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The Return on Investments of Empathy In Measuring Patient Experience

Posted By Dr. Avnesh Ratnanesan, Friday, March 10, 2017
Updated: Tuesday, March 7, 2017

Empathy in healthcare is both a traditional concept as it is a new-age buzzword. That’s because it has never lost its importance as a legitimate element of a patient’s healing process.

Simply defined, empathy is the capacity to walk in the shoes of another. Essentially, the ability to understand, appreciate and relate to someone else’s emotions. There is more chatter in the industry now about defining, teaching, learning and measuring empathy in healthcare than there has ever been.

Making emotions a visible part of your (formal or informal) measurement validates the feelings of patients which in turn, 3promotes patient satisfaction, enhances the quality and quantity of clinical data, improves adherence and generates a more therapeutic patient-physician relationship.

Ultimately, it all links back to the Net Promoter Score (NPS) or the Friends and Family Test (FFT). A key HCAHPS question, the NPS or FFT asks the patient point-blank if they would recommend the hospital to family and friends.

There’s your ROI.


Human emotions are core to every patient experience. At every stage of the patient journey, there is a feeling, sentiment or attitude that will, collectively, define the experience for the patient at the end of their engagement with a healthcare setting.

Hospitals are often obsessed with benchmarking against other hospitals in term of their respective performance indicators, however there is a need to first benchmark against the EXPECTATIONS of your own patient population:

  • If the experience < expectations, then you have a satisfaction deficit which leads to frustration and anger
  • If the experience > expectations, then you have a satisfaction profit which leads to delight and excitement

Frustration and anger are detractors to the patient experience. If these emotions are experienced, then you can be sure that the patient is on their way to relay their negative experiences to others or not return, or both! Feelings of delight and excitement on the other hand naturally motivate patients to ‘promote’ your healthcare setting to others.


Measuring emotions is key part of our 6E Framework, a step-by-step guide to producing a true holistic picture of patient experience. Its measurement impacts the full spectrum of this framework:

Understanding the real patient EXPERIENCE through EMOTIONAL data ENERGISES staff in their purpose and EXECUTION of solutions. Successes are repeated to produce EXCELLENCE in delivery and organizational capability in patient experience EVOLVES.

How do you draw these emotions out of a patient so you can understand, measure and respond appropriately? Some state it boldly, some 3hide their emotions through seemingly rational questions or casually drop a comment about their emotions, to test the waters on how it would be received in the healthcare setting. Pick up on these clues, don’t ignore it or change the topic.

For the uncertain and non-forthcoming patient, surveys are a great way to get emotional data. One would imagine that a survey asking about their emotions would not only surprise them but send a clear message that there is a space in that setting to talk about emotions, that a culture exists that encourages and supports emotions.


When the clinician and non-clinician are able to recognize the emotions around a patient, it allows them to be more authentic and honest in the support given to the person (not patient).

Clinicians are able to view the person’s emotions within a more accurate context and address it in specific ways: 2

  • Learning: Where the patient is fearful because of a lack of information, there is an opportunity for staff to help educate the patient to reduce his fear
  • Empowerment: Where the patient feels helpless in the face of his health, there is an opportunity for staff to develop the patient’s sense of power over the situation through education, tools and technology
  • Self-discipline: Where the patient is frustrated over their personal management of their health, there is an opportunity for staff to help the patient develop discipline through motivation, tools and technology
  • Feelings of control: Where the patient is overwhelmed with the amount of information around their diagnosis, there is an opportunity for staff to ensure that the communication of information is at a pace and volume that the patient is comfortable with and to involve the patient’s family members or friends in managing overwhelm.

When an organization can undertake the above in a systematic way, an ‘energy’ or a vibe starts to infiltrate through the ranks. Clinicians and non-clinicians start to discover or re-discover the meaning in their roles and the organization becomes more congruent with its purpose.

What’s the vibe like where you are?


1. Empathy and Emotional Intelligence: What is it Really About?’, International Journal of Caring Sciences, Volume 1 Issue 3, Alexander Technological Education Institute of Thessaloniki, Greece
2. Adapted/Inspired from information from a Chapter Abstract from Patient Emotions and Patient Education Technology:
3. “Let me see if I have this right...”: Words That Help Build Empathy, Coulehan JL, Platt FW, Egener B, Frankel R, Lin CT, Lown B, et al. (2001). 

