To target patient experience improvement efforts, get the patient involved

Hospitals and health systems are laser-focused on improving patient experience, to the point of disaggregating HCAHPS scores and tying providers' individual financial incentives to them — to the dismay of CMS officials. But there is a better way to target patient experience improvement that focuses less on physician behavior and more on patients' actual wants and needs.

Christina Dempsey, MSN, RN, is Press Ganey's CNO. She has been a nurse for more than 30 years and took on her current role in late 2012. Ms. Dempsey says hospitals do need to segment HCAHPS and other patient survey data, but instead of attaching scores to an individual physician's financial bonuses, hospitals should boil the data down to specific patient populations, because patients have different needs and wants depending on their illness. From there, hospitals can draw out more nuanced findings to apply to certain groups of patients.

"We can segment groups of patients to understand their specific needs, which may or may not be different" from the patient population as a whole, she says. "It's about understanding your specific patient population and what their needs are. Intuitively, as a nurse, we've known that all along, but now we can actually demonstrate that with data."

For instance, chronic heart failure patients, when compared to other patient cohorts, tend to need more information about what to do after discharge to stay healthy and avoid readmission. Carving out time for these patients prior to discharge to give them ample time to understand their post-discharge treatment plan can improve not only their outcomes but also their HCAHPS scores for discharge information, thus improving the hospital's overall patient experience scores.

Hospitals are still "on the journey…to maximizing their data capabilities" when it comes to HCAHPS scores, Ms. Dempsey says. While those data mining systems are developing, there is a low-tech option for hospitals looking to target their patient experience improvement efforts — a patient/family advisory council.

As the name suggests, PFACs bring together former patients with hospital staff so officials can get feedback straight from the source. In addition to the patients and families in attendance, leaders from the C-suite typically attend council meetings, as well as staff from the hospital's patient experience office. When leaders attend the meetings, it "speaks to the patients…that leadership of the organization really cares about what they think," Ms. Dempsey says.

Ms. Dempsey's advocacy for PFACs partly stems from a personal experience as part of one of these groups that left a lasting impression.

"I had a less-than-wonderful experience when I was a patient in a hospital," she says. She ended up being invited to that hospital's PFAC, where she explained her situation. "Before I left, they were developing an action plan. That meant, No. 1, they cared about what I thought, and, No. 2, they were going to act on what I said."

Experiences like that one, made possible by a PFAC, drive loyalty and word-of-mouth marketing, Ms. Dempsey says, while also allowing the hospital to hear straight from patients about what they want from their hospital experience.

Blending data analysis and real human feedback can create the perfect cocktail focusing improvement efforts more intensely on what actually matters to the patient, and therefore hopefully not only improve patient experience but also reduce suffering.

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