patient experience

Patient Satisfaction: A Normal Experience Will Never Be Amazing

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Are Hospital Executives Ignoring Their Own Survey Results?

I was reading the survey results of ache.org’s 2012 “Top Issues Confronting Hospitals: 2012”. Two things jumped out at me. Improving Patient Satisfaction was in essentially a statistical tie with two other issues for third place.

Second, Decreasing Inpatient Volume was essentially in a statistical tie for third place for financial challenges that need to be addressed.

Ache.org only reported the results. It did not draw any conclusions. It seems there is little point in surveying people unless someone acts upon the results–I may have made the same point before regarding HCAHPs.

That said, I will offer a conclusion, one that can be derived without studying the numbers.  I bet there is close to a one-to-one relationship between Patient Satisfaction and the decrease of inpatient volumes.  Fix one, fix the other.

I like that the survey labeled the issue of patient ‘satisfaction’ instead of CMS’ patient ‘experience’.  Every patient, and every prospective patient has an experience with the hospital. However, not every experience is satisfactory, and normal experiences will never be amazing.

Why not have your goal be “A remarkable experience for every patient every time and on every device? If that doesn’t work you can always erect another billboard.

Patient Satisfaction: The Problem with Patient Surveys

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So there I was going through the mail and I happen upon a letter from a restaurant I dined at a few months ago, Le Nez Du Cochon—the nose of the pig—go figure, it is French.  Enclosed is a survey; twenty-seven questions.  Tell me if you know where this is headed.

The questions were grouped in a number of areas; food quality, communication with the wait staff, noise, and cleanliness of the restroom.  I completed the survey, but I was only guessing at my responses because it had been so long since my meal. What I do recall however were things that the survey did not cover.

I made my reservation online and that the restaurant had no record of my reservation.  I even remember calling the restaurant to confirm my reservation, which they did over the phone and then somehow had no record of it.

The directions I copied from their website were wrong. I told the maître de I had requested a table by the window and was promptly seated by the kitchen door.  When I went to pay for the meal I was overcharged because they brought me a wine different from the one we ordered.  The manager explained that since we had drunk the wine there was no way he could change the bill to reflect my order.

Needless to say, the directions to return home were also wrong.  My experience was poor from the moment I initiated contact until and after I arrived home.

But the survey did not ask anything related to the parts of my experience that related to whether I would return or not.  Having clean restrooms and a polite wait-staff did not overcome the rest of my experiences.

We all have experiences.  The problem is that not all of the experiences are satisfactory.

What hospitals fail to notice is clean restrooms, and scoring well on the other twenty-six HCAHPs questions are not reflective of a patient’s total experience, and they offer zero input as to the level of satisfaction a patient or prospective patient—a buyer of healthcare—had on the web or by phone.

Hiring coaches does nothing to improve the interaction on the web or the phone.

Buying data does less than nothing.  Putting those two efforts in place and thinking you have a handle on patient experience is as futile as counting backwards from infinity twice.

Patient satisfaction: A remarkable experience for every patient every time…on every device.

An Open Letter to Hospital Executives

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To whom it may concern,

I am passionate about improving the experience patients and prospective patients have with hospitals, from prior to be admitted and through post-discharge interactions.  HCAHPs only address a fraction of an individual’s experience, and surveying what happened months ago will not help retain or refer patients. The same are true regarding hiring coaches and purchasing patient satisfaction data.

I have improved customer experience and customer interactions for firms who have a combined customer base of more than two hundred million.  More people probable visit the hospital each day via the web and by phone than walk through its doors, yet the satisfaction of those interactions is unknown. This becomes even more important as the business model moves from heads in beds to population health. 

Below are links two documents for your consideration. One looks at defining a global patient experience strategy for the organization, the second lists twenty-seven questions about patient satisfaction left unasked.

http://www.slideshare.net/paulroemer/defining-a-global-patient-experience-for-your-health-system

http://www.slideshare.net/paulroemer/step-aside-hcahps

Please let me know if we may meet or schedule a call.

