The Time is Now for CMOs to Learn from Patient Experience Feedback

Advocate Health strives to listen to groups of patients and individuals, then redesign care at scale.

Patient experience is crucial for healthcare organizations because it impacts health outcomes and patient satisfaction. A positive patient experience leads to greater patient adherence to care plans. A negative patient experience leads to decreased patient loyalty.

Advocate Health, which operates 69 hospitals, tracks patient experience for more than 6 million patients annually and implements related redesign of care at scale.

Listening to the feedback of millions of patients then redesigning care based on that feedback is a differentiator for Advocate Health, according to Bradley Kruger, MA, MBA, vice president for patient experience at the Charlotte, North Carolina-based health system.

"We get more than 2.5 million patient experience surveys back every year," Kruger says. "That is a lot of feedback, and the patterns we see are actionable."

An example of patient experience feedback that is actionable in real-time is related to medication, Kruger explains. A patient may have a medication change, and with that change, they could not afford to pick up their script.

"We have feedback loops hard-wired at the clinic level," Kruger says. "When we get feedback, we call the patient and learn more, then help them get the resources they need to get their medication."

Advocate Health aggregates other feedback and looks at the patterns across different groups of patients. Scale allows the health system to hear things that other health systems may not hear, according to Kruger. For instance, during this year's flu season, there were a lot of RSV cases, so there was a large respiratory illness spike in January and February that resulted in patient feedback.

"We could see the impact that spike had on patient experience, quality, and safety through listening and feedback," Kruger says.

Advocate Health is taking the information it gathered on the respiratory illness spike and planning for the future.

"We found that patients needed information on access urgently and acutely," Kruger says. "Wait times became a concern for patients in the emergency room and urgent care centers."

By listening intently to patient experience feedback, Advocate Health also implements changes based on the experience of individual patients.

"We had a patient at Advocate Illinois Masonic Medical Center in Chicago who had been hit by a car while riding a bicycle and came into the emergency room," Kruger says. "As part of the care process, she had to have her hijab cut off. She put into her survey feedback how unsafe that made her feel."

Advocate Health investigated the incident and looked for ways to avoid a repeat patient experience.

"We partnered with a Muslim-owned startup that makes disposable hijabs," Kruger says. "Now we have disposable hijabs stocked across the enterprise."

Bradley Kruger, MA, MBA, is vice president for patient experience at Advocate Health. Photo courtesy of Advocate Health.

Using volunteers to improve patient experience

Advocate Health is using volunteers to boost patient experience.

"At Advocate Health, we have more than 10,000 volunteers who contribute more than 500,000 hours of effort every year," Kruger says. "That time supports patients at the bedside—we are using the volunteers to improve patient experience, quality, and safety across the organization."

One volunteer initiative uses 100 virtual volunteers who are mainly pre-med students.

"They learn how to navigate Epic and how to talk with patients," Kruger says. "They call patients within 24 hours of them being admitted to a hospital, mostly patients over the age of 65 who have been admitted from the emergency room."

The virtual volunteers welcome the patients and ask whether there are any family members that they would want to contact. If they do, the volunteer can reach out to family members and connect them to the patients.

The virtual volunteers also ask patients whether they left any essential items at home before they were hospitalized. For example, if a patient comes to the emergency room via ambulance with trouble breathing and they are admitted to the hospital, they might have left their hearing aids or glasses at home.

"In the past, this would be communicated to a nurse, and the nurse would have to call the family," Kruger says. "Now, a virtual volunteer can take this task off the nurse's plate—the volunteer can contact the family and coordinate pickup and delivery of anything the patient may need that was left at home."

Volunteers are a touch point that can personalize and individualize the patient experience, Kruger says.

Keys to patient experience success

To provide a positive patient experience, listening is crucial. According to Kruger, leaders must put aside any premise they may have as an individual, healthcare leader, or health system and listen to the patient

"You need to ask questions. You need to ask what you can do to improve," Kruger says. "It needs to be a continuous process that becomes part of your culture. We are constantly listening, then by acting, we move into innovation."

Health systems should constantly look for new ways to engage patients, Kruger explains.

"You need to look at creating new communication pathways or implementing new technology to help a specific group of patients feel that they understand their plan of care, understand their medications, and understand how to live their healthiest life," Kruger says. "You must utilize resources across the health system to help achieve these goals."

Health systems need to listen to their patients then act on the feedback, according to Kruger.

"Listening then acting tends to move healthcare organizations and drive innovation," Kruger says. "It also provides the ability to use new technologies in a way that moves outcomes and personalizes care for patients."