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The state of patient experience: Gains and losses

Posted Sep 11 2013 9:43am

by Anthony Cirillo

I may be late to the game in reacting to the research report "The State of Patient Experience in American Hospitals ." The biannual survey was conducted by The Beryl Institute and Catalyst Healthcare Research and included 1,072 respondents from 672 unique organizations.

In the research announcement my friend, colleague and fellow Hospital Impact blogger Jason Wolf , president at The Beryl Institute noted:

"The bottom line is clear, patient experience remains a top priority among American hospitals and continues to be a key issue for hospital leaders. This reinforces the point that the patient and their experience--the quality of their outcomes, the safety of their environment, the service they are provided--must be and should remain central to our healthcare conversation."

So what is the state of patient experience?

In 2011, when answering the question--How do you feel about the progress your organization is making toward in improving the patient experience?--25 percent of people were very positive. In 2013, that number dropped to 17 percent.

Positive responses dropped seven points from 61 percent in 2011 to 54 percent this year while neutral and negative responses increased slightly.

Those working in the field are not as optimistic as they had been. And this comes at a time when most of their organizations' stated top priority was patient experience/satisfaction, up seven points from 2011 and topping quality/patient safety, cost reduction, electronic medical records and the usual laundry list.

While patient experience is a top priority, fewer organizations established it as a formal mandate this year, almost as if to say, yes of course this is our number one priority but get around to it as best you can.

But more organizations have adopted a formal definition and structure for patient experience than previously, so they are laying the groundwork. However, the commitment does not seem to have full support when you consider the following.

  • A committee (26 percent) and then a CXO (22 percent) have primary responsibility and direct accountability for patient experience.
  • Only 23 percent of organizations have a person allocated 100 percent of the time to these efforts. Little staff supports them.

So again, this is the number one stated priority though it seems the commitment by leadership falls short. And I have been well documented in my thoughts about committee rule. In fact, one of Beryl's white papers documents the importance and positive results of having a definitive leader at the top of the organization leading patient experience efforts.

I also have been on record about chasing scores versus addressing systemic issues in patient experience . I believe in the latter; the industry, mostly the former.

In terms of importance on a scale of one to six, with one the most important, the report shows the most important driver toward providing a great experience is HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey scores. And organizations act in kind with key components of programs such as "sharing patient satisfaction/experience scores" and "special initiative(s) to improve HCAHPS domains." These were ranked number one and number five, respectively, out of 25 criterion. HCAHPS scores are the number one metric used to measure success followed by patient surveys and discharge calls.

Granted, we need to start somewhere in terms of what we measure ourselves against so we know how and what to improve. HCAHPS is it at the moment.

For me the issue presents mixed messages. Hospitals are laying great intentions and foundations. Yet resources do not match up. And that is perhaps why those surveyed are not as optimistic.

With no definitive leader or rule by committee, well, the job will not get done. We know how slowly healthcare moves. And just as we get patient experience right inside the building, poof, things move outside.

As the report notes, "support from senior leadership continues to be the biggest driving force in supporting [patient experience] efforts, and distracted leadership now the biggest roadblock."

It would seem now is the time to walk the talk.

Anthony Cirillo, FACHE, ABC, is president of Fast Forward Consulting , which specializes in experience management and strategic marketing for healthcare facilities. He also is the expert guide in Assisted Living for About.com .

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