Regards,

Paul Roemer

Chief Patient Experience Officer

The Democratization of Patient Satisfaction

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So, how can you tell how the hospital’s patient experience improvement effort is progressing?  Perhaps this is one way to tell.

A man left his cat with his brother while he went on vacation for a week. When he came back, he called his brother to see when he could pick the cat up. The brother hesitated, and then said, “I’m so sorry, but while you were away, the cat died.”

The man was very upset and replied, “You know, you could have broken the news to me better than that. When I called today, you could have said the cat was on the roof and wouldn’t come down. Then when I called the next day, you could have said that he had fallen off and the vet was working on patching him up. Then when I called the third day, you could have said the cat had passed away.”

The brother thought about it and apologized.

“So how’s Mom?” asked the man.

“She’s on the roof and won’t come down.”

If you ask someone how the patient experience improvement effort is going and she responds by saying, “The project leader is on the roof and won’t come down,” it may be time to get a new leader.

There are more than 120,000 URLs returned when searching “’Why do patients choose’ hospital”.  Based on what I read, the URLs all take the reader to something written by the hospital.

Sixty percent of people say they use the internet to make a healthcare decision.  Sixteen percent of hospitals use social media.  Eighty-one percent of prospective patients stated that a hospital with a strong social media presence is likely to be more cutting edge—you do the math.

Whether your hospital has a strong social media presence may be less relevant because your prospective patients certainly do.  So what does that knowledge do to your organization’s patient experience strategy?   Do you double or triple you social media output?  Does your one or two person internet department try to out-social-media thousands of prospective patients, Twittering away, and constantly posting to Facebook?  Trying to catch up is like trying to walk across a room, and with each successive step cutting the remaining distance in half—you never get to the other side.

The social media “experts” would tell you that is exactly what you need to be doing—more is better.  I think the experts are wrong.

If the experts are wrong, what is the right approach?  The internet is a powerful touchpoint for both patients and prospective patients.  The internet is a large component of patient satisfaction, patient experience, and patient choice.

Rather than going wide and shallow with social media or social-CRM think about a narrower mobile digital strategy that goes deep. For example, think about your hospital’s website.  For starters, what you have is probably just that, just a website. 

There are dozens and dozens of reasons a patient or prospect would go to your site.  A high percentage of them go there because they do not want to try to accomplish something by dialing any of the hospital’s multiple phone numbers.  When they go to the website if it does not entice them to stay on the site, bookmark it, or make it their homepage, the website might as well not exist.

Your website is where purchasing decisions are made and lost by prospective patients, and where satisfaction is raised or lowered for patients.  If a patient cannot accomplish the task they set out to do in an intuitive and user-friendly way, their satisfaction with your entire organization just dropped.

Many more people go to your website than go through the front door of your hospital.  The good news is that you control the user experience of someone on your site.  The bad news is that most organizations are controlling it in a way that gives users a poor experience.  The list of things users cannot do on your website is much longer than the list of things they can do.

Having a tab that reads ‘schedule a visit’ is worth nothing unless the patient was able to schedule a visit, in fact, it probably kills satisfaction.  Having a tab that reads ‘get your health records’ that requires someone to download a PDF, print it, and mail it is equally bad for patient satisfaction.

What should your website be?  At a minimum it should be some combination of a patient portal and a knowledge management system.  It should also be your billing department, your scheduling department, admissions, discharge, housekeeping, food services, support groups, and education services.

Your website should offer every service your hospital offers with the possible exception of a hip replacement—a 24 by 7 virtual hospital minus patient care.  Two-way.  And mobile.  Available on any device at any time.

If you want to interact with your community, patients and non-patients, you need to go to where they are.  And where they are is online.  It is not good if someone with heart disease can watch an angiogram on YouTube or on a competitor’s website and on your website they cannot even find a meaningful cardiology link.  Online patient support groups at the best hospitals provide a real-time referral group—can your patients do that on your site or do they have to go to someone else’s?

Patients are democratizing information. If the information provided by your organization is asymmetrical, it has some catching up to do.

Patient satisfaction—a remarkable experience for every patient every time; in the hospital, on the web, and on the phone.