The fine print of patient satisfaction scores: Leaders weigh in on the interactions, data points and hospital departments that matter

Few healthcare leaders disagree on the importance of patient-centered care, yet many are challenged to effectively move the needle on patient satisfaction metrics as reported by HCAHPS. To identify and address the drivers of patient satisfaction, hospital leaders are seeing value in deploying both analytics and nonclinical rounding to foster connections with individual patients. 

In the last decade, patient satisfaction surveys have gained attention from hospital leaders as a useful tool to identify opportunities for quality improvement. Patient satisfaction is a patient's cumulative evaluation of his or her healthcare journey, from the first phone call through discharge. As such, consumer feedback reflects the quality of a hospital's personnel, processes and physical environment.

Patient satisfaction can also affect care quality outside of the inpatient setting. Studies have shown patient satisfaction influences a number of key outcomes post-discharge, including clinical effectiveness, medication adherence, patient retention and even patient payment behaviors.

As such, "it's no surprise healthcare organizations dedicated to improving quality are examining patient satisfaction surveys more closely than ever," said Alison Saine, global healthcare director of patient insights and experience at Sodexo, during an executive roundtable discussion April 18 at Becker's Hospital Review 8th Annual Meeting in Chicago. 

Ms. Saine, joined by Ryan Sawyer, president of operations management software firm Hydracor, discussed three key learning points on driving patient satisfaction, including how to enhance the patient experience through informal data collection, help environmental services partners manage their performance and use nonclinical rounding to improve satisfaction.

More patient feedback doesn't equate to more satisfied patients

Gathering and analyzing patient feedback is integral to better understand and serve a patient community. Two important data sources are HCAHPS surveys and nonclinical rounding, during which hospital leaders — executives, directors, managers and supervisors — meet with patients to collect firsthand feedback about their experiences.

Some hospitals have implemented analytics programs that use feedback data to assess past and near-time performance and predict HCAHPS scores, such as discharge information and cleanliness scores. Tracking and managing performance is useful to identify environmental issues affecting patient satisfaction. However, using data analytics alone to improve HCAHPS scores can have less-than-desired results, according to Mr. Sawyer.

"Analyzing extensive patient satisfaction data has helped organizations to hone their accuracy in predicting HCAHPS scores, sometimes to within a decimal," Mr. Sawyer said. "But that doesn't necessarily equip [hospital leaders] with the information they need to raise HCAHPS scores."

Instead, healthcare organizations see a greater change in patient satisfaction when they both analyze feedback and promote connection between hospital leaders and patients.

Studies have positively linked nurse leader and other clinical rounding with higher patient satisfaction rates. Nonclinical rounds are another opportunity to address patient satisfaction. Hospital administrators that use rounding to connect with and listen to patients, as well as collect feedback, demonstrate a true patient-centered approach to care from the top down.

In fact, Mr. Sawyer found hospital systems that divided their resources between analyzing feedback and connecting with patients during rounding saw substantial improvement in patient satisfaction levels, compared to their peers that invested in data analytics alone.  

Collecting patient feedback during rounds is important. But "when it comes down to it, your labor hours are better spent driving patient value than in duplicating the data already present in your HCAHPS surveys," Mr. Sawyer said. For this reason, Mr. ­­­Sawyer recommends rounding hospital leaders strike a balance between collecting patient feedback and personally connecting with patients to positively affect an organization's HCAHPS metrics. Every interaction with the patient should drive value for that patient. 

Find ways to guarantee consistent and effective operations across service lines

Promoting connection between leadership and patients is the first step toward driving patient satisfaction. The second step is finding ways to ensure and maintain high quality, consistent operations across environmental service lines. Creating a "service line depot," or an enterprisewide quality assessment team, can help hospital leaders efficiently identify and resolve problems that affect patient satisfaction in nonclinical departments, such as food and nutrition, housekeeping and administrative assistance.

Patient experience is shaped by a variety of environmental factors generally grouped under people, process and place. Factors such as cleanliness, infrastructural and cosmetic maintenance, noise levels and food quality have substantial affects on how patients perceive the quality of their care — and HCAHPS surveys evaluate hospitals' performance in each category. Environmental services partners who have tools to track near-time performance and maintain quality can help hospitals to improve satisfaction scores.  

"Everybody needs to be aware of performance, every operator needs to see where they're at," Mr. Sawyer said. To reduce variability and improve patient satisfaction, he recommends implementing technology that gives environmental services partners near-time insight into performance data. This helps operators pinpoint and correct issues, such as replacing unpopular food options or using a different laundry detergent.

The most effective and actionable analytics platforms represent this data visually, as charts and graphs are often easier to understand than black-and-white statistics, he adds. "If [end users] can't analyze large data sets in 30 seconds or less, then the technology really isn't helping," Mr. Sawyer said. Operations leaders can then incorporate data into strategic, specific action plans.   

Define and drive value for patients — not just for hospital staff

Finally, improving patient satisfaction is about putting the patient's needs before the hospitals' needs, Ms. Saine said.

Rounding is one example of an opportunity to put the patient's needs first. To sick patients and their families, not all rounding is created equal. Patients generally enjoy rounding by their nurses and physicians since this makes them feel physically safe.

However, patients are often less thrilled when it comes to rounding related to their nonclinical experiences — or rather, lack of thereof. It is far better to focus on discussions they will find valuable, such as orientations. In fact, a patient experience study in U.S. World & News Report found that a lack of orientation to their room and dining plan by staff was one of the top 10 complaints patients had about their hospital experiences, according to Mr. Sawyer.

The vice president of operations for a large nonprofit physician group on the East Coast suggested one way hospitals can address this complaint. Leaders who perform nonclinical rounding should focus on making the patient comfortable during their visit rather than collecting feedback on the patient's experience.

"When the rounding benefits [the hospital], then you aren't driving patient value. It's important to make sure rounding is adding value to the patients, rather than valuable to you as a hospital," he said.   

"To help improve patient satisfaction, hospital and health system leaders should ensure they are taking a holistic, team-based approach that uses their organization's available resources — including the third-party professionals who manage those important nonclinical services and spaces," he added. 

To learn more information about Sodexo and patient satisfication, click here, or email Alison Saine, Sodexo's global healthcare director of patient insights and experience, at

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