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Patient Experience: Putting the Patient Front and Center

Posted By Katie Joyce and Katie Ziemer, Friday, April 20, 2018

Better patient experience has been linked with better health outcomes, improved treatment adherence, and increased provider and staff satisfaction. It creates a continuous positive upward spiral. However, initiating that upward spiral can be difficult due to the complexities of patient experience.  

To continue the dialogue around understanding and addressing these complexities, we decided to bring together experts in the field, including healthcare services researchers, technology innovators, and leaders in clinical organizational improvement. We published their perspectives in the Ipsos Understanding Society, Patient Experience edition. Below, we provide the main take-aways from this initiative.

What is not measured is not improved

Before patient experience can be improved, it must first be measured, but measured in the right way. Measuring the patient experience allows us to see what needs to be improved, and points to how to improve it. When tracked over time, it lets us see whether our improvement efforts are actually making a difference. However, a number of factors need to be taken into consideration when measuring the patient experience so that we can ensure the results are actionable and accurate. 

  • First, it’s important to measure the aspects of the healthcare experience that actually matter to the patient. What are their expectations? What barriers impede them from getting their needs addressed? Using a journey mapping approach, where patients describe their entire experience before, during, and after the encounter, can be a useful way to get this information.

  • Second, the patient experience needs to be linked to the systems and staff that impact their experience. What procedures do the staff use to check patients in? What are the rules for family visitation in hospitals? This information points to which aspects of the system or staff need to be changed to have the biggest impact on the patient.

  • Third, measuring the patient experience should place as little burden on the patient as possible. Increasingly, this can be accomplished through technology, such as online surveys and incorporating alternative data streams.

  • Fourth, we need to consider and account for the factors that can influence patient experience scores to gain as accurate of a picture as possible. For instance, primary care providers who have an ongoing relationship with their patients tend to receive higher scores than emergency care providers. This context needs to be taken into account when comparing scores between providers to make them equitable. Ipsos has developed fair scorecards that provide adjusted benchmarks to account for this context.

  • Fifth, while patient experience is important to measure, we also need to recognize that it represents subjective perception rather than objective clinical care. For example, patients’ satisfaction with their experiences depend on their expectations. If an experience meets or exceeds expectations, the patient will be more satisfied with the experience, whereas if the experience falls below expectations, the individual will be dissatisfied. 

Making the data actionable 

Once patient experience information is collected, the question then becomes what do you do with it?  Again, it’s important to identify the aspects of the patient journey (good and bad) that have the biggest impact on the overall experience. Patient-provider communication, care transition, and the availability of home-based medical care are all aspects of the patient experience that tend to significantly impact perceptions of the overall experience. Patients want to feel heard and respected by their doctor, a seamless transition once they leave the hospital, and the convenience of having their care team come to them (especially for elderly patients). 

Once the most important aspects of the patient experience are identified, the units and staff responsible for these aspects of care need to be engaged and part of the feedback loop and continuous improvement process. Getting the right information to the right people who can take action is essential.  In addition, getting staff buy-in and having a concrete action plan with tailored guidance and defined accountability are indispensable for creating successful improvements. This is often easier said than done as improving patient experience may necessitate large-scale institutional change. For instance, the Department of Veterans Affairs (VA) is rolling out patient experience improvement initiatives such as WECARE Leadership Rounding, where hospital leaders connect with patients and staff on a regular basis. Given the time, effort, and resources these initiatives require, facility leaders need to continually assess the success of these initiatives, keeping the ones that work and discarding the ones that don’t. This continuous feedback loop ensures that only the most effective initiatives are continued and promotes the upward spiral of providing patients with a better experience. 

Additional details about our findings on the challenges and solutions for improving the patient experience can be found here: https://www.ipsos.com/en-us/knowledge/society/understanding-society-us-edition-patient-experience

Katie Joyce leads the US Public Affairs Government and Healthcare Service (GHS) research portfolio, with full business management responsibility. She oversees a senior team of data scientists, Ph.D. social scientists and statisticians, technologists, and project managers, as well as a behavioral science practice. In addition, Katie leads the portfolio of private health work in consumer survey research and brand tracking – key clients include Anthem, Blue Cross Blue Shield, and Kaiser Permanente. 

 

 

Katie Ziemer, PhD, is an Associate Research Scientist at Ipsos Public Affairs. She conducts behavioral science research for federal and non-federal clients, including study design, data collection, data analysis, reporting, and advising. She also co-leads the development of a Behavioral Science Community of Practice which brings behavioral science service offerings to market and builds internal capabilities. Her research interests include attitude formation, behavior change, health promotion, disease prevention, brief psychosocial interventions, and positive psychology. Katie is a licensed clinical psychologist with a doctorate in counseling psychology from the University of Maryland.

Tags:  data  measurement  patient experience  process improvement  research  survey 

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Comments on this post...

Andrew Gallan says...
Posted Wednesday, May 9, 2018
"What is not measured is not improved." Two issues with this perspective: 1) This creates a risk that PX becomes measurement, when your own fifth point indicates that experiences are owned by the patient. 2) Health care organizations collect vast amounts of data regarding patients' experiences that are not analyzed. Unstructured (qualitative, narrative) data are a good example.
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Susan E. Mazer says...
Posted Wednesday, May 9, 2018
Measuring the immeasurable is a challenge that faces us daily. For example, pain scales the use self-report are the least reliable in understanding how a patient copes with pain and the context (social and cultural) that informs their willingness and capacity to be honest. Understanding the limitations of the anything we attempt the measure that is about the lived-experience is critical lest we makes patients a number and ignore the obvious. It would be worth an ethnography to look at the waiting experience, identifying variations in acuity, variations in age, in expectations, and anxieties. Then, of course, we look at interventions and redo it to find what changed. Takes time, insight, ...but not alot of "N." We collect data and are not fully aware of what it does not say...and what we will always need to discover through our relationships in real time with those we care for.
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