What's Missing From Your Patient Experience Strategy?

Maybe the hospital field can learn a thing or two from banks and car rental companies in trying to improve the patient's experience and provide a more consumer-oriented approach to health care.

Hospitals have been keenly focused in recent years on making sure that patients leave feeling satisfied with their stay. That's because not only do satisfaction surveys now impact the bottom line, but the growing proliferation of high-deductible health plans and narrow networks are also forcing patients to treat their health care like any other business, shopping around for the highest-quality, most-affordable experience. But do Hospital Consumer Assessment of Healthcare Providers and Systems surveys really address every possible facet of each patient's experience?

Perhaps, key pieces of the patient visit are ignored by HCAHPS surveys, which are administered by the Centers for Medicare & Medicaid Services, according to a new report from consulting firm McKinsey & Co. Hospitals will need to start gathering a much greater depth of data to truly change the patient experience and impact business performance, the authors argue.

For instance, McKinsey notes, HCAHPS doesn't take into account a patient's understanding of the bill, the comfort of waiting areas, the timeliness of appointments, and the quality of food. Improving satisfaction can translate to better clinical care, and it's high time that health care catches up with other industries in addressing the customer experience, says Jenny Cordina, a principal with McKinsey and co-author of the report.  

"On the hospital side, the focus has been on delivering great care, and not necessarily thinking about whether or not that is an experience the consumer is engaged and satisfied with," she says. "Folks are beginning to realize now that, actually, you can deliver better care if the consumer is engaged and satisfied, because they are more likely then to follow up and do the right sorts of things afterward — like take their medications or come back for a follow-up appointment."

The report cites the car rental industry as one example of a business that knows its consumers as fully as hospitals should. One major car rental company, for instance, theorized that the selection of cars was the most important factor for business travelers, its most lucrative customer segment. And yet, after surveying those consumers, the company actually found they were more concerned about the speed of getting in and out of the rental facility after their plane landed, and communication about reservation status. With that in mind, the firm used technology to streamline the process and send updates on reservations.

Similarly, in one recent McKinsey survey of patients hospitalized in the past three years, most said "outcome achieved" was most important to them. And, yet, surveys after care was delivered showed that nurse empathy toward the patient actually had the greatest impact on satisfaction scores.

Authors lay out a handful of steps that hospitals and health systems can take to unearth more robust patient experience data, including:

1. Determine which business outcomes the organization wants to target, such as increased patient volume or customer retention.
2. Conduct research with patients, whether through surveys or focus groups, to figure out what questions gauge satisfaction tied to those objectives.
3. Gather additional information on the factors that most strongly influence how patients respond to those questions, and metrics that enable the hospital to gauge performance in those areas.
4. Use the data to develop a robust measurement system to uncover operational insights and allow for continuous front-line improvements.
5. And finally, repeat this research every few years to ensure that the hospital's understanding of each patient's experience stays relevant.

In the end, however, none of these steps matter without support from the hospital's executives, Cordina adds.

"For these sorts of initiatives to be successful, it often really takes the senior leadership teams to agree that this is a priority," she says. "Sometimes you end up getting pockets where specific initiatives will happen that do some great things, but unless you get the culture of the organization to really say this matters, it won't work. It really starts at the top."