Going Beyond HCAHPS to Measure the Patient Experience

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PEX-thumb5Hospitals are traditionally seen as a healthcare resource, rather than as a healthcare partner, observes Jacqueline Fellows in a recent article at HealthLeaders Media. What if healthcare consumers, however, started seeing hospitals as more than just the place to go when they were struck by illness, disease, or some other condition requiring medical attention?

How would that impact their loyalty to the organization?

As we mentioned yesterday, this kind of loyalty can only be attained through proper communication with the patients. You have to hear what they’re saying about your organization.

Global strategy consulting firm Bain & Co. in Boston, Mass., has created and developed a metrics model, known as Net Promoter Score, that is specifically designed to help hospitals and healthcare facilities understand what their patients are experiencing by gauging their loyalty to the organization.

Fellows outlines how it works: Customers are asked “to assign a number, on a scale of 0 to 10, to the question, ‘How likely is it that you would recommend to a friend or colleague?’ A patient who chooses 0–6 is labeled a detractor and is likely to negatively talk about the experience. Scores of 7 or 8 mean the patient is passive—satisfied but ‘unenthusiastic and vulnerable’ to competition. The jackpot is a 9 or 10. Either of those means the patient is loyal and is extremely likely to promote the organization to friends and family members.”

NPS then applies math to the results: “Subtract the percentage of detractors from the percentage of promoters, and that is the score.”

Kevin Gwin, vice president of communications for Ardent Health Services in Nashville, Tenn., began using NPS after devastating feedback from patients threatened to upend Ardent’s morale and reputation.

He has embraced NPS, believing it to be superior to HCAHPS in that it provides “data [that] is raw, relevant, and returned quickly” and also because measuring loyalty takes it one step beyond HCAHPS’ metrics.

Fellows writes, “Ardent uses an outside vendor to conduct an NPS survey with a representative sample of patients who are discharged weekly. When the surveys are returned, the scores are pushed out to each hospital’s C-suite team. …[L]eaders in Ardent Health hospitals are empowered to manage their own NPS scores; the data is to help them make decisions, but there is a corporatewide standard of calling back a patient who was surveyed and turned out to be a detractor. [Gwin] says hospital leaders are the ones who make the calls because he believes the most effective and meaningful way to change culture is to hear—really hear—from the patient what the experience was like.”

Although Gwin still uses HCAHPS, he observed this about NPS: “If our hospital leadership interacts with patients and they hear complaints, they act immediately, but for some reason, when it’s on paper or it’s on your computer screen, it becomes a little less real. I just want our leaders, even our charge nurses and our department directors, to get used to hearing from our customers. Even the corporate CEO reads every patient comment every week and makes a few phone calls, because we just need to get into the practice of hearing from patients so we can better align our organization.”

NPS’ frequency and specificity with regards to the patient experience has improved Ardent’s operations. One Ardent facility, Bailey Medical Center in Owasso, Okla., saw its scores go up from the 50 or 60 percentiles to 95 percent under NPS.

These results are similar to what Ardent is experiencing throughout its organization, because its culture is changing, Gwin said, and it is now hearing directly from its patients, rather than simply scoring them.

Does your organization need a metrics system apart from HCAHPS that would enable your professionals to better understand the patient experience? How would improving the patient experience at your organization enhance the loyalty of your patient population to your facility?

-by Pete Fernbaugh

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