Patient Experience: Can You Go Beyond HCAHPS?

Groundhog Day, the movie.  Bill Murray is trapped in time, every day is the same day, Groundhog Day.

Numbers can be rather interesting.  For example, the number 81 is one of two numbers whose digits, when added and then squared give you the number: 8 + 1 = 9; 9 squared is 81. Or the number 3,435.  Take the digits and then take three to the third, plus four to the fourth, plus three to the third, plus five to the fifth equals 3,435.

Healthcare loves using numbers to measure how it is doing improving patient experience.  Most of the numbers I have seen contain very little information.

The December issue of HealthLeaders Magazine had an article about changing the culture to change patient experience.  The article featured a chart in the HealthLeaders Media Intelligence Report, Patient Experience Beyond HCAHPS.  Nothing to complain about so far, right?

The chart showed what healthcare executives rated as the biggest stumbling blocks to creating an effective patient experience strategy in their organization. It yielded these as the top four issues:

  • 49% difficulty changing organizational culture
  • 20% too many other higher priorities
  •  11% lack of funding
  •    8% lack of leadership commitment

Essentially, the leaders’ responses rank the reasons why they are unable to improve patient experience in their organization.  Listing why something cannot be accomplished does not lead to accomplishing it.  Leadership.

Changing organizational culture, 49%.  What if you could dramatically improve patient experience without having to worry one iota about changing the organization’s culture?  Would you do it then?

Improving patient experience beyond HCAHPS requires hospitals to define what is beyond HCAHPS.  HCAHPS happens within the provider’s facilities.  Inside the facilities is where cultural change would occur.  That is the place for which hospitals purchase data and hire smile coaches.  Beyond HCAHPS happens outside of a provider’s facilities.  In general, it does not need to involve people who wear scrubs, and it should not only be about people who have been admitted but not yet discharged.

It needs to involve other people, people who do not work for the hospital and people who are not inpatients.  Who are these people?  They are patients, former patients, and prospective patients.  They are you and me.

Here are the two stumbling blocks those surveyed should have listed about why they cannot create an effective patient experience strategy.  Nine of ten healthcare organizations, that is 90% for those who are not mathematically inclined, do not have a definition of patient experience or a written patient experience strategy.

You cannot have an effective strategy if you do not have a strategy.

The second stumbling block is that in general providers have no idea of the experiences of 95% of the people who interact with their organization.  People whose experiences are unknown, unmeasured, and unasked include:

  • Outpatients
  • Discharged patients
  • Former patients
  • Future patients

Some hospitals will try to argue that I am wrong.  Their argument will be based on the fact that they survey this group or that group, or that they have a secret shopper program, that somehow this gives them insight about the experiences of those stakeholders.

There is very little profundity to be gained from surveys or secret shoppers.  None.

If a hospital is serious about improving patient experience it should do the following:

  • Define patient experience
  • Include all of the stakeholders in the definition, not just current inpatients
  • Develop a patient experience strategy

The strategy should include tasks to enable you to answer yes to all of the following:

  • Can people access the organization?
  • Can they access it when and how they want?
  • When they access it can they get the information they need?
  • Can they accomplish the tasks they needed to accomplish?

Being able to access the hospital, which in most cases means that someone answers the phone when they call is critical.  Today, many hospitals cannot answer a high percentage of calls.  Of those calls that are answered, they are only answered for a brief number of hours.  Of those callers, whose calls were answered because they called at the right time, a huge percentage of them will not get the information they needed or they will not be able to accomplish the tasks they set out to accomplish.

You do not need a survey to measure their experience, and you do not need the threat of being penalized by CMS to understand their experience.  Their experience was poor.

If you shift some of the execution of those experiences to the web, people get the same results, poor results.  If you design your web solutions correctly, those experiences will be remarkable.

When you can answer yes to these questions you will have improved patient experience.  You will have done so without having to purchase any more data and without having to hire someone to teach your employees to smile.

If you cannot manage to deliver a remarkable experience for someone who is considering purchasing healthcare from your organization, you will not have to worry about surveying that person, about whether the hospital room was noisy or whether the radiology nurse didn’t smile, because the person with the bad experience will never have chosen your hospital.

Patient Experience: A remarkable experience for every person every time on every device.

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