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Patient Experience: Hospitals' Holy Grail?



With increased transparency, pay for performance ramping up, and social media communications increasing in popularity, the patient experience has become the key differentiator among healthcare providers.



30 comments on "Patient Experience: Hospitals' Holy Grail?"
William (10/28/2011 at 11:38 PM)

Nina, great points! People will never remember what you did or how you did it, but will always remember how you made them feel. And if you love your job, and are in medicine for the right reason, to help people, it will show in your work and your contribution to the scores. God bless.
mHealth Innovations (10/26/2011 at 11:44 AM)

Relationship with patients determinate the satisfaction's level of the client, totally agree with that. But I believe that as well is the sum of some other factors that make the experience to be good or bad. Those factors goes from hospital or health centre installations, time of waiting to be seen, the possibilities of getting an appointment when the patient can make it... in my opinion factors that can be improved by using mobile applications
Nina (10/19/2011 at 9:30 AM)

Relationships are tough to build in today's society, whether due to time factors or communication systems. I know as an RN, I have to force myself as I walk into the room to slow down, connect with the patient, and have a presence. When I reflect on my day, if some of those components do no occur, the day does not give me pride in my job for that day. I love being a Nurse and I want my patient's to remember the care I gave them.
Kate Ebbutt (10/19/2011 at 7:36 AM)

My current favourite comment on this comes from Jim Martin "when feedback is ignored and becomes a complaint, it risks changing from being an asset to a cost" At Patient Opinion, we think that peoples' stories of healthcare are hugely powerful tools for transformation and culture change, and that the web is a fantastic tool to help make the most of these stories. By sending patient stories to just the right heath service staff, we try to create changes to services and to make a culture where patient experiences are embedded in how staff think about the work they do. We've found that while patient experience might be the holy grail, not enough staff think it is. Hopefully empowering patients through the web will help...
Jean E. Howard, M.D. (10/18/2011 at 9:38 PM)

After reading the other comments I will expand on mine. I have lymphoma and I am BC in Heme/Onc so my illness is in the same area as my subspecialty. So I am in position to determine whether standard of care (or whether even legal violations have occurred) has been met and in most instances in my case it was not. The pt satisfaction questionnaires are useless to determine whether standard of care was met. They are too infantile to address sophisicated issues.
Jean E. Howard, M.D. (10/18/2011 at 9:16 PM)

How do you measure patient experience? I am a retired physician and now a physician pt with a serious illness. My experience at five institutions including a major university medical center and a VA medical center has been uniformly miserable and terrible. So how would you measure my experience?
Well stated... (10/18/2011 at 3:34 PM)

Corporate influence in medicine is detrimental to patient safety. Experience shows that in the boardroom, profit will always trump humane concerns and ethical qualms.
ali naffaa (10/18/2011 at 2:37 AM)

Totally agree with you Brian. No body is better at understanding patient experience than the patient himself. When we say that hospitals should partner with patients to improve quality of services, it also means employing people with hospitalization experiences and proper preparation to act as educators.
Margaret (10/17/2011 at 7:42 PM)

As positive as this appears to the patients, it will put added stressors on the caregivers. As a nurse, most of my 12-hour shifts were 13-hour shifts without any breaks or dinners. When new measures were introduced, it was in addition to the already full load of responsibilities! Rarely was work taken away from us. With this initiative, the nurses are going to work even harder without any additional time provided.....and when the patient satisfaction scores are not met, nurses will be held accountable at raise time.
Mark (10/17/2011 at 1:16 PM)

i believe the most negative change, in the past few years, for the hospitalized patient is obvious. It is the use of the "so-called" hospitalist. It is great for physician practices, but really is unpleasant,at best, for the patient. The use of "intensivists" in critical care units, is on the other hand, altogether different. With the INTENSIVIST the critically ill patient is getting the best and brightest, with the HOSPITALIST the patient is often getting the opposite.
Ernie Vesta (10/15/2011 at 8:13 AM)

