How will this module help me build a patient experience program for my practice?
Outlines six steps to creating a successful patient experience program
Provides answers to commonly asked questions
Provides tools and resources to use during and after program implementation
Provides examples from other practices describing how they have implemented patient experience programs and their impact
Enhancing the experience of patients and their loved ones is crucial in today's health care environment. Competition in the health care market has led patients and insurers to become more informed consumers who expect higher quality, more value and better outcomes. Patient satisfaction is viewed as an important indicator of quality of care and assists in understanding patients' perceptions of their care.
That being said, building a better patient experience goes well beyond patient satisfaction scores.
Patients make choices based on how you make them feel, not just the quality of clinical care you are providing. Therefore, a comprehensive strategy relies on team engagement to create a culture of empathy in the practice that is palpable to patients. Successful patient experience efforts are grounded by creating a burning platform for change, leveraging transparent feedback and providing effective training. Building a patient experience program is not only important for improving patient satisfaction, but can also be a rewarding activity for your practice.
Six steps to create a patient experience program
Assess the current state of patient satisfaction
Define your “North Star”
Engage key stakeholders in experience design
Develop and implement your patient experience strategy
Analyze feedback and determine impact
Recognize accomplishments and improve over time
STEP 1 Assess the current state of patient satisfaction
Start by gaining an understanding of the current state of patient satisfaction in your practice. There are several options for collecting patient feedback in a timely and cost-effective manner. One way is to provide patients with a patient satisfaction survey. Surveys give patients the opportunity to provide anonymous feedback that can be used to make improvements. This is a popular and simple approach that can also be used to continually evaluate the patient experience over time.
You could also enlist members of your team to have brief, casual conversations with patients during their clinic visit. Anyone in the practice can get a pulse on patient experiences by simply asking patients, “How was your visit today?” or, “Do you have any feedback you'd like to provide to us?” These questions can be asked by staff at check-out, by a medical assistant as they escort the patient out of the exam room at the completion of the visit or by anyone in the practice that finds themselves sharing an elevator with a patient. Any pertinent positive or negative feedback can then be relayed to the practice manager. If accessible, reviewing patient complaints and grievances can also offer perspective.
Review the results of the current state assessment to identify themes and trends you can highlight when discussing the program direction with other practice stakeholders. The feedback collected could help create guiding principles for the program and serve as a catalyst for change.
STEP 2 Define your “North Star”
Your North Star is what your practice will strive towards and guides your program's purpose and structure. When defining your North Star, make sure you gather and discuss different team member, patient and caregiver perspectives. Take time as a team to characterize the ideal patient experience and outline goals for the program. Consider how you'll engage other physicians, staff, patients, families and loved ones.
STEP 3 Engage key stakeholders in experience design
Culture is critical in creating a sustainable patient experience program. To build a relationship-centered program, you need to have a culture that encompasses teamwork, integration, good communication and an environment supportive of continuous learning.
Quiz Ref IDInvolve all clinical care team members, administrative leadership, front desk and scheduling staff, physicians and, perhaps most importantly, your patients in program creation. Share the results of your assessment of the current state of the patient experience and discuss reactions and trends. Hold a brainstorming session to come up with ideas for your patient experience platform. Take the opportunity to ask employees about the challenges they face in daily operations to identify areas where additional training could be useful. You can also include patients in the design process by holding a focus group to evaluate ideas.
STEP 4 Develop and implement your patient experience strategy
Work with your patient experience program team to determine which processes or changes to implement first. To ensure success, start small and pick an option that is sustainable and scalable for your practice. Here are some ideas:
A PFAC is a partnership between patients, families, caregivers and members of the care team that encourages honest feedback and constructive criticism to make the practice better. A PFAC ensures the voice of the consumer is integrated into prioritization of decisions your practice makes related to changes that will affect the patient community. Strengthening the partnership between the practice and its patients can help you achieve goals and provide better care to patients.
STEP B Institute regular leadership “rounding,” where leaders are out in the clinic speaking directly with patients, families and caregivers about their experience in the practice.
Rounding enables the clinic leadership to connect with patients in real time to gain a deeper understanding of tactics to strengthen care. This approach also provides opportunities for immediate service recovery and feedback for staff and physicians. You could assign a team of leaders to specific clinics or request that the manager, administrator or lead physician engage with patients in their own clinic. Leadership rounding can occur on a weekly, bi-weekly or monthly basis.
STEP C Make improving employee engagement a priority.
Employee engagement is imperative to a successful patient experience program. It is important to understand what drives employees and why they come to work each day. Consider conducting an employee engagement survey to better understand how staff members feel about their work environment. Communication, teamwork, safety, confidence in management and the ability to provide quality care are key topics to cover in an employee engagement survey. You can also personally check in with your staff through leadership rounding to get a better understanding of what is working and what needs further attention. Listening with empathy to your employees is just as important as listening to your patients. Studies show that less than half of the U.S. healthcare workforce is highly engaged in the work they do.11 It is important to make positive changes to the work environment based on the employee feedback received so that staff feels that they are being listened to, which itself can make them more engaged. More engaged employees make for more satisfied patients.
