, you learn where the person feels they fit into the global scheme of things.   It takes time and trust to get to this level of communication where it is safe to share political, religious, or personal preferences without judgement.

Why is connecting with patients important?

We work in a competitive market where many organizations vie for the healthcare business of our patients.  Connecting one on one with each patient and giving the impression that you understand them as an individual creates a loyal client base.  However, the greater benefits include higher patient and provider satisfaction, improved patient safety, and improved outcomes.  Simply stated, we tend to take better care of patients when we feel a sense of connection and, likewise, patients are more likely to comply with medical directions when they trust and feel connected to the provider.  Actively gaining insight into our patient’s consumer intent is a win/win for patients, providers, and healthcare organizations.

Tom is an experienced leader, educator, author, and requested speaker.  Click here for a video introduction to Tom’s talk topics.