I teach it often, "No one cares how much you know until they know how much you care".
Brian Hess (10/13/2011 at 11:30 PM)

I was glad to read this topic and see that someone else feels as I do. I myself am a kidney patient of over 23 years, having been on dialysis for 14 of the last. I started out as a patient at the age of 6, but rather than just grow up and try to be the best patient I could, I have taken things a step further and learned as much as I can about medicine and biological sciences. I've also spent enough time volunteering and shadowing in the medical field that anyone that knows me could tell you that I would make a great patient educator for those with kidney disease. Sadly, the truth that I'm running into now after having my college degree is that potential employers are still taking what they consider the safe bet and going with the person with established work experience. Apparently because I'm still young and only have hours and hours of volunteer and college experience, despite my background, I can't get anyone to take a chance on me. My bottom line: I believe that we need more patient educators, especially those that are patients themselves armed with both knowledge and experience, but someone has got to give "patient" educators a chance to prove themselves instead of always going with the safe bet.
Gaynor (10/13/2011 at 1:41 PM)

I am re-training to return to health care after a long absence. I see a lot of changes & emphasis put on areas less important than others. Patient Education is very important. Patients have the right and need to know everything about their diagnosis, treatment options, outcome / prognosis. Health care givers must understand how to convey information to the patients and use feedback to confirm they fully understand. Perhaps there is a language barrier. There should be a way to make arrangements for translation services & re-schudule the appointment. Too many patients just nod, the care giver assumes they understand, the patient walks away none the wiser or at worst more confused. Health Care Has Become an Industry!Patients are consumers and have many options to choose from if they are educated. I have more ideas and comments but this is only a comment page, not a place to write an essay. Thank you for reading and please share your opinions if you wish.
Anonymous (10/13/2011 at 12:05 PM)

I just did an overview on CAHPS, with emphasis on HCAHPS and CG CAHPS for a team at work, so this is timely. I agree with quite a bit of what you're saying, and to be sure, there needs to be a strategic decision to change the culture, hiring people that balance clinical quality AND are service-oriented, i.e. they actually like taking care of people too. I do think you diminished the importance of checklists, because it's been shown, particularly in healthcare as of late, that they can be very effective. Dr. Atul Gawande wrote a whole book about it called "The Checklist Manifesto". You're getting flack, probably from physicians, who argue that you can't judge the quality of a patient experience. That's an excuse from people who are resisting change. We judge quality on the experential all the time, otherwise, Lean Six Sigma wouldn't be used to improve services and would be limited to manufacturing processes to improve product quality. HCAHPS has identified areas for improvement that will affect reimbursement. Now roll up your sleeves and do some work. To test patient experience, Kaiser built up theaters walking actors through procedures, and got feedback on how they do the things that HCAHPS will test, like clinician communication. Cleanliness and noise levels can certainly be fixed. It means paying more attention to them. It means using technology to be more responsive to patients needs. The best hospitals out there already do great in these areas. It's not easy, but it's certainly possible, and worth it. Every other industry has had to do it. Healthcare's gotten away with excuses for too long.
Anonymous (10/13/2011 at 10:21 AM)

As a healthcare provider, I can say one thing for certain. What the patient wants is not always what is good for them or indicated by best practices. How they perceive their care based on if they get what they want, even if they are treated with respect and attempts are made to educate them, will inevitably lead to low "scores".
Jim P (10/12/2011 at 10:17 AM)

An article describing way to improve the patient experience would help. An article describing that the scoring has to be "always" would also help. It is easy to say you need to have Doctors and RN's always communicate well w/ patients, but how is that accomplished?
Ardella Eagle (10/11/2011 at 10:52 AM)

Interesting article, however it's assuming that the patient is educated enough to understand what their input means. As a patient myself, there are many times where I just toss out the questionaire that I receive two to three weeks after my appointment, and I consider myself a modestly educated individual. Yes, you will receive surveys back, but will you receive enough back to give you a good cross section of the care delivered?
Aileen (10/8/2011 at 8:22 AM)

