What is Patient Experience? Definition, Measurements, and Example
What is Patient Experience?
There are many definitions of the patient experience. A global leader on improving the patient experience in healthcare, The Berly Institut defines the patient experience as a set of interactions and situations experienced by a person or their family and friends during their health care journey. These interactions with the health care system, including doctors, nurses, and other staff in the hospital, are shaped by the organization culture, that influence patient perceptions across the continuum of care*.
Despite the complexity to know which of those multiple definitions is right, there is a general agreement that the patient experience incorporates patient’s perceptions during his health care journey, and it is influenced by the organization’s actions during this journey.
(*): definition inspired by The Beryl Institute.
Why is it important to measure Patient Experience?
Measurement of patient experience is important because it provides an opportunity to assess the quality of services, monitor health care performance, and document benchmarks for health care organizations. It’s a real opportunity for healthcare providers to develop their own care practices or improve the existing ones so they can meet or exceed patients’ expectations.
Furthermore, organizations also want patients to return, to refer their friends and family, and to provide positive word-of-mouth about their health care experience. Although many patient experience measurement initiatives are still in development stages, several studies have reported care improvements after systematic collection and analysis of patient feedback.
How to measure Patient Experience?
Lavela and Gallan (2014) in their article Evaluation and measurement of patient experience said that measuring patient experience can be accomplished using a quantitative, qualitative, or mixed-methods approach. The quantitative survey approach is by far the most widely used. It’s easier and faster to analyze and relies on larger samples, which allow using statistical tests to study the relationship between different variables and to compare certain groups of individuals. Closed-ended survey questionnaires are among the most common form of quantitative measures of patients’ experience. There are several structured questionnaires that measure patient experience or components of patient experience such as CAHPS Surveys, CPES, NHS Patient Surveys, CQI, etc.
The downside of the quantitative approach is that it doesn’t allow the respondent to provide answers and express his feelings but only to choose from a list of pre-selected options. This is the reason why an increasing number of studies are highlighting the strength of the mixed methods approach.
The mixed-methods approach includes both quantitative and qualitative methods and it helps to gain broader perspectives than would be achieved by using one predominant method alone. It lies not only in obtaining the “full picture,” using the quantitative approach but it also allows to get rich, qualitative data using the subject’s own knowledge and feelings. It offers the opportunity to obtain an in-depth understanding of patient perceptions and behaviors and the meanings they attach to their experiences, that quantitative alone doesn’t provide. The mixed-methods approach allows to answer the “what” (quantitative) and the “why” (qualitative) of patient experience. It helps to explain the results provided by the closed-ended part of the questionnaire through the analysis of the open-ended part of the questionnaire or other sources of feedback or additional qualitative data collection using interviews or focus groups with patients.
As mentioned before, qualitative methods offer the opportunity to obtain an in-depth understanding of patient experiences because it allows patients to describe their experiences and perceptions using their own words. Open ended responses of surveys, as well as traditional qualitative methods such as interviews and focus groups, are often used to capture the patient experience. Ethnography may also be used to measure and better understand patient’s perceptions.
What aspects of Patient Experience should be measured?
There are several dimensions of the patient experience that can be measured. The most frequently cited dimensions are those of the Institute of Medicine (IOM) and the Picker Institute. Both were developed based on the work of Gerteis et al. (1993). This work described seven dimensions of the patient experience as defined from studies that involved focus groups with patients and hospital staff. These dimensions are:
- Respect for patient values, preferences and needs
- Coordination and integration of services
- Information, communication, and education
- Physical comfort
- Emotional support
- Involvement of families and loved ones
- Continuity and transition of care
The UK Department of Health (NHS) published in 2012 a framework of nine measurable dimensions of patient experience, based on the IOM and Picker Institute models, with a new dimension corresponding to the “overall evaluation of the institution”. This framework is used in all health care sectors. It is applied to both acute care and long-term care and for all conditions (Soubeiga et al., 2013).
Short Case Study: Measuring Patient Experience at Ottawa Diamond Medical Care Center
Ottawa Diamond Medical’s five care centers needed a way to measure the quality of their patient’s experience and to communicate patient feedback in a way useful for clinicians and managers.
“The patients are the ones who pay our salaries.” says the general manager Dr. Brenan Powell. “If we focus on the patient, everything else takes care of itself”.
Receptionists asked patients to provide their phone number and email address so they can send them a link for an online survey right after they visit the medical center.
Every patient receives an email or a text message from the organization communications department with a link to an online survey about their experience from the beginning to the end. Managers wanted the survey questionnaire to be short and be completed within 5 minutes. Five important questions were selected and asked on the patient experience survey and the patient was able to comment at the end of the survey:
#1: How easy was it to schedule an appointment?
#2: How long did you wait (beyond the appointment time) to be seen by the provider?
#3: How satisfied are you with the cleanliness and appearance of the facility?
#4: How would you rate the overall care you received from your provider?
#5: How likely are you to recommend our facility to a friend or family member?
#6: General comment
An average of 20% of patients responded to the survey.
The survey data and patient feedback were shared with clinicians and staff instantly through secured online dashboards provided by MetricsXM.
With thousands of responses recorded, the survey data enables the organization to measure continuously its performance and improve the services based on patients’ feedback. When 90.71 percent of patients said they would refer family and friends to Ottawa Diamond Medical, leaders set a new goal, pushing their benchmark up to 91.21 percent. Three years after launching the survey, says Powell, patient referrals are at an all-time high.
A data-driven focus on patient feedback has helped put Ottawa Diamond Medical Center among the top 10 percent of financial performers for healthcare organizations of its size across the Ottawa region medical network. The organization also gets high marks in measures of patient engagement: a high patient pay revenue, portal adoption rate, and very few no-shows.
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Soubeiga A, Tiendrebeogo G, Hejoaka F, Belem EM, Compaoré PL, Wolmarans L, Ouangraoua N. (2013):