Patient Experience isn’t a “Good Thing to Do:” It’s Everything

Some health care executive professionals regard improving the patient experience as an important, although separate, endeavor for their teams. Outcomes improvement, cost efficiency and human resources initiatives are pursued by specific committees while patient experience is the domain of others. And all too often, attention to the patient experience involves a series of quick actions to boost HCAHPS scores.

To me, patient experience is everything. It is essential to our work toward better outcomes, heightened efficiency and employee retention. Let’s consider how all of these efforts –clinical quality, efficiency and human resources –can be positively impacted when we put the patient experience at the center of all that we do.

First, we need to challenge the belief that the pursuit of patient experience is antithetical to better outcomes. I am well aware of the 2012 study published by Joshua Fenton at the University of California, Davis¹ which found the most satisfied patients had greater expenses and statistically significantly greater mortality risk compared with the least satisfied patients. However, it is important to note the conclusion to this study which calls for better therapeutic discourse between patient and physician.  Without question, we can all get behind the recommendation of more open communication between the patient and care team. A better patient experience means an open dialogue, not necessarily always granting any patient or family request.

If we focus on an optimal patient experience, I believe we can definitely achieve better outcomes. According to a 2013 NHS study² on patient-centered medicine, patients who receive clear information and two-way communication and feel they are treated with respect are more informed and involved in ensuring the success of their treatments. Evidence also shows that patients will be more will be willing to share information and comply with physician and hospital guidelines.  Additionally, they are more attuned to understanding what to expect from treatment and motivated to report adverse events or complications.

As for all our efforts to operate more efficiently, they are also better served when the patient experience is top of mind. In fact, data from 3,035 U.S. acute-care hospitals reveal that 25% of hospitals with the highest HCAHPS scores were also the most profitable.³ Lower performers showed significantly lower productivity. The relationship between productivity and patient experience also makes sense when you consider the concept of “lifetime value of a customer.” Patients who are more satisfied continue to use the services of physicians and hospitals throughout their lives and they are more likely to provide positive recommendations to family and friends, which is particularly critical during this age when patients reach out to broad social media networks to review our services online.

Finally, one of the most important aspects: employee relations. We all agree that our employees are our most important resource. Let us also remember that these talented professionals are often driven by a desire to make a difference in other peoples’ lives. This direct link is very tangible: When we rally around improving employee engagement and satisfaction, we see an engaged team directly improve the patient experience. The most satisfied and engaged employees deliver the most optimal service. This desire to provide excellent service permeates the best of our hospitals and health systems, from the clinical care & support team who strives for excellent clinical outcomes to the IT department that will work tirelessly to develop tools that empower patients or make processes more efficient.

All too often, when it comes to patient experience, there is a focus on preparing for the test rather than mastering the subject matter. Health care organizations will be limited if the focus is only on those patient experience activities which boost HCAHPS scores. In the short run, this strategy may get a higher score, but it won’t have as lasting an impact as when we make patient experience a core activity.

Ultimately, a values-based culture focused on its care giver talent and engagement is one that keeps patient experience at its core, proving its lasting worth as a community resource.

1. Fenton, Joshua, MD, MPH; Jerant, Anthony, MD; Bertakis, Klea D.,, MPH; et al, A National Study of Patient Satisfaction, Health Care Utilization, Expenditures, and Mortality, JAMA, May 12, 2012, jamanetwork.com/journals/jamainternalmedicine/fullarticle/1108766?resultClick=3
2. Doyle, Cathal; Lennox, Laura; Bell, Derek.  A systematic review of evidence on the links between patient experience and clinical safety and effectiveness, BMJ Open, January 3, 2013.http://bmjopen.bmj.com/content/3/1/e001570.full
3.  “Press Ganey 2011 Pulse Report: Perspectives on American Health Care.” Accessed April 6, 2015. http://www.pressganey.com/Documents_secure/Pulse%20

Tarek Salaway, MHA, MPH, MA, is the chief executive of Mission Hospital, part of the St. Joseph Hoag Health network of care in Southern California. Prior to being named chief executive, Salaway was the hospital’s chief operating officer (COO) overseeing a wide scope clinical and ancillary services, including the overall operations of the hospital’s campuses and off-site locations. Salaway has held various leadership roles at Keck Hospital of USC and USC Norris Cancer Hospital at the University of Southern California, serving most recently as the chief operating officer. Salaway also served as the Administrative Director of Cardiovascular and Neuroscience Services at Stanford Health Care -- Stanford University Medical Center. In addition, he held various leadership positions within the Providence Health & Services organization.