Award-Winning Healthcare Providers Share Keys to Patient Experience Success

Patient experience is linked to reimbursement, patient safety, and clinical outcomes.

Executives at a pair of healthcare organizations that earned Pressy Ganey patient experience awards say that following best practices has allowed their institutions to excel in patient experience.

Patient experience is a key performance indicator for health systems and hospitals. It's tied to reimbursement from the Centers for Medicare & Medicaid Services, and it is linked to patient safety and clinical outcomes.

Press Ganey recently announced the winners of their 2023 Pinnacle of Excellence Award for patient experience. The award recognizes health systems, hospitals, and other healthcare providers that demonstrate top performance in patient experience for three years. Nearly 100 organizations earned the honor in 2023.

Executives at two of the award winners, Hoag Orthopedic Institute in California and Dartmouth Health in New Hampshire, recently shared the primary elements of their patient experience success with HealthLeaders.

Steven Barnett, MD, chief medical officer of Hoag Orthopedic Institute, says patient experience needs to be a top concern for CMOs, other top executives, and physicians at hospitals.

"Patient experience reflects on all of us in our practice at the hospital," he says. "All of the doctors at the hospital work in private practice, and the experience our patients have in episodes of care, whether it is a joint replacement surgery, knee ligament reconstruction, or a spinal decompression, directly reflects on us and our practice. As CMO, patient experience is critical to my career."

Brant Oliver, PhD, MS, MPH, system vice president for care experience at The Value Institute at Dartmouth Health and associate professor at Dartmouth College's Geisel School Medicine, says there are three reasons why CMOs should be concerned about patient experience.

"First is the bottom line," he says. "About 12.5% of CMS reimbursement is predicated on patient experience performance. The better we do on patient experience, the better the bottom line will be."

“Secondly," he says, "the better we do on patient experience, the better workforce engagement will be. Working on patient experience can make working as a healthcare professional better. Thirdly, patient experience is connected to quality and safety outcomes. Evidence shows that as safety improves, so does quality and patient experience."

Patient experience best practices

At Hoag Orthopedic Institute, Barnett says, there are seven key components of patient experience at the hospital and the organization's ambulatory surgery centers.

• Ensuring that patient navigation through the episode of care, from pre-surgery to surgery to post-op to discharge, is easy and seamless.
   
• Educating patients before surgery to set realistic expectations about care and outcomes. Patients should not be surprised by anything during the episode of care.
   
• Whether it is phone calls or office visits, follow-up is part of the episode of care, and care teams want to make sure patients are achieving what they are expected to achieve.
   
• Staffing with dedicated and competent clinical care professionals is critical. The institute has been successful in maintaining high nurse-to-patient ratios, which promotes responsiveness in care settings.
   
• Offering patient engagement tools and applications that patients can use throughout their care. These resources are easy to access, so any questions that patients have that can't be answered by someone on the phone can be addressed through the tools and applications.
   
• Ensuring the hospital is clean and well-maintained.
   
• Scheduling monthly meetings of the patient experience committee to discuss opportunities for improvement at the hospital and ambulatory surgery centers.  

Oliver says there are several important facets of patient experience at Dartmouth Health.

"Effective communication between patients, families, and healthcare professionals is critical," he says. "Another critical area is access. Patients need to able to get access to what they need when they need it in a way that works well for them. Access can mean not just getting in to see a provider but also being able to get a response back when you call in."

"Another part is recognizing feelings and preferences," he adds. "Oftentimes in healthcare, we focus on the right service, the right medication, or the right diagnostic work, and those things are important. But if we do not know the patient's preferences and what they value most, we will miss the target in trying to help them. There also must be a respect for diversity, culture, and different backgrounds. Different people from different cultures have different expectations and different healthcare needs."

Dartmouth Cancer Center, Alice Peck Day Memorial Hospital, and New London Hospital have been leaders in patient experience at Dartmouth Health, Oliver says. At those facilities, there are common elements of patient experience success.

"They are frontline-oriented, meaning that if there are issues or concerns about care experience, the frontline people work to address those issues or concerns rapidly," he says. "There is also a high degree of senior leadership empowerment and engagement for patient experience activities. For example, at New London Hospital, the CEO goes on rounding with the patient relations and patient experience manager to speak with patients directly. This may seem like a small thing, but it empowers care experience actions at that site."

Avoid patient experience pitfalls

Barnett and Oliver say there are ways to avoid detracting from patient experience.

"It is important to hire the right people," Barnett says. "People who are not engaged in patient experience do not get hired at Hoag Orthopedic Institute. Patients tell us that our staff is the most caring and friendly staff they have ever experienced at a hospital. You also should never tell patients that you are too busy to do something."

Patient experience should not be approached as a matter of only amenities, Oliver says.

"Like many other fields, patient experience has evolved over time and in some health systems it is positioned as part of a communications department, HR department, or marketing department," he says. "In these health systems, patient experience efforts may be focused on improving the food in the cafeteria or having better televisions in patient rooms. Those things are helpful, but they do not target the main drivers of experience such as trust, confidence, communication, and responsiveness. So, one pitfall is to go after 'shiny things' rather than the practices that we need to focus on to optimize the care experience."

Another main patient experience pitfall is the belief that focusing just on doing the right technical things will provide a good experience, Oliver says.

"Technical prowess is necessary but not sufficient," he says. "It is critical to communicate well with people in addition to doing the right technical things in clinical encounters. It is also critical to focus on the things that are important to patients and families as opposed to the things in guidelines that we have to do."