Improving patient experience in healthcare

As the healthcare industry increasingly focuses on whole-person and value-based care, patient experience is emerging as a key topic to address. Studies have shown that patient experience can play a role in improving patient engagement, as well as health and financial.

Improving patient experience can feel like a daunting task for many hospitals and providers, but it does not have to be that way. Read on to learn more about the importance of patient experience and four key ways the range of healthcare interactions can be enhanced.

What is Patient Experience?

According to the Agency for Healthcare Research and Quality, patient experience is a set of behaviors that foster the inclusion of patients and their family as active members of the healthcare team. Working as collaborative partners, a care team’s goal of patient experience is to engage the patient and family to improve the quality and safety of health care in hospital and provider settings.

Patient engagement is also a key part of improving patient experience. Patient engagement is the involvement of patients, caregivers, and families in improving healthcare and safety, which is key to helping patients play an active role in their care by acknowledging a patient’s preferences and self-efficacy. This is all to say: Recognize patients as valued partners to improve patient outcomes, quality, and safety.

Importance of Patient Experience in Hospitals

With more dedicated focus on moving toward patient-centered care and population health management, patient experience will continue to play a large role in measuring quality, safety, and health outcomes. Healthcare organizations can use patient experience measures to assess patients are receiving care that responds to their individual preferences, needs, and values.

Including patient engagement plans to promote a better patient experience can improve:

  • Quality and safety
  • Financial performance
  • Patient outcomes
  • Patient satisfaction in healthcare
  • Market share and competitiveness
  • Employee satisfaction and retention

In addition to these insights, reimbursement opportunities and regulations from federal agencies enact regulations and provide reimbursement opportunities as ways to enforce and reward organizations, respectively, with risk pool incentives and shared risk models that consider patient-reported experience. For example, the Centers for Medicare & Medicaid Services (CMS) require publicly reported Hospital Consumer Assessment of Healthcare Providers and Systems, also known as HCAHPS, which compile four consecutive quarters of patient surveys. HCAHPS scores allow for fair and accurate comparisons across hospitals, and adjusts for factors that do not directly relate to hospital performance but affect how patients answer the survey.

HCAHPS scores are included in multiple quality programs including:

  • CMS Star Rating Program to measure quality for Medicare beneficiaries
  • National Committee for Quality Assurance (NCQA) Accreditation
  • CMS Star Ratings for health plans participating in federal health insurance marketplaces

From an organizational perspective, measuring patient experience can highlight relevant system issues and key financial indicators. If a patient is at a follow-up appointment after a hospitalization but doesn’t hear back about test results for two weeks after the appointment, this can highlight delays in returning results and issues in follow-up communication that can impede quality clinical care. Conversely, when patients feel like their provider is proactively managing their care, they are more likely to want to continue seeing that provider.

One study found that patients who reported poor quality relationships were three times more likely to leave that physician’s practice than patients who felt they had a high quality relationship with their provider. AHRQ found that hospitals that implemented initiatives to improve the experience saw higher patient satisfaction scores. For example, Sharp Coronado Hospital in California, implemented patient-centered strategies in one medical surgical unit, and found that that unit consistently demonstrated higher overall patient satisfaction scores than a comparable unit that had not implemented any strategies. Another example is Georgia Health Sciences Medical Center, which implemented patient and family engagement strategies and experienced a significant increase in patient satisfaction scores, climbing from the 10th percentile to the 95th percentile.

Increasing patient experience also has downstream effects on organization retention and employee satisfaction. One hospital found that by deploying interventions in communications and information technology, staff role design, and process flow, patient satisfaction reached over the 95th percentile— while additionally improving staff satisfaction, productivity, and internal and external recognition. The increase in patient satisfaction further resulted in a 4.7 percent reduction in employee turnover.

These instances illustrate that by developing patient experience initiatives, there is a correlation between improved experience and patient satisfaction. In addition to patient satisfaction increases, research shows that patient and family engagement consistently forecasts hospital performance for some crucial business outcomes, including earnings before the deduction of interest, tax, and amortization (EBITA) per adjusted admission and net revenue per adjusted admission.

Patient Experience in Healthcare

Studies have shown that positive experiences are associated with better clinical outcomes, with broad implications across the healthcare continuum and for long-term health outcomes. Patient experience positively correlates to both prevention and care processes for disease management. A study found that at both the practice and individual provider levels, diabetic patients exhibited more self-management skills and reported better quality of life when having positive interactions with their providers.

Patient experience can also play a role in better discharge processes and ensure better transitions of care. During discharge or transfers, effective communication is needed to ensure medication adherence and continuity of care. Transfer of patient records, through admit, discharge, or transfer (ADT) notifications or other methods, can enhance experiences by facilitating care coordination between primary care and specialist providers.

