Patient Feedback and the Role It Plays in Improving Patient Experience

by Sarah Hitt

My first post in this four-part “Influencing Patient Experience” Blog series, New Technology and The Customer Experience, recapped a very informative webinar by Alverno Laboratories (watch the recorded webinar here).  Focused on what they have branded “The Alverno Experience,” they strive to provide the best patient experience to all individuals who use their services. To overcome the difficulty of collecting and analyzing patient feedback at the point of experience Alverno partnered with HappyOrNot. In just one month and four Smiley Terminals™ they were able to surpass their satisfaction rating target.

Today, we look at survey methodologies, what they measure and how new techniques can be applied to raise the bar on not only patient experience but profitability.

Quality instant feedback and patient experience

The preponderance of online customer ratings in today’s global marketplace underlines the very important role they play in influencing the decision-making process of consumers. Although these ratings were prevalent in most consumer-facing industries, they weren’t quite so popular in the healthcare industry – until recently.

In the US, due to rising medical costs and insurance premiums, consumers are being forced to assume greater financial responsibility in regards to their healthcare. As such, they’ve become more active in healthcare decisions and strive to receive a commensurate value or quality of care for their money.

When deciding which healthcare providers to go to or which medical professionals to seek care from, patients now look to online reviews as well as patient experience and satisfaction scores.

Prominent patient surveys

Two of the prominent patient satisfaction measurement tools in place today are HCAHPS and Press Ganey Surveys.  Both surveys are conducted post patient discharge. The HCAHPS is structured to collate quantitative feedback and assesses “how much” care a patient received.  While the Press Ganey Survey is tailored to provide a more qualitative view of the patient’s experience, it is basically an assessment of “the quality of care” a patient received.

Let’s explore each a little deeper.

The quantity of care assessment

The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is required by CMS (the Centers for Medicare and Medicaid Services) for all hospitals in the United States.  It was designed to achieve three major goals:

1. To continuously obtain data on patients’ experience of care, allowing for meaningful and objective comparison of hospitals locally, regionally and nationally.
2. To create new incentives for hospitals to improve the quality of care they provide by publicly reporting survey results.
3. To increase transparency and visibility into the quality of care provided by hospitals in return for public investment, thus facilitating enhanced accountability in health care.

The HCAHPS survey consists of 32 questions directed at discharged patients. It quizzes patients about their experience during their recent hospital stay and asks them to rate the frequency of specific events during their care (always, usually, sometimes, and never).

Impacts of HCAHPS ratings

Survey results are very important since they capture the opinion and feedback from patients, enabling providers and the entire community to have insight into how patients experienced the care that was provided.

Aside from publishing the HCAHPS ratings of hospitals across the country online, the government provides reimbursement based on results – ensuring that hospitals with excellent performance ratings are financially secure.

A hospital’s HCAHPS ratings also account for 25 percent of a value-based purchasing score – a score that directly impacts its Medicare payments.

Ultimately, HCAHPS aims to obtain actionable information that validates how healthcare consumers experience care, to allow providers to pinpoint areas that require improvement in their healthcare delivery.

While hospitals are expected to conduct certain surveys by various agencies, how often should they conduct their own research? What measures should they use? And how do they use the information they have to drive improvement?

The quality of care focused assessment

The Press Ganey Associates methodology consists of several patient experience surveys that are customized to the service line and setting. These questions have been tailored to address communication and service issues in a bid to improve interpersonal relationships between clinical teams and patients.

It enables providers to understand the psychological and physical suffering of patients during their inpatient care, allowing them to take an active interest in controlling various processes that contribute to patient distress or discomfort. Some of these factors include a lack of compassion, poor communication, and inadequate information on a patient’s medical issues.

Press Ganey surveys combine HCAHPS questions with patient-centered questions that have been scientifically developed to provide comprehensive coverage of patient experience. In addition to the official HCAHPS program questions that measure the frequency of services provided, Press Ganey questions enable a more balanced and holistic perspective of care by focusing on the qualitative aspect of care (how well a particular service was provided).

The Press Ganey survey methodology meets scientifically rigorous standards and has been tested in national validation studies to ensure construct validity, predictive validity, and reliability.

Discover your winning combination

By leveraging both survey methodologies, providers gain a holistic outlook on what a patient felt and experienced during their stay at their facility.

You should note that, by itself, patient experience is a key indicator of quality, and how patients perceive the quality of care you provide determines their overall experience. Ensuring a positive patient experience requires you to treat patients with respect and dignity at all times and also involve them when making decisions about their care.

To improve the delivery of care, you must develop an effective and seamless approach of measuring, since patient experience enables you to pinpoint areas where targeted intervention is necessary.

However, to truly gauge the actual patient experience for your organization requires the development and use of a combination of effective survey instruments and feedback methods.

Introducing new techniques

HCAHPS and Press Ganey surveys are traditional tried and true methodologies. While they present a broader approach, feedback is solicited and collected at some point in time following patient discharge. Newer techniques of measuring feedback enable the real-time gathering of patient feedback. These techniques help to optimize patient care by facilitating low-cost, repeatable measurement of patient experience data.

Such repeatable measurement is key since patient experience varies between departments, teams, and wards. This makes the routine measurement of patient experience at all levels of your organization a critical activity – one that should be done alongside the measurement of health or clinical outcomes (which assures the public of the quality of your healthcare delivery system).

When developing and implementing care and quality improvement plans for your organization, it’s a good idea to involve those members of staff that work directly with patients. Such staff can offer useful opinions on improving patient experience, and their expertise can help develop targeted quality improvement initiatives.

Ultimately, patient feedback should be leveraged as part of a focused approach toward improving quality and delivery of healthcare services.

Benefits of incorporating an instant feedback methodology

Research has shown that providers who leverage quality instant feedback methodologies are better able to develop and rapidly implement quality improvement initiatives to improve operational performance within their organizations.

The feedback obtained at the point-of-experience is seen as valuable since it captures the opinion of patients immediately after the interaction and before they leave the facility.  There is no need for patients to stretch their memory to recall at a later date what their patient experience and perception of the provider’s healthcare delivery was like – as is the case with comment cards or surveys sent via mail and email or telephonic surveys.  And, the responses are typically greater in number.

The instant feedback received is more accurate and there is less room for bias. A patient’s perception of care may be influenced by external factors and may change after leaving the healthcare facility. By leveraging quality instant feedback, providers can immediately introduce improvement initiatives targeted at patients’ pain points in a bid to reduce or eliminate their negative experiences.

By monitoring and analyzing the results of quality instant feedback methods, providers can rapidly take action to increase their patients’ satisfaction levels.

Proven positive effect on net patient revenue

Instant, point-of-care feedback mechanisms are becoming popular; they are being used as standalone systems as well as to supplement and support other forms of traditional evaluation approaches such as HCAHPS and Press Ganey surveys.  Patient experience improvements made early have been shown to improve the outcomes of these very important public-facing surveys. A very critical fact to keep in mind, as reported in the 2018 Global health care outlook: The evolution of smart health care by Deloitte, patient satisfaction accounts for a difference of $444 of net patient revenue (per adjusted patient day) between “excellent”-rated and “moderate”-rated hospitals.

Our next featured blog in the four-part “Influencing Patient Experience” Blog series is “Employee Experience Drives Healthcare Patient Experience”. And I explore how focusing on employee engagement helps drive increased patient satisfaction.