I agree with Lee. The culture is the whole basis of the performance of quality care. Administration on down must demonstrate the culture of excellent care every patient, every time, every day. Staff who are unhappy will not uphold that culture and deliver the kind of care that will boost any score you are trying to achieve.
Lee (10/6/2011 at 9:42 PM)

What is most surprising to me is this: there is so much focus and money being spent on outrageously expensive programs to improve HCAHPS scores when the root of the problem is each employee at the hospital. Each of us is a reflection of the hospital's culture. Culture trickles down – management to staff. My philosophy is simply; it's the Golden Rule. Mine is: Hurt not others in ways that you yourself would find hurtful. Translation to my profession is simple too: if I am the patient, how do I want to be treated? When staff members lose sight regarding the impact they make when encountering and providing care to our patients and family members, all the smoke and mirrors in the world cannot change the impression our customers take away. An observation I have made is that genuine kindness amongst all (including co-workers interactions with each other) is something we can't really teach. An opportunity for remediation should be provided but if necessary, a little "house cleaning" would go a very long way. Those who have a bad attitude on a regular basis should find a new career! I have observed many folks who don't care that they have contaminated a sterile item or can't be bothered to slow down /speed up to do the right thing. There are folks who basically feel live just sucks and really do hate their job. Negative and unsafe behaviors should not be tolerated; ultimately, the facility and the community served will pay the price.
Isabelle (10/6/2011 at 6:41 PM)

Just want to point out two things: 1. The HCAHPS score is worth 30%, not one-third. 2. And is graded on a curve, using the fiftieth percentile and ninetieth percentile.
Wiliam (10/6/2011 at 4:56 PM)

As a physician on staff at 8 facilities, and a former co-administrator of an ED at has been ranked in the top 1% in patient satisfaction since opening 7 years ago, now regional administrator for a large group, I can honestly say that the quality and efficiency of healthcare is improving drastically the last few years. Do the providers care more? Are the facilities staffed better? Are they paid better? No. The are finally being held accountable. There is a transparency that allows those that do a phenomenal job to realize they are succeeding, so they even take further pride in their work and strive to continually improve. At the same time, they are doing more with less. As Medicare and Medicaid reimbursement pays pennies on the dollar, and continues to decline... With private insurance following, the money is not there. Quality hospitals succeed doing more with less by maximizing efficiency through standardization and process improvement while closely following metrics. By adding the transparency and tying in reimbursement there is also a larger recruitment of hospitals striving to improve. These changes are necessary and long overdue. The additional cuts to Medicare and Medicaid reimbursement, however, and much of Obamacare threatens to crumble even the strongest parts of our healthcare systems that have weathered the storm through optimizing efficiency and demanding excellence.
Sandie Bock (10/6/2011 at 9:46 AM)

I have worked in the healthcare business since 1964 and in that time have been a nurses's aid, Lab Technologist and now a Physician Assistant and have been since 1978. Unfortunately, I have also been a patient a number of times. I worked for 22 years at the largest hospital in Boston who is now partners with some other hospitals in Boston and surrounding communities. I was a patient recently in a sister hospital of that one I worked in for 22 years and had been a dedicated patient in that same hospital. The patient care, the attention to the patient at that sister hospital was so much ahead of my original hospital I wrote to the CEO of both hospitals(same man). Their care was very much patient centric whereas the original hospital was definitely about their reputation, their staff were tired, and in some cases angry. The sister hospital was such that I asked what they put in the water here at the hospital for the employees to have them so happy with themselves and the care they give. Each seemed happy with their work, the doctors spent a lot of time with me, unlike the 5 or so minutes I got at the original hospital. I have suggested that the staff at the sister hospital teach courses on patient care and satisfaction, attitude and listening skills to the older original hospital. Suggestion to each- the billing department that is the same for both is terrible, misbills and could care less when you bring this to their attention. That is part of patient care, the bill being wrong can sour the whole experience. The hospitals should spend less on rugs and adornments for offices and more on what will make their patients more comfortable, their staff more safe.
Ade (10/6/2011 at 9:14 AM)