STEP D Implement service excellence training for employees at all levels.
Service excellence is more than a friendly face. It requires a core set of standards that yield a framework for treating patients with courtesy and respect while offering the highest quality of care. Such training teaches staff how to effectively handle patient concerns in real time as well as how to respond in a way that demonstrates empathy to the patient's concerns. Acknowledge, Introduce, Duration, Explanation and Thank You (AIDET®)18 and Communicate with H.E.A.R.T.® are examples of common service excellence training tools that help teams establish powerful communication frameworks for staff to use with patients, families and each other.
Service excellence training will not prevent all service breakdowns, so it is also important to have a strong service recovery strategy. Service recovery can turn a disgruntled patient into someone who is happy and loyal to your practice. In the event that service recovery is needed, staff should be prepared to apologize and acknowledge the breakdown in service, listen to the patient's concerns and act quickly to fix the service issue. While all practice staff should be prepared to handle these types of situations, it is helpful to identify an individual, often a supervisor or practice manager, to lead service recovery efforts.
STEP E Teach effective and empathic communication.
The strength of the relationship between a patient and their physician and other care providers significantly impacts the patient experience. A strong relationship is founded on effective communication. Initiate conversations with clinicians to understand how they are currently introducing the computer, working with patients on agenda setting and other aspects of the patient encounter to understand any challenges they are facing in effectively communicating with their patients. Find avenues to maximize communication and peer training. Practice listening with empathy, teach-back and other methods to foster strong communication. Consider applying evidence-based models such as the REDE Model of communication, which stands for Relationship, Establishment, Development and Engagement19, or the Four Habit Model17. REDE emphasizes creating a safe and supportive atmosphere as you establish the tone for the conversation with the patient.
STEP 5 Analyze feedback and determine impact
You may choose to repeat patient satisfaction surveys as a part of your ongoing program strategy. Many surveys use similar measures that you can trend over time. If you are working with a vendor such as Press Ganey to distribute and analyze your survey or using the free CG CAHPS outpatient satisfaction survey, you can submit your practice data to a database for benchmarking.
It is likely that you won't be able to quantify all parts of your patient experience program. Qualitative input can be just as valuable. Look for trends in the comments section of your patient survey. If you started a PFAC, ask how it's going. Is meeting attendance strong? Are patients engaged and happy to be participating? Are physicians and staff deriving value from the PFAC?
If your practice has recently undergone a change or initiated a project aimed at solving a particular problem, look at patient visit statistics, complaint data and referral patterns to assess impact. For example, patients may have been particularly dissatisfied with the communication about wait times in your practice, so you recently put a process in place where the care team updates the front desk when the physician starts to run behind. That has allowed your front desk staff to let patients know about a delay at the time of check-in, which not only updates them immediately upon arrival, but also provides them with the opportunity to reschedule if they are not able to wait. You can track patient complaints and survey comments or complete leadership rounding to gauge the impact of this new communication strategy from the patient perspective.
STEP 6 Recognize accomplishments and improve over time
Building a patient experience program can be a challenging process. Your team will continue to stay engaged if they feel the program has value. Make the program a key discussion topic in team meetings. Continue to ask for employee feedback and suggestions on ways to improve and enhance the program. Regularly share any results and positive affirmations gleaned from surveys. Share patient suggestions and stories from the PFAC or leadership rounding. Physicians and management should lead by example by participating in the various patient experience initiatives within the practice.
Celebrate the team members who are shining in this effort. Share uplifting or positive patient narratives, invite a patient to speak and present the highlights of mystery shopping to raise awareness of how the practice is moving towards its North Star.
“I have had and continue to have excellent service from Dr. Smith's staff and excellent, professional and caring medical care from Dr. Smith herself. I am retired from the U.S. Army and I have had myriad experiences with medical doctors, civilian and military, national and international. Dr. Smith is by far, one of the most knowledgeable, professional and personally caring physicians I have encountered. She is never hurried. She listens and hears my questions and concerns with compassion. Most important to me, she gives me the best professional instructions and guidance, and leaves me with the confidence I need to take better and better care of my health. Dr. Smith is a stellar example of what physicians should be; she is pragmatic about her decisions to affect my healthcare courses of actions. I have and will continue to recommend her to professional and community associates, and friends.”
Anonymous patient comment about their experience
Building a patient experience program is a team effort that requires dedication along with an openness and desire for change. The voices of patients and their loved ones can provide valuable input on what a practice is doing effectively and where improvement opportunities exist throughout the patient journey. Using this information and partnering with patients allows practices and organizations to design services that transform clinical care, enhance patient loyalty, and most importantly, bring more meaning and joy to patients and caregivers.
“I have learned so many skills that will not only aid me in teaching this curriculum but are highly applicable to leadership endeavors and professional interactions. Not only will it improve the patient experience but it has the potential to really restore a joy in patient care that so many physicians are lacking and desiring. I am happy to see that this initiative has such strong support amongst the leadership of this institution. It will be successful if we continue to model that support to our colleagues.”
Physician feedback about the patient experience program at the Cleveland Clinic