Using continuity of care documents to ensure seamless care transitions can help curb patient and family confusion of post-discharge instructions and subsequently reduce hospital readmissions. An analysis of studies showed that patients hospitalized for heart attacks had better health outcomes a year after discharge with more positive reports about their experiences.

Using continuity of care documents to ensure seamless care transitions can help curb patient and family confusion of post-discharge instructions and subsequently reduce hospital readmissions.

Furthermore, patients choose to stay or change providers based on their experience with providers, and the quality of a patient-provider or patient-organization relationship is a predictor of patient loyalty. Remember, patients are three times more likely to leave a physician’s practice due to a poor-quality relationship than patients who reported a high-quality relationship. A separate study confirmed this sentiment, finding that 41 percent of patients would be willing to switch hospitals for a better patient experience.

How to Improve Patient Experience

For organizations looking to improve the experience, cooperation across all levels of the organization is critical. Here are four ways to begin improving patient experience, as well as overall patient satisfaction in hospitals:

1. Identify current patient experience and create a strategy
To effectively improve the experience, it is necessary to evaluate where the organization stands currently. Does the institution have a formal definition for patient experience? Is there currently a plan in place? This could mean looking at patient satisfaction surveys or identifying leadership, patients, and staff to examine the current state and conducting an environmental scan of patient experience in the organization.

Once the environmental scan is complete, define a process for continuous patient and family engagement and community partnership. Employee and provider satisfaction are also vital factors in a patient’s experience, so staff, clinicians, and healthcare professionals should be included in creating this process.

Strategies for involving patients and family members in management and processes within the hospital include establishing patient and family advisory councils, introducing other opportunities for patients and families to be involved, and eliciting patient and family feedback to facilitate organizational change.

2. Incorporate patient feedback and technology that improves patient experience into daily workflows
Patient feedback is crucial to improving patient experience. Organizations should include multiple feedback channels in their strategies to obtain as close to real-time commentary as possible. Patient feedback collected 24 to 72 hours after an encounter can provide beneficial insights about the organization’s information exchange, overall responsiveness, and provider engagement, and enable channels to improve existing strategies.

Other initiatives can include using patient-friendly technology that provides updates on care plans and clearly outlines next steps, preventive health measures, and information on managing health and wellness.

3. Promote better internal and external communication strategies
To positively impact health outcomes, healthcare organizations should utilize health information exchanges as a seamless communications measure to ensure that, externally, primary care physicians or receiving organizations have the necessary continuity of care documents to provide the best follow-up care, post discharge.

Internally, operationalize interventions and strategies to engage patients and families as part of the healthcare team, including encouraging participation in beside rounds, change of shift reports, and other areas where providers can include the patient in their care.

4. Use Patient Experience as an Indicator, Not an Outcome
While the experience is tied to quality and safety, and can be correlated with improved health outcomes, healthcare organizations should ensure that initiatives to improve patient experience are used as an indicator and not an outcome. Patient experience should be used to make quality of care improvements without disregarding possible negative impacts.

Patients can, for example, have positive experiences with their providers and the healthcare institution, but be navigating a terminal disease. Measuring patient experience can qualify how well providers and staff are handling their care and helping their patient and family navigate terminal disease.

On the other side of the spectrum, healthcare organizations can implement a program focused on outcome measures that can negatively impact patient experience. For example, initiating a program to reduce length of stay could lead to some patients feeling that their discharge is being rushed, leaving patients with a negative feeling towards their care and the organization. This is where staff engagement and education can play a major role in improving the patient experience, by ensuring that all patient questions are answered, and next steps are clear. Feedback channels can play an integral role in ensuring that outcome-driven initiatives do not negatively impact patient experience.

About the Author
Eliana Donner-Klein About the AuthorEliana Donner-Klein is Senior Associate for Marketing at Audacious Inquiry, a national industry-shaping health IT company that developed the single most impactful platform for aligning better care across the healthcare continuum. At Audacious, she works to support marketing and business development strategy through market research, case study and content creation, and product marketing. Eliana has been a patient advocate since 2015, working to raise awareness about living with chronic migraine and other invisible illnesses through writing, speaking engagements, consulting, and political advocacy.

Donner-Klein previously worked as an Associate at Sirona Strategies where she focused on a variety of health policy issues including Medicare and Medicaid, value-based care, health information technology and interoperability, telehealth, and the social determinants of health. In addition to her policy and regulatory work, she worked as the communications manager to redesign and run coalition websites, strategic communications campaigns, and thought leadership through events and newsletters.