What are the patient experiences of the unsurveyed?

Does the fact that there are so many different definitions of patient experience among hospitals belie that fact that there is no definition of patient experience? 

Most patient experience definitions seem to be missing a few things; they do not exist much beyond the four walls of the hospital—sort of like EHR, they are highly, if not exclusively, focused on things having to do with HCAHPs.

(If you want a downloadable presentation on the questions not covered by HCAHPS, you can get it at: The Experiences HCAHPS Doesn’t Survey)

Every day many more patients and prospective patients interact with the hospital using the internet and their phones. Much determination on patient satisfaction, by patients, is made using these tools. Retention, referrals, and ‘win-backs’ are influenced here. “Buying” decisions are made and lost here.  The hospital either met or did not meet expectations.

Yet most hospitals invest almost nothing in the two areas that have the highest number of touchpoints.

If I were asked to define a goal for patient experience I would recommends “A remarkable experience for every patient every time, obtainable on any device, at any time, at any facility.”

To move towards the goal of being remarkable, one must talk to patients and observe them in those touchpoints that all patients use. Surveying patients puts out the fire, it does not prevent fires.  Their bad experience has already happened. 

Surveying patients, paying for patient experience data, and paying for coaching does nothing of value for most of the people in the hospital’s radius of influence. It does nothing for all of the prospective patients and nothing for former patients whose next visit to the hospital is never recorded because that patient went somewhere else.

The level of satisfaction for these individuals is determined outside of the hospital’s four walls.  Writing a million dollar check to have a firm coach your employees does nothing.  There are gobs of people—a consulting term of art—who never become patients or never become patients again. These people make their decisions based on their online experiences with the hospital and on how their calls to the hospital are handled.  HCAHP surveys will not entice them to become your patients.

There is not a patient in the country who can tell you the HCAHPS score of any given hospital.

These people whose experiences are unknown belong to a group called the unsurveyable.   They also represent a healthcare spend higher than the hospital’s total revenues for last year.  Why not pay attention to their experience?


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