Most health care leaders consider patient satisfaction surveys to be essential — and inadequate. At Cleveland Clinic, Chief Experience Officer Andrea Boissy, MD, supplements patient satisfaction scores with other information, including complaints and compliments that come through the health system’s ombudsman office.

Boissy and her colleagues are beginning to analyze other data, including caregiver engagement and patient safety scores, in conjunction with patient satisfaction scores. One early finding: high caregiver engagement scores correlate with high scores on some domains of patient satisfaction surveys, but not all.

Integris Health, a 16-hospital system in Oklahoma, also uses multiple data sources.

“We have a two-prong tact — we use HCAHPS to measure satisfaction with our clinical efforts and Press Ganey to measure satisfaction with our front-end, including pre-registration and registration,” says Greg Meyers,  system vice president-revenue integrity. When patients use Integris’ online bill-pay technology, they are asked to complete an online survey about their experience with paying their healthcare bill.

Meyers encourages healthcare organizations to adopt a simple metric—primarily used outside of healthcare—to gauge whether they are moving in the right direction. The net predictor score uses responses to a single question: Would you recommend this to your friends and family. The number of  “no” responses is subtracted from the number of “yes” responses to calculate the score.

Health systems and hospitals typically use a mixed bag of data sources to track their progress in improving patient experience.

The HCAHPS survey is required by the Centers for Medicare & Medicaid Services to assess inpatient satisfaction. Each hospital’s score is posted on the Hospital Compare website and figures into CMS’ calculation of the value-based purchasing modifier that determines hospital payment.

The HCAHPS survey includes 22 questions about the hospital, its staff and its reputation. Patients are asked to assess:

  •  How often nurses treated them with courtesy and respect
  •  How often the room and bathroom were kept clean
  •  Whether they would recommend the hospital to friends and family


Surveys conducted by vendors that assess various aspects of patients’ healthcare interactions. For example, a survey to collect physician ratings and comments and that are posted on the organization’s website. Patients are asked to take a 20-question survey in which they use a five-point scale to rate their visit on measures such as:

  • Friendliness/courtesy of the care provider
  • Amount of time the care provider spent with you
  • Your confidence in this care provider
  • Likelihood of your recommending this care provider to others

Read our feature story on patient satisfaction for more.