Skip to main content

Patient Experience Journey Lacks Defined Direction

 |  By Michael Zeis  
   August 22, 2012

 

This article appears in the August 2012 issue of HealthLeaders magazine.

We're on a journey here," says Robert Permut, MD, chief medical officer for Provena Health, a health system that operates six hospitals, 16 long-term care/residential facilities, and other health facilities in Illinois and Indiana. "It's constant gardening," says Douglas Luckett, chief operating officer for CaroMont Health, a health system based in Gastonia, N.C. Providing positive patient experiences involves doing a lot of little things right.

All told, 84% place patient experience among their top three priorities in the 2012 HealthLeaders Media Patient Experience Survey. "Eighty-four percent is a massive number," says Jeffrey Thompson, MD, CEO of Gundersen Lutheran, a not-for-profit healthcare system serving patients in 19 counties in Wisconsin, Iowa, and Minnesota. "Most will say you can only have several top priorities. The topic is really out there."

Adequate investments?
With this new survey data, we see that having a high position on the priority list does not necessarily qualify patient experience as a budget-worthy activity, though. More than half (58%) say they have not made specific patient experience investments, or cannot specify what the investment was. Thompson, an advisor for the Intelligence Report, says, "People are saying it is a high priority, yet so many have no investment." At Gundersen Lutheran, patient experience has its own line item. "Ten years ago it was in the same pool as quality," says Thompson, "but we split it out to get people to focus on it." That patient experience line item represents about 3% to 4% of the operating budget.

 

Whether they can count it or not, 85% of respondents say they have invested additional time and resources in the past 12 months to improve patient experience scores. Training and other staff-awareness activities were mentioned frequently. Some have contracted with third-party consultants to help the staff become more patient-centric. Others have added staff with specific patient-experience responsibilities. Several respondents mentioned that they are investing in staff incentives for good performance.

Motivated by money?
Only one-third of respondents (33%) say it is very important to tie compensation to patient experience measurements. Says Permut, an advisor for this report, "When you look at how important patient experience is going forward, I would have expected a higher percentage. At Provena Health, we have made patient experience a bonus opportunity for physicians. People are tracking both clinical quality and service quality, and it's intuitive to tie compensation to both."

Permut also reminds physicians that soon patients will be rating them the way they rate hospitals now. "In January 2013, there will be Physician Compare. This will be the first publicly reported data on physicians, which I expect to be somewhat similar to Hospital Compare."


ACCESS. INSIGHT. ANALYSIS.
Patient Experience and HCAHPS—Little Consensus on a Top Priority

Our new premium report provides everything in the free report, plus: segmentation data; key takeaways and actionable strategies; three real-world case studies; and discussion questions.
Buy Now


CaroMont's Luckett, the lead advisor for the Intelligence Report, credits a change in incentives at his facility to a single-year turnaround of hospitalist alignment toward the patient experience goal. There are two levels in bonus compensation, he says: One level is meeting the goal, one level is exceeding the goal. At CaroMont, the patient-experience performance bonus is based on group performance rather than individual performance. This year, the group-based tie-in is being tested with leadership in several additional departments.

 

Getting buy-in from nonemployed physicians can be challenging. Many contracts with independent physicians include performance metrics. However, as Provena's Robert observes, "Most of the time, they are the hard metrics, such as quality, complications, readmissions, and hospital-acquired conditions."

Thompson says Gundersen Lutheran has several tactics beyond compensation to help physicians improve their patient experience skills; among them are goal-setting, transparency in sharing performance results, and coaching. "People from our service excellence department accompany physicians on rounds. They observe the visit from start to finish, trying to figure out what could be done to improve the patient's view of the interaction."


ACCESS. INSIGHT. ANALYSIS.
Patient Experience and HCAHPS—Little Consensus on a Top Priority

Our new premium report provides everything in the free report, plus: segmentation data; key takeaways and actionable strategies; three real-world case studies; and discussion questions.
Buy Now


Poor assessment about HCAHPS
More than half (54%) of respondents say they do not consider HCAHPS to be an effective measure of patient experience. Quite a few respondents do not like having "always" as a response choice. Says one, "The word 'always' sets the organization up for failure. Patients rarely mark anything as 'always' occurring." According to another, "Studies have demonstrated higher morbidity and mortality data with increasing patient/consumer satisfaction. That suggests that higher patient satisfaction does not necessarily translate to better care." One respondent recognizes that being hospitalized is stressful: "Because patients and families that are asked to participate in the survey at that time are stressed, sometimes their responses are driven by the stress associated with their situation."

 

On the other hand, nearly half (46%) say that HCAHPS is an effective measure of patient experience. "It is an effective measure of patient perceptions but should be only one of several listening tools employed by the hospital," says one. Another survey respondent offers, "HCAHPS scores help caregivers to prioritize and reach goals for patient experience."

Communication and consistency
Every single patient-staff interaction is a patient experience opportunity. The team responsible for patient experience should identify interactions that are predictable, such a patient arrivals, rounds, meal delivery, medication, preparation for procedures, and so on, and decide which training and education activities are appropriate for which staff groups.

It may be easy to underestimate the complexity of training for patient experience, since the domain for patient experience is so large and the responsibility is widely distributed. Synergies with other priorities such as clinical quality, safety, and patient care must be found, and can be found.

Reprint HLR0812-3


This article appears in the August 2012 issue of HealthLeaders magazine.

See Also:

Pages

Michael Zeis is a research analyst for HealthLeaders Media.

Tagged Under:


Get the latest on healthcare leadership in your inbox.