Listen, learn and change: Three underutilised principles of patient-centricity in the German healthcare system

What it’s all about

If the statements on websites and in social media are to be believed, the various players in the German healthcare system are doing everything they can to provide their patients with the best possible care and support within the scope of the services they offer. However, patient surveys often paint a very different picture of the reality.

👂Listening

One reason for this is that service providers do far too little to analyse patient opinions. It starts with the usual conversations, in which too little attention is paid to what the dialogue partners are saying. However, it is often only simple side comments or half-sentences that could provide important information for creating greater patient proximity. Active enquiry about facts, for example about employees, is also a rarity. Instead, assumptions or deductions from indicators (no complaints = 100% satisfaction) are widespread in order to get a picture of patient requirements and satisfaction.
If surveys are carried out, there are often methodological shortcomings, e.g. the use of school grade scaling, which does not adequately reflect the reality of patient satisfaction. Systematic and professional “listening” in the sense of monitoring criticism and suggestions is rare.

💡Learning

However, the availability of patient feedback is far from leading to learning processes, which in turn form the preliminary stage for change. Where analyses are carried out, the content is often not taken into account because the investigations are only implemented pro forma, e.g. to comply with quality management documentation requirements. Criticism or requests for improvement are dismissed as individual opinions in order to avoid having to deal with them further, as the aspects listed often contradict the firmly established self-image. And last but not least, patient criticism is primarily negatively emotionalised by managers and attributed to the failure of individuals. Coping with criticism then consists of identifying the person or persons responsible instead of seeing the aspects described as suggestions for improvement and a path to excellence.

🔧 Change

“We’ve always done it this way!” No other statement is heard more often in healthcare consultations. The desire to maintain established and familiar routines is widespread and manifested. One reason for this is the often high work pressure that people believe they can counter with standards. However, the disproportionate strain often results from misalignments in work structures and processes, so that changes could significantly reduce the overload problem. If these adjustments were harmonised with patient requirements, a new, demand-oriented quality of service would emerge almost automatically.

Conclusion

In the German healthcare system, there is often a lack of consistent patient orientation, which should be characterised by systematic listening, learning and change. Patient opinions are rarely analysed thoroughly and feedback is often not translated into learning processes that result in actual change. The common practice of dismissing criticism and suggestions for improvement as individual opinions or attributing them to individual failures in an emotionally charged way prevents feedback from being used constructively. In addition, there is a strong tendency to stick to established routines instead of adapting work structures and processes, which often exacerbates the strain on healthcare staff. However, a switch to demand-orientated service quality could not only reduce overload, but also significantly improve patient satisfaction and care.