Cliff Notes for Improving Patient Satisfaction

Dickens wrote, “There are books of which the backs and covers are by far the best parts.”   Hopefully, this post will not be among them.

I have spent a lot of time—yours and mine—musing and opining about the would’a, should’a, could’as around patient experience management. 

You see, I have had this notion that improving patient experience management was a much more achievable exercise than had been presented.  On Friday I spoke with a hospital president who had also been an executive vice president of customer experience with one of the world’s top hotel chains.  He corroborated my belief that the most fixable parts of patient experience management have to do with fixing the nonclinical processes.  And the great news is that those are the processes that impact all of the patients rather than a select few.

Hospitals and hotels.  Patient Experience Management and Customer Experience Management.

One is being managed well and the other is not.

Nobody is suggesting that hospitals should not strive to continuously improve the clinical processes.  Part of the problem is that the HCAP scores are somewhat anathema to nonclinical processes, yet the nonclinical processes are the ones about which patients often complain.

Permit me to group the clinical and nonclinical processes respectively as barely repeatable processes (BRPs) and as easily repeatable processes (ERPs).

BRPs are characterized by collaborative events, exception handling, ad-hoc activities, extensive loss of information, little knowledge acquired and reused, and untrustworthy processes. They involve unplanned events, knowledge work, and creative work.

ERPs are the easy ones to map, model, structure, and improve. They are perfect for nonclinical processes like scheduling, admissions, billing, and room service.  Another perfect example of ERPs is all of the processes within a hospital’s call center.

How can you tell what type of process you are trying to improve? Here’s one way. If the person standing next to you at Starbucks could watch you work and accurately describe the process, it’s probably an ERP.

So, why discuss ERP and BRP in the same sentence with improving patient satisfaction? The reason is simple. The taxonomy of most, if not all patient experience improvement projects, is that they are designed to support clinical processes. Healthcare providers are faced with the quintessential square peg in a round hole conundrum; improving enough BRPs enough to cause the overall satisfaction scores to improve. Much of the ROI in improving satisfaction comes from being able to redesign the workflows of ERPs. Doing just the BRPs will either sacrifice the “R”, or the “I” will be much higher than planned.

The other notion to bear in mind is patient expectation management, a topic that receives almost no attention.  What good is it to measure a level of experience if you have nothing against which to compare it?  A good experience; as compared to what?  What did the patient expect to experience?  There is no point measuring one if you do not know the other.

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