Quality Management and Patient Centricity in The Doctor’s Practice

Guest article by Nils Buske, Medical Editor and Online Marketing Manager at Medizinio

When expectations regarding one’s personal health are not met by a doctor’s practice, this can cause anger for patients. Such expectations not only relate to patient care and communication, but also to general processes. In order to avoid this scenario, the concept of patient centricity in the doctor’s practice can be helpful. It focuses on the patient and their individual needs, from scheduling appointments to the actual examination or treatment. This concept is typically implemented with a quality management system in mind, which supports the optimization of work processes and behavior for the benefit of the patient. Quality management should be understood in medical practices, because it not only serves patient centricity, but also staff satisfaction. This article will analyze what this could look like and what patients expect from doctors.

What’s it about?

1) Definition: Patient centricity in healthcare

2) What do patients expect from medical practices? 

3) Why is patient centricity important? 

4) Ensuring quality management in medical practices

5) QM procedure of the KBV: QDP – Quality and development program in medical practices

6) Implementing a quality goal with the help of PDCA cycle 8

1) Definition: Patient centricity in healthcare 

Patient centricity in healthcare describes the focus on the individual patient’s well-being when performing medical or nursing procedures. However, this process does not start during the medical examination, but long before the first contact. The Robert Koch Institute understands patient centricity as the focus of action around the desires, expectations and satisfaction of patients. This concerns not only doctors and medical assistants at the micro level of a medical practice, but also parties at other organizational levels: 

• Macro level: The focus on socio-political developments and legal framework conditions
• Meso level: Focus on institutions and associations 

The meaning of patient centricity can vary depending on the point of view and leaves some room for interpretation. While a patient representative understands patient centricity as autonomy and guaranteeing patient rights, the economist focuses on the efficient management of healthcare. The nurse, on the other hand, puts the care and therapy of the patient first. In hospitals, the further development of quality management is a high priority, since complaint management, patient safety and satisfaction are taken into account here. 

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2) What do patients expect from a medical practice? 

In order to offer the best possible level of patient centricity in the doctor’s practice, it is necessary to know what patients expect from it. DHBW Ravensburg analyzed the expectations of patients in an online survey in May 2020 with 950 participants. As a result of the Covid-19 pandemic, patients place great importance on hygiene measures. This includes a separate waiting area for infectious people or a disinfection dispenser. Furthermore, the majority expects a smoothly running practice organization (accessibility, waiting time, services, consultation hours) as well as friendly and competent staff with specialist knowledge. 

As digital consultants for doctors, we at Medizinio can confirm that interest in a medical practice has increased considerably from a doctor’s point of view, partly due to the Covid-19 pandemic. This term refers to the use of digital telematics infrastructure applications (e.g. e-patient file, e-prescription etc.) and further services (e.g. online appointment booking, online video consultation etc.). The Jameda patient study (2019) underlines the importance of digital services, which was conducted as part of a representative online survey of 1,067 patients. The study found the following:

• More and more patients are using digital services offered by medical practices

• There is a large gap between the desire for digital services and what is actually offered

3) Why is patient centricity important? 

Patient centricity in medical practices is important for meeting the growing expectations of patients. If the doctor’s office does not meet these expectations, the patient will not come back. Even worse: The patient will tell their friends and family or leave a negative review online. Word of mouth and the internet are the two most important channels in a patient’s search for a doctor. Patient centricity should be understood as an important marketing measure for medical practices. It has a direct impact on patient acquisition and therefore also practice turnover. At the same time, an improvement in patient centricity can also result in more efficient work processes (time and costs), which in turn has a positive effect on the staff, and indeed on the entire medical practice. 

The National Association of Statutory Health Insurance Physicians (KBV) associates the following advantages with patient centricity:

4) Ensuring quality management in the doctor’s surgery 

A structured quality management (QM) system can ensure a minimum quality of a doctor’s surgery. The minimum quality or the goal of QM means the focus of all practice staff on legal, professional and contractual principles for the benefit of patient-centric care. Simply put: Theoretical QM should prevent errors in practice and make processes more efficient. The results of the process-optimizing measures should be regularly reviewed internally and, if necessary, work processes should be adapted to promote quality. 

It is taken for granted that patients are treated in a friendly and helpful manner. However, there is much more to patient-centric QM. Good QM not only ensures satisfied patients, but also satisfied practice staff. It is therefore desirable to create a culture of safety for doctors, staff, patients and all others involved.

In Germany, quality management is required by law in § 135a SGB V. It is up to the doctor to decide how QM should be implemented in their surgery. Supporting information is provided by existing QM procedures such as QEP, KPQM, KTQ, EFQM, EPA or DIN EN ISO 9001 : 2000. 

5) QM procedure of the National Association of Statutory Health Insurance Physicians: QEP – Quality and Development in Practices

For a doctor’s surgery, for example, the QM procedure “QEP – Quality and Development in Practices” is recommended, which was developed by the National Association of Statutory Health Insurance Physicians (German: KBV), physicians in private practice, psychotherapists as well as employees of associations of statutory health insurance physicians and QM experts. QEP has been especially designed for doctors’ surgeries and medical care centers and offers quality targets and practical suggestions for implementation on all relevant topics.

The QEP quality goal catalog is made up of various building blocks that interlock and can be tackled step by step: 

• Patient care 
• Patient rights & patient safety 
• Staff & training 
• Leadership & organization 
• Quality development 

In addition to the QEP catalog, for which a fee is charged, the KBV has published specific tips on the topics of practice management and practice organization as well as patient care and patient perspective. From this, the most important information can be derived as follows:

Practice management and organization

Patient care

A fundamental pivotal point in the organization of the practice is not only the staff, but also the practice management system. It serves as a central data repository and supports patient data management, treatment documentation, billing and much more. The “digital command center” can significantly influence the patient centricity in the doctor’s practice: An error-prone practice management system with poor support from the provider causes a bad mood among staff and patients. Although changing a practice system is a relatively large project, in the long run it may also offer the greatest potential in terms of staff and patient satisfaction. But which system is the best? A comparison of the top 10 practice software , for example, can provide information on this question.

The market share of the respective software can be an indication of how satisfied doctors are with it. Apart from that, the software should of course match the individual requirements profile of the doctor’s surgery. 

6) Implementing a quality goal with the help of the PDCA cycle

The PDCA cycle (Plan, Do, Check, Act) is a concept that provides support in the optimization of quality goals in a doctor’s surgery. Quality objectives refer to specific practice tasks or areas and serve the further development of quality management. Ideally, self-set quality goals are not static, but a repetitive process of change, adaptation and optimisation. The four phases of the PDCA cycle are characterized as follows: 

1. Plan: Analysis of the current situation, identification of opportunities and problems, formulation of goals, planning of implementation 

2. Do: Implementation of the planned measures and gaining insights 

3. Check: Target-actual analysis, checking the implemented measures with regard to the defined target 

4. Act: Fixed implementation of the checked measures or adjustment of the measures and/or goals

Conclusion

Yes, quality management may seem very theoretical at first glance and it does not directly influence the pure medical performance. But the modern patient of today is increasingly paying attention to service and appreciation. QM can be used to focus on patient centricity in the doctor’s practice on several levels. Communication guidelines, digital tools (online booking of appointments etc.), a working practice management system, complaint management – all of these are measures that can be tackled in a structured way by the team. In addition, optimized processes not only ensure satisfied patients, but also satisfied practice staff. In any case, you cannot avoid quality management in a German doctor’s office, since the legislator prescribes it by law as a mandatory quality assurance. Although this does not guarantee that every patient will leave the practice with a smile on their face,. QM is an instrument for increasing this probability.