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| The Surgical Technologist | JULY 2016 308 centric care agendas. Yet paradigm paralyses among many members of healthcare facilities, their provider groups and caregivers alike have caused slow acceptance of any relationship change between themselves and their patients. The struggle patients encounter when lost in the endless uncertainty of what is happening during their care can cause more frustration and add to the lack of good health. P R O B L E M S T A T E M E N T Don Berwick, former Administrator of Centers for Medi- care and Medicaid Services (CMS), challenged the health- care industry to acknowledge that units of production and throughput are not the fundamental business of health- care; rather it is the positive relationships between care- givers and patients that provide ultimate positive health results. These relationships begin with healthcare orga- nizations and caregiver groups recognizing the signifi- cance of taking time during service encounters to provide patients with a connection that engages meaningful dia- logue. Informed patients who have appropriate, timely and reliable information makes them part of the healthcare team. Likewise, patient education and information, which help to inform patient choices, can also encourage joint decision-making. When caregivers engage with patients, they can solicit immediate feedback, thereby addressing care issues proactively and possibly reducing the cost of care. Collaborative decision-making fosters trusting relationships and are touted as essential components for improving quality and reducing cost. 15 Furthermore, meet- ing patients’ expectations when providing care undoubt- edly leads to their satisfaction and makes them part of the health production equation. Comments made by researchers of a recent prospective cohort study of 4,709 surgery patients concerning patient satisfaction stated, “… how we deliver healthcare may be of key importance along with the specifics of what we deliver … .” 11 Responses from patients in this study pro- vided researchers with an understanding of the contention that patients’ ultimate satisfaction is controlled by meet- ing their expectations, taking away their pain and creating a positive experience. 11 To accomplish satisfaction at this level, a model of care – which engages patients and their families in the healing equation – is vital. Despite changes in pay-for-performance guidelines and the vast amount of research connecting patient engage- ment with positive patient outcomes and lower healthcare costs, skeptics have paid little attention to these studies and discount any legitimacy between patient engagement and positive patient outcome correlations. This article will promote the concept that health is a product. It also will discuss the Certified Surgical Tech- nologist’s (CST) role in adding to the production of patient health through patient engagement practices by focusing on communications between the CST and the patient dur- ing the short time these members interact in the operating room. L I T E R A T U R E R E V I E W Other industries have studied and reported on the signifi- cance of engagement encounters and the relationship these encounters have on customer satisfaction, cost and positive outcomes; however, the healthcare industry has been some- what slow to study these correlations. Critics of patient sur- vey tools used to score satisfaction do not believe patients are credible sources for meaningful data because they lack the medical education necessary to provide validate infor- mation. 18 Moreover, the lack for understanding this corre- lation may be contributed to a myth that patients desire a paternalistic physician-patient relationship: one where cli- nicians drive patients’ decisions concerning clinical treat- ment. Now that more attention is focused on government’s involvement in healthcare, satisfaction becomes the back- drop of pay-for-performance initiatives. Consistent, open and honest communications about health coupled with transparency of price and quality outcome data will become determining factors patients and their families use when making healthcare decisions. Joint decisions are the very inputs required to produce a success health product. Consumer Driven Care The healthcare industry is becoming more and more con- sumer driven as cost, satisfaction and perceptions of quality are valued in the customers’ selections of medical insur- ance coverage, caregivers and healthcare facilities. Jessica Liu, a Practice Manager for The Advisory Board Company, explains that high-deductible healthcare plan enrollments mean healthcare product buyers (patients) will become “the new clinical shopper.” The digital age supports this claim through the development of new technologies such as smartphone applications that allow potential healthcare customers to shop for hospitals and care providers by price quoting (www.Pokitdok.com, 2014) and personal computing