The most important thing for hospitals and healthcare industry should be "Efficient and effective healthcare delivery with patient satisfaction". If we would just concentrate on those things only, no one would be talking about pay for performance and all the other stuff.I have seen a great deterioration in our delivery system in the last 15years. Health care organizations are too focused on "the outside governing rules". All these lead to poor performance by staff (nurses, doctors, allied) in the long run.
Elisha Lowe (10/6/2011 at 8:20 AM)

I am a Registered Nurse who have also experienced being a patient which I think has given me some real insight into health care delivery. What we label health care users is of no importance when the care delivery is lacking. For some organizations reimbursement policies has been the impetus for them to focus on improvements in this area. For others, striving to be a center of excellence was the driving force. Personally I don't care what motivates hospitals to pay attention to service levels, just that they do. I also hope that the leadership gets that the staff members (the ones actually delivering care) need to be engaged, informed, recognized for their achievements, and continually educated in areas of customer service and clinical competency. Lastly, when any hospital employee repeatedly fails to meet standards, they should be let go. It is after all a matter of life and death. Elisha Lowe, RN BSN
Grant (10/5/2011 at 6:43 PM)

In relation to Patient (I much prefer the term GUEST) Experience it is a shame that Government reform has been needed to "ensure" facilities do what most would consider 'common courtesy'. In no way is anyone trying to take away the importance of clinical care and clinical outcome, but for far too long GUESTS have been suffering in silence about the way they are treated (not clinically teated) in the facilities. It is not too much to get the small and basic service ethics right, which have such a large impact on the "experience" and ultimately have an impact of clinical outcome. I invite you to look at the Healthcare Warrior website (www.healthcarewarrior.com) for some complimentary training programs and a Cost of Poor Service Calculator as well .... Keep fighting the good fight Grant Muddle www.healthcarewarrior.com
larissa marangoni (10/5/2011 at 3:30 PM)

In health care you have to individualize and analyze each patient depending what they need and not what is more convenient for the Doctors. The Hospital attention has to become almost as if you are at home with your family taking care of you, with quality, warmth and spirit.
rick kernan (10/5/2011 at 12:52 PM)

to whom it may concern: it is a travesty the way the health profession is dealing with what patients must go through just in order to be seen. i can assure all of you that if you actually went through what a patient must endure just to get in and see their assigned doctor your attitudes would be totally different. i want to tip my hat to the Contra Costa Regional Medical Center and their CEO Anna Roth, who are tackling this problem with earnest to insure that their patients are seen in a timely manner and that their patients can obtain an appointment with their doctor before something serious happens because they couldn't deliver care for a patient. It is time that the medical community as a whole take notice of what they are doing and make an attempt to do the same thing. If this is accomplished every one in the medical world will develop a beter attitude and the moral of everybody would be vastly improved. thank you for allowing me to express my sincere concerns for something that is long overdue to be addressed. Richard Kernan patient
Richard McCrone (10/5/2011 at 9:06 AM)

I would like to believe that the new rating standards will lead healthcare providers to look at their systems of delivery to find critical quality points. (The procedures that result in errors) This can be anything from pre-surgery procedure, how trays are packed in sterilizers, how Legionnella is controlled. If errors can be prevented costs can be significantly reduced.
Jeffrey Hamilton (10/4/2011 at 10:00 AM)

Patient Experience: Hospitals' Holy Grail? I find it interesting that the author felt inclined to make it a question rather than a statement. Truth is, no matter what hospital administration and staff may want you to believe, the patient experience is still secondary to the bottom line.
Anonymous (10/4/2011 at 9:12 AM)

One thing the writer failed to mention about HCAHPS is that HCAHPS has nothing to do with patient experience. HCAHPS measures how often something was done, not how well it was done. Patient experience is all about how the patient perceives their care. An employee can go to work everyday, which would get an always under HCAHPS. But, the employee could be horrible at their job, which would get a fair or poor when it comes to patient experience or satisfaction.