Patient Experience: What does it mean?

Many hospitals in the USA are concerned with patient experience especially with HCAHPS reimbursement rules come into effect. However, there is confusion about what customer experience actually refers to. A Health Leaders Media survey of hospital and health system senior leaders that states that “34% chose “patient-centred care,” 29% selected “an orchestrated set of activities that is meaningfully customized for each patient,” and 23% said it involved “providing excellent customer service.” The remaining 14% said it was creating a healing environment which seems most aligned to what’s measured by HCAHPS. It is not just semantics. The definition used makes a difference because it determines what a successful outcome will be or not.

The honest truth is that while many hospitals will always have been concerned with the patient experience they did not have a clear vision of what it actually is. Successful outcomes were measured by a variety of yardsticks. HCAHPS may not be a panacea but it is an aligning force that is basically says patient experience is everything outside of clinical care and involves all parts of the hospital.

This understanding of patient experience follows what is known from the larger customer experience space. Customer experience as a discipline started to take off in 1998 with the seminal HBR article “Welcome to the Experience Economy”. Beyond Philosophy provided the unifying definition of customer experience as follows:

A Customer Experience is an interaction between an organization and a customer as perceived through a Customer’s conscious and subconscious mind. It is a blend of an organization’s rational performance, the senses stimulated and emotions evoked and intuitively measured against customer expectations across all moments of contact.

There are three key points here. Patient experience is about 1) the whole organisation delivering, 2) the rational as well as the emotional experience and 3) dealing with the intuitive perceptions (i.e, gut feelings) of patients.

1. Patient experience is about the whole organisation delivering

The health Leaders Magazine article makes it clear that hospital leaders are in general just coming to terms with the first point – that patient experience is about an interaction between the hospital and a patient. This simple phrase packs a lot of weight. It does not say that patient experience is about an interaction between

• the front line and the patient
• any individual or individual department and the patient

    2.   Patient experience is about the rational as well as the emotional experience

• Think of patient experience as being an iceberg. The part that is above the water is the rational experience. This would be all of the normal things you would expect any patient or health care professional to state is important – facilities, competency, etc. As patients answer questions about what they want or like, they must process an answer. The act of processing the answer means that the most obvious logical sounding things will make it through and this is what they answer.
• The part that is below the water level is the emotional experience. This part of the experience is difficult for the hospital to see. Think of this as the “bedside manor” the whole hospital displays. To be frank, this is where the biggest opportunity is to improve patient satisfaction. So the trick here is to develop the hospital’s ability (remember we are talking about the whole hospital) to view the emotional experience. It is certainly more difficult to address what you cannot see.

 3.   Patient experience is about dealing with the intuitive perceptions (i.e, gut feelings)

• Think about it, most patients are not trained medical practitioners. They generally have limited practical ability to assess the experience on the basis of sound clinical practice. Instead, they pickup clues and make inferences about the overall experience. A classic article that describes this phenomenon in a hospital is Clueing in Customers. The point is that this gut reaction on the part of patients is often dependent on the little things (i.e., clues ) in the experience. These clues could be such things as the quality of the toilet tissue, visible cleanliness of seating, name tags turned right way around, etc. – things that people do not tend to primarily focus on in a healthcare setting.

Any hospital executive that is looking to make significant improvements in its patient experience needs to keep the above definition and its implications in mind. Overlooking or inadequately considering any of the three key points will significantly hinder progress.

For a more info and a case study in Patient Experience improvement – click here.