In Part 1, we talked about why patient experience and its effective measurement is so important and will become even more so in the future. Now we’ll talk about how to impact it. In the context of managed care, including shared savings programs, ACOs and other value-based contractual arrangements, patient satisfaction is often measured through surveys sent to patients to assess their experience.

These types of surveys are still evolving, are confounded by a number of variables and most certainly not without their detractors. For example, some studies have found that doctors who overtreat their patients can achieve very high satisfaction scores. But these types of surveys are here to stay; payers will use them to determine bonus and contract terms and they can leveraged to identify concerns around withholding care, a key lesson learned from the “HMO days,” when some providers denied care in misguided efforts to reduce cost and utilization.

In addition to mandated and formal survey instruments like those from Press Ganey, providers of care are also rated informally on sites like Facebook and Yelp by their patients, sometimes with surprisingly strong correlation to clinical measures. These surveys, imperfect though they may be, matter.

We are convinced that understanding and impacting the entire patient experience gives provider organizations a competitive advantage in a changing marketplace by deepening patient engagement. It doesn’t have to start with a radical “money back guarantee” as recently announced by Geisinger Health System. Just like the manager of a hotel or a retail store, just hearing the concerns of patients begins the process of building closer and more successful relationships with them. The approach we suggest is:

  • Think of this as beginning the dialogue and set a tone of incremental improvement and mutual support early. Changing cultures is neither easy nor fast.
  • Utilize quantitative and qualitative information to get an understanding of the current state. We believe that survey data should be informed by interviews with past and present patients about their experience. Similar reviews should be done with staff, ideally both past and present as well.
  • Map the patient workflow through your organization. Where is it strong, where does it break down? Look at it from the outside as well; how do hotels and retail remove the “friction” in their process?
  • Identify a future state, mixing a broad vision with measurable and financial impacts of success, where possible.
  • Identify opportunities for near-term and demonstrable improvement to improve capacity and build momentum; keep scope narrow and focused.
  • Build clinical and business task forces to tackle goals, get the benefit of existing teams if possible, like quality leadership or multi-disciplinary teams like those involved with new contracts, EMR implementations or ICD-10 upgrades.
  • Communicate to all stakeholders, especially patients. Where in the patient workflow can you educate them on the work you’re doing and how you are working to improve their care? Patients may not know all the good you’re doing for them unless you tell them.
  • Don’t just talk, listen. What would happen if at the end of a visit, an administrator or manager asked each patient a simple question: what could we have done better for you today?
  • Lean on appropriate technology; all EMRs have some type of patient engagement tools that can give patients convenience and accessibility. Tie their use to your organizational goals first before looking at point solutions from vendors that can be time consuming and complex to implement.
  • Never stop.

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