Patient experience or patient satisfaction: what should you measure?
Measuring patient experience and patient satisfaction is becoming more and more important to assess the quality of care. But the concept of patient experience is
surprisingly complex and is often used as a synonym to patient satisfaction. Even in the literature, both terms are frequently used interchangeably. Confusing and unfounded, because patient experience and patient satisfaction are two different things. In this blog we will describe the differences. We will show you what you should measure to collect useful data and improve the quality of care within your organization and achieve the Triple Aim objectives. And how you make sure your patients are satisfied.
Patient experience and patient satisfaction: the differences
Although the terms patient experience and patient satisfaction are often used interchangeably, there is a subtle difference between the two (see Figure 1).
Patient experience comprises all interactions a patient has with healthcare providers and how they experience those. Anything from being welcomed by a receptionist to the care of doctors, nurses and other healthcare providers. When measuring patient experience, we look at if what should have happened, actually did happen.
Patient satisfaction is based on the expectations of a patient in relation to the healthcare sector and if those expectations were met. This means two people who received completely identical care services, can score completely differently on patient satisfaction.
Figure 1: Patient experience vs patient satisfaction
In short: patient satisfaction is often very personal, whilst patient experience is about testing a defined quality standard of care. So, subjectivity versus objectivity. The subjectivity of the patient satisfaction survey is also confirmed through a variety of research (Evans et al. 2018; Dunsh et al 2018). These show that:
- Patients have a tendency to give a positive assessment directly after treatment;
- The chances of a positive assessment are higher if the questions are framed more positively;
- Satisfaction is not a reliable measurement for quality.
So everything points to patient experience being a more useful measure. That is why that will be the focus for this blog.
Why is positive patient experience so important?
Of course we want to provide healthcare that our patients experience as ‘good’. It’s nice to have satisfied clients, but positive patient experiences can also bring about important clinical and financial advantages, research has shown. Here are a few examples:
- Research amongst patients with coronary diseases has shown that positive patient experience affects their mortality (Meterko et al., 2010).
There is proof that positive patient experiences leads to lower average costs for healthcare institutions (DiGioa et al., 2007; Charmel et al., 2008).
Quality of life
- Research has shown that positive patient experiences have a positive influence on self-management skills and quality of life of diabetes patients (Greenfield et al., 1988).
- There is a proven correlation between positive patient experiences and therapeutic compliance in patients with chronic conditions (Doyle et al., 2013; Beach et al., 2006).
Satisfied healthcare providers
Positive patient experiences lead to lower turnover of staff and more job satisfaction amongst healthcare providers (NHS, 2010; Agency of healthcare Research & Quality, 2016).
Research has also shown that patients want to be more involved in the decision making process about their treatment (Picker Institute, 2006).
So good patient experiences affect several Triple Aim outcomes. By working to improve patient experiences as a healthcare institution, you create a win-win situation.
Improving patient experience: this is how you do it
But how do you improve patient experience as a healthcare organization or provider? This can be done in many different ways and it will be different for every organization, because no organization and no patient population are the same. But even though there is no one-size-fits-all approach, there are several proven methods to improve patient experience. Here are a few:
Communicate waiting times and make sure waiting lines don’t become too long, for example by using online and offline solutions so patients can book their own appointments.
Make it easy for patients to find their way in your organization. Digital navigation is that future as far as that’s concerned.
Use communicative means with translation functions. A patient who doesn’t understand the language, is less likely to be satisfied about the healthcare provision.
Create waiting areas with a calm, relaxed, comfortable atmosphere. The logics are simple: if patients feel positive about the space in which they are waiting for treatment, then they are more likely to be positive about the experience as a whole.
Make sure your staff are positive about what they do. One way to do that is be designing work processes in the most efficient way possible to prevent unnecessary work stress. But also by giving insight into which behavior leads to positive patient experiences. How patients are treated by staff might have the biggest impact on one’s patient experience.
Involving patients in their own care
Try to choose the best care with the patient and divide the tasks. Show messages about developments in healthcare in your waiting room and offer patients the possibility to give feedback through a survey.
Measuring patient experience: PROMs and PREMs
Patient experience is one of the most important parameters to determine the quality of care. You could even say that the survival of healthcare organizations is increasingly dependent on the ability to ensure good patient experiences, which means good quality. The patient is the person to highlight the bottlenecks in your healthcare provision. But patient experiences are only useful if they are measured through valid and reliable measurement tools. That is why we have PROMs (Patient Related Outcome Measures) and PREMs (Patient Related Experience Measures). The PROM allows the patient to express how they assess their health in terms of for example pain, exhaustion and depression. A PREM measures how the patient experiences the full care process, such as a cooperation between healthcare providers, treatment by staff and efficiency of care. PREMs are particularly interesting for value based care, which can be seen as the way to make our fragmented, expensive healthcare system healthy again. The problem is that very little PREMs have been validated yet. Based on scientific research, Essenburgh has developed a PREM for integrated care and has had it internationally validated. This makes it a reliable instrument to gain insight into how patients experience the healthcare provision in your organization. The short survey connects to the patient’s perception and shows whether and where they experience fragmentation in the healthcare process. The strong and weak points of the care process become visible in one glance. And because it is possible to compare the scores at the level of a practice, neighborhood or (sub)population, it shows you best practices and concrete leads for improvement.
Figure 2: PROMs & PREMs
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