Dr. Avi Ratnanesan is a medical doctor with broad healthcare sector experience including hospitals, biotech, pharmaceuticals and the wellness industry. He is a leading expert who coaches and consults to senior executives, entrepreneurs, practitioners, organizations and governments.

Tags:  emotion  empathy  expectations  experience  NPS  Patient Experience  ROI 

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When it Comes to Experience Management Many Hospitals are Stuck in 20th Century Thought

Posted By Lou Carbone, Tuesday, November 19, 2013
Updated: Monday, November 11, 2013

Given the dynamic changes taking place in healthcare, it’s not surprising patient experience is a top priority for most hospitals. What is surprising, however, is the outdated mindset hospitals often have about how to improve the experience. Many are investing in quality and process improvement. They’re recognizing they have customers, and they’re integrating patient feedback in making tactical improvements in hospital design.

This mindset is deeply concerning. Hospitals need to realize that experience isn’t the result of a process improvement. They’re under leveraging how they’re using patient input because they’re still focusing on WHAT patients think versus on HOW they think.

Old school thinking focuses on asking for opinions and suggestions as input. Today, success depends on understanding how patients think about their experience, and then designing and managing the experience accordingly. However, many hospitals are suffering because they’re trapped in an outdated way of thinking in an industry that’s changing rapidly.

Hospitals need to be "clued in” to the patient experience. In other words, do you know how the clues you’re delivering are making your patients feel? Better yet, do you even know how your patients want to feel when they’re at your hospital?

Let’s tackle these questions. Know it or not, you’re constantly delivering a barrage of clues to your patients. What they see, smell, hear, taste and touch will create their "experience” and affect them emotionally, even though they aren't even aware it’s happening. That’s because research tells us that 95% of our mental processing takes place unconsciously; only 5% of your patients’ decisions are based on conscious rational thought.

To engage patients, you need to dig deep into this uncharted 95% of experience processing. Which helps us answer the second question. Most hospitals look at the experience from the company-out, focusing on what their brand must project to affect patients’ impressions of its service. I believe, however, the holy grail is thinking and looking at everything from the customer-back, identifying the emotions patients want to feel during their experience and then designing and managing the clues embedded in the experience to elicit these emotions.

I recently worked with Nemours (which has children’s hospitals and clinics in Delaware, New Jersey, Pennsylvania and Florida) to help improve the ED experience. Knowing that a trip to the ED is inherently stressful, we dug deeper and discovered that above all, ED patients and families want to feel understood, secure and confident. This trio of emotions became the framework around which the patient experience was redesigned.

Nemours learned that having the child seen swiftly by the physician upon arrival in the ED minimizes parents’ anxiety and reassures them their child is in good hands. So, there is now a physician in triage so the patient is seen right away upon arrival, as well as a "pivot nurse” who provides a fast assessment and quickly moves with the patient and family to the place where care will be provided.

To minimize the times patients and families have to tell the story of what brought them to the ED and their health history, they are experimenting with conducting intake interviews via "team huddles” in which the team of doctors and nurses interviews the patient and family together.

When nurses change shifts, the hand-off is now conducted at the patient’s bedside, involving the family in conversations about the patient’s condition, how care will be continued during the shift, upcoming tests and procedures, etc.

Given the variety of doctors, nurses and staff that are involved in a patient’s ED care, all hospital personnel wear color-coded uniforms so the patient and family feel more secure knowing what that person’s role is.

As Nemours learned, understanding the experience from the inside out helps you get into the minds of your patients. Once you understand the unconscious drivers that impact patient behavior, you can transform to intentionally designing and delivering experiences that give you a competitive edge.

Lewis P. (Lou) Carbone is the Founder, President and Chief Experience Officer of Minneapolis-based Experience Engineering, Inc., and the author of Clued In: How to Keep Customers Coming Back Again and Again (recipient of the celebrated Fast Company Reader’s Choice Award). Widely recognized as the founder of customer experience management, Lou has spent more than two decades leading the world in the development of experience value management theory and practice in a broad range of industries.

Tags:  design  ED  emotion  feedback  patient engagement  patient experience  priority  process 

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