According to James W. Saxton, a Lancaster, PA based attorney and author of The Satisfied Patient: A Guide to Preventing Malpractice Claims by Providing Excellent Customer Service, “It should come as no surprise to know that patients and clients who perceive a provider as courteous, attentive, and having their best interests at heart are less likely to sue than patients and clients without these perceptions, especially if the outcome isn’t exactly what they had hoped.”

One of the primary roles of the NCM that reflects Mr. Saxton’s philosophy, according to the Certified Case Management Commission: is “to act in the individual’s best interest in a complex and fragmented health care system. (The CCM) facilitates communication among the patient, family, doctors, hospitals, insurance companies, and other parties; this approach achieves optimum value and desirable outcomes for all—the clients, their support systems, the providers, and the payers.

This is not “new” to those who are working with injured workers. Mr. Saxton points out that this practice applies to all professionals in healthcare. Satisfaction begins with your first impression. “You need to invest in that first 10 seconds,” Saxton said. We can utilize these practices in the management of workers compensation cases.

Mr. Saxton recommends the following: “Greet patients/clients by surname, unless they request otherwise. Look them in the eye, smile, and treat them the way you would want to be treated or the way you would want your parents to be treated. When starting to work with a patient or client, take a few moments to explain what you are about to do and ask if he or she has any questions so you can assess the individual’s comfort level and allay any concerns. Communicate clearly, using layman’s terms, rather than clinical terminology.” By explaining your role you can set up an initial relationship that will be a solid foundation for the successful outcome of the claimant’s case.

For adjusters with heavy caseloads, it may be difficult to address all claimant’s concerns and expectations. Saxton points out that “Failed” communication with patients or clients and their families is one of the most common causes of lawsuits. “The importance of listening can’t be overstated,” Saxton said. By asking “Is there anything else I can do for you?” or “Can I answer any other questions?” often defers the patient’s and/or client’s from feeling they are being rushed. “Asking some type of open-ended question generally doesn’t take more time and it sends the patient (claimant) satisfaction sky–high.”

July 2010
Author: Deborah Goza, MS, RN, CCM, COHNS
Editor: D. Perry