It's been a couple of weeks since I first asked for your thoughts on the future of bettering the patient experience. Is there really a "next big thing" when it comes to leaving your visitors feeling satisfied? Should all hospitals be bending over backwards to achieve satisfaction? Or is this topic overblown, with much more pressing matters confronting providers?

The topic seems to have struck a chord, as I received way more responses on my last blog than any other I've written in the past nine months since I joined H&HN. Reaching and sustaining the ideal patient experience is an important goal for hospital leaders, though not every one agrees on how to get there.

Health care consultant Anthony Cirillo believes that there isn't a new fad in patient satisfaction, and really it's about putting in people who care about what they're doing — from the chief executive on down.

"There is no new best thing in patient experience," Cirillo writes. "Providers have tried to approach this tactically. And it is a human issue. The only path to sustainability is the people, and the people, starting with the CEO, have to have deep passion for what they do and trust in one another to move forward. That is the foundation, whether it is looking at patient experience or LEAN or whatever you bring in. Nothing is sustainable if the foundation of people alignment is not there."

Tapping patients for their input is critical to bettering their experience, and to staying ahead of problems at a hospital, writes Nicole Cloutier, a patient advocate at Wentworth-Douglass Hospital in Dover, N.H. The hospital has convened councils of 12 to 15 former patients or family members, which meet monthly to gather feedback and help leaders make decisions.

"Having the patient's perspective early on is more helpful than putting in place something we think is wonderful and having the patients tell us otherwise. Then it's often costly or too late to make changes," Cloutier writes. "This is what we are doing to make sure our patients have a constant voice in our processes and decisions because, after all, they are the heart of our organization."

There needs to be more discussion about how the small hospitals can address patient experience, according to Eve DeVaro, director of patient advocacy for Bon Secours Baltimore Health System. Too often, leaders focus on shiny expensive toys — such as flat-screen TVs and comfy furniture in larger rooms — and it starts to seem as if satisfaction is a luxury for big health systems that are flush with cash.

"We are a Catholic hospital, and view our work as ministry," DeVaro writes. "We still operate out of the original facility built here in 1919. The rooms aren't all private. There isn't sufficient space to accommodate large numbers of visitors, or loved ones who wish to spend the night. The building has leaks and drafts and some floors are cool in the summer while others are hot, and cozy in the winter while others are ice cold. So when I read about concierge health care and flat screens in every room, I am discouraged.

"The literature doesn't address such facilities, leaving me feeling (on my cynical days) that patient experience initiatives are a luxury. We want to satisfy our patients, to 'wow' them, but we don't minister in luxury. We minister in poverty. The patient dissatisfaction that we encounter regularly doesn't usually issue from us, has nothing to do with us, and can't be made better by us. And flat-screen TVs would just get stolen off the wall anyway. Yet if we don't figure out how to delight our patients and improve their health care outcomes (familiar with social determinants of health?) we're no longer going to be reimbursed at the same rate from Medicare and Medicaid for taking care of them.

"Why aren't safety net hospitals and their cohorts represented in this discussion? What can such facilities do to promote patient experience and improve patient satisfaction within their means?"

For people like Karen Peake — the patient experience officer at Deaconess Hospital in Evansville, Ind. — satisfying HCAHPS surveys isn't about fancy bells and whistles at the bedside. As Cirillo alluded, she focuses on the human side of the care equation, asking herself every day how she can calm the patient and his family's anxieties.

"The next big thing? Getting all physicians on board to see themselves as role models for their staff and the ultimate key player in reducing anxiety in their patients," Peake writes. "Detached concern is wrong for their patients to experience … this is health care today, and it is the right thing to do for the patients and their families."

Susan Mazer, president and CEO of Healing HealthCare Systems Inc., cautions providers to not get too caught up in just reaching the next benchmark, and glossing over the day-to-day needs of each individual patient.

"HCAHPS, the new survey that is supposed to reflect the actual patient experience, is but a small peak into what matters to patients," she writes. "More critical, however, without understanding the implications of each question, hospitals can get stuck in 'training to the test' or 'policy-making to the test.' "

So what is your hospital doing to better the patient experience? And is there a "next big thing" others should be watching for? Share your thoughts in the comment section below.