What is “the patient experience?”

In hospitals, many of us are prone to a disorder known as “bright shiny object syndrome.”  We doggedly chase the latest management system or improvement methodology in hopes of finally finding the magic bullet that will make managing a breeze and dramatically improve patient care — ideally while reducing costs.

Sadly, that magic bullet doesn’t exist. A decade ago, Peter Drucker identified healthcare as the most difficult, chaotic and complex industry to manage and suggested that the hospital is altogether the most complex human organization ever devised.  And in the 10 years since he penned those words, things have only become more complicated.

The “latest bright shiny object” that is growing in popularity is the notion of patient experience.  Patient experience has quickly become the buzziest of all buzzwords in healthcare.  If we just focus on the patient experience, all else will fall into place.

I believe this growing focus on patient experience is a very positive one.  Putting the patient at the centre of the story and trying to look at what we do to patients from their perspective can only result in positive change.  There’s a growing body of literature that links positive patient experience to better clinical outcomes, so our focus is truly a worthwhile one.

Troubling though is the definition that some seem to be applying to patient experience.  A literature search reveals that there is no common definition of the “patient experience” – in some usages, it refers to the quality of care; in others it refers to access, while others have decided that patient satisfaction surveys measure patient experience and they are one and the same.

This definitional confusion repeats the sins of the past in that once again, we have failed to look at it from the patient’s perspective.  Instead of deciding what the patient experience consists of and what’s important, we should invest some time in asking our patients what’s important to them.

At The Scarborough Hospital, we took some time to do exactly that through a series of focus groups and survey tools.  We gathered information from over 2,800 of our patients about what the ideal patient experience might consist of and what we could do to improve.

Our key findings from this work were as follows:

  1. Patients would like all staff members to provide service that is friendly, courteous and respectful.
  2. How long patients wait for services is a critical issue that impacts the quality of the patient experience.
  3. Involving patients in the care plan is a key element, although the involvement they are seeking is generally at the inform level – they want to know what their options are, what the various steps are in the process and how long they are likely to wait.
  4. The right technology is considered an important element of the care experience.
  5. Patients trust us to provide quality care.

Perhaps none of these key findings are terribly surprising; however, because our work was initially dialogue- based, we learned other things that may be more surprising.  We learned, for example, that for some patients, having gowns that are more modest is a critical issue.  The current gowns, they felt, were deeply humiliating.  Others were challenged by the food we serve – it was unfamiliar to them, and families were struggling to bring in something else, something more familiar, for friends and relatives to ensure that they ate.  These are not issues that are important to every single patient, but for those who raised them, they were critical.

What critical elements are your patients ready to tell you about?

The National Health Service Institute for Innovation and Improvement in the UK illustrates a positive patient experience as the intersect between safety, quality of care and experience.  I like this construct because it shows that patient experience is not the same as safety and quality, but they are definitely related.  All the great “experience” in the world can’t make up for a lack of quality and safety.

The definition of patient experience I like to use is the one from the Beryl Institute.  Patient experience there is defined as “the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.”

We need to look at all the interactions, not just the clinical ones, and look at them through the patient’s eyes.  What is important to them and what can we improve? I have yet to solve the universally hated parking rate issue (and deserve a Nobel Prize if I figure that one out), but we’re working on some of our other issues.  What solvable issues are preventing your patients from having a positive experience?  Solving them may not be the magic bullet, but it might be an important part of the overall puzzle.