At the close of 2021, I wrote that we were in a patient experience crisis. With the pandemic grinding on and omicron surges hitting most of us, the outlook was grim. My colleagues and I had never seen patient experience metrics drop so rapidly, and this development was a critical concern for the operations leadership and boards of many health systems. At the end of 2022, I wrote that, although some improvement had been seen, national indicators were still trending flat to negative.
It’s now mid-year 2023, and COVID-19 seems to be receding from the landscape. What is the current state of patient experience?
I’m happy to share that recent national reports show the curve in patient experience ratings has finally begun to bend upward. As winter ended, we saw the first months of increases since before “the great decline” began in 2021. This upward trend is encouraging. What is behind this change in trend, and how do our organizations ensure that our patients are feeling this improvement?
At NewYork-Presbyterian, we are experiencing our best quarter for patient experience metrics in recent memory. We believe our continued and accelerating recovery is due to a number of factors.
First, our staffing is stabilizing. Our vacancy rates continue to decline and, perhaps even more encouraging, we are seeing improvement in our ability to retain employees. At recent employee town halls across our organization, we are seeing optimism return to our teams. This stabilizing base gives oxygen to our patient experience improvement work. We have been able to welcome and train our newest team members in our patient experience best practices. We’ve been able to restore some practices ‚— like bedside shift reports — that were not possible only months ago. Improving staffing is a huge piece of our recovery and is also likely driving improvement nationwide.
Another factor is an improved ability for our system to address patient progression and length of stay. COVID-19 surges coupled with staffing challenges caused many emergency departments to become adjunct inpatient hospitals in recent years. There is nothing that chills the patient experience more than having patients held in the emergency department waiting for "a bed upstairs." As we have been able to once again restore patient flow in our organization, we have seen "ED holds" decline, helping to drive improvement in our patient experience metrics. All of us in healthcare know that length of stay is a perennial challenge. Continuing to tackle this work is an absolute prerequisite for patient experience recovery and improvement.
Of course, these improving trends must be accompanied by diligent and thoughtful execution of patient experience strategies. As staffing stabilizes, we must have the right programs to engage and train new team members. At the same time, we need to relaunch and recommit to core practices that enhance communication and coordination at the bedside. These efforts must be titrated carefully to match the pace of recovery within our organizations. It’s both a science — watching unit score trends month over month — and it’s also art, understanding the pulse of our teams and adding elements back in as our colleagues are ready to take them on.
Patient experience leaders and teams need to be prepared to meet this moment of opportunity. We have the knowledge to take the right steps that can help all of us ride this wave of recovery. However, our teams also need support. I have watched with concern as many patient experience leadership roles have been eliminated and teams reduced by organizations around the country. If we profess that patient experience is a core aspect and measure of any healthcare organization’s effectiveness, then we have to invest in the resources to drive improvement. Most patient experience teams are small but mighty. We need these content experts in our organizations to ensure that we are attending to this core aspect of our mission. Organizations that eliminated or reduced these resources may have some catch up work to take advantage of the factors that are now turning back in our favor.
As we move into the summer, my colleagues and I are optimistic about the results we can achieve for our patients and families in the months ahead. The recovery we have worked for is finally materializing. Now is the time to mobilize strategically to reap the benefits for our organizations and those we serve.