The definitive guide to improving patient satisfaction

Learn how patient satisfaction has evolved, and how you can start using patient satisfaction surveys as part of a wider effort to improve the end-to-end patient experience with our ultimate guide.

Many healthcare organizations will ask patients for feedback as part of their efforts to improve patient satisfaction. It’s an approach that has arisen largely as a result of the success in consumer industries of customer experience programs that look to drive loyalty and revenue by improving satisfaction.

But how valuable is patient satisfaction, really? In recent years, many leading healthcare organizations have begun to move away from ‘satisfaction’ as a KPI and instead are moving towards a more holistic patient experience program.

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Patient satisfaction vs patient experience

Put simply, patient satisfaction is a measure of a patient’s sentiment following a single interaction with a healthcare provider. This could be a physician’s visit, using a booking system online, or after they receive care in a hospital or clinic.

Patient experience on the other hand is defined by the Beryl Institute as ‘the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions along the continuum of care’.

It’s a difference between a single, point-in-time interaction, and a complete patient journey. Patient experience looks at a whole host of factors that impact the experience a patient has over time, versus patient satisfaction which looks at each interaction in isolation.

At Qualtrics, we’re firm believers that patient experience is a more complete and effective way to understand what patients need, and take action to improve both the service and care that they receive.

Is patient satisfaction still useful?

Patient satisfaction surveys are still useful — particularly in countries like the US where reimbursements are contingent on achieving high patient satisfaction scores — but should be seen as part of a wider patient experience program.

After all, there are many elements of the patient lifecycle that mimic consumer experiences, like researching and choosing a new healthcare provider, booking an appointment through an online portal, or getting in touch with the support team to resolve an issue.

Asking patients how satisfied they were with these interactions is an incredibly useful tool — by understanding their satisfaction, and knowing the key drivers behind their score is essential to being able to drive action to improve the experience.

But how do these interactions fit into the wider patient journey? Patients today will interact with healthcare across a whole host of channels from apps and websites to the more traditional clinics, hospitals, and contact centers.

Each one of those interactions has an impact on their perception of the care they receive and the experience as a whole is the cumulative effect of them all. So understanding the experience of each one is a good start, but you need to be able to bring them all together to know exactly which lever to pull to provide a better overall experience.

Similarly, there are some settings where ‘satisfaction’ is just not valuable. Like in a clinical setting for example, asking patients how satisfied they were with the care they received. In these settings, patients expect safe, convenient, and competent care — asking how satisfied they were will not provide any insight into those three critical expectations.

When to use patient satisfaction surveys

Within a wider patient experience program, you could have a number of ‘satisfaction surveys’ running across multiple channels. Rather than view patient satisfaction as a single, all-encompassing survey or program, think about it as multiple points of feedback along the patient journey, some of which may use ‘satisfaction’ as a metric.

These are typically more ‘consumer-like’ interactions, where a patient is looking to complete a specific goal (e.g. book an appointment online) and a satisfaction metric is a useful way to help drive improvement.

But remember, these should form part of a wider patient experience program, incorporating other patient feedback, metrics, and even employee experience measures.

Here are some of the more common places where you’ll find patient satisfaction metrics used: 

HCAHPS surveys

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is the first national, standardized, publicly reported survey of patients' perspectives of hospital care. It’s essentially a patient satisfaction survey, standardized to enable country-wide comparisons for reporting and also managing Medicare reimbursements.

The HCAHPS survey is designed to measure patient satisfaction within an inpatient hospital setting. The survey measures, and publicly reports, 8 domains of care:

• communication with doctors
• communication with nurses
• responsiveness of hospital staff
• communication about medicines
• discharge information
• cleanliness/quietness of the hospital environment
• transition of care
• overall rating

It includes questions such as:

• During this hospital stay, how often did nurses listen carefully to you?
• During this hospital stay, how often did doctors explain things in a way you could understand?
• Before giving you any new medicine, how often did hospital staff describe possible side effects in a way you could understand?

HCAHPS results are publicly reported to show quality comparisons to other hospitals locally, regionally, and nationally at medicare.gov/hospitalcompare

Traditionally, healthcare organizations have followed the standard HCAHPS approach when it comes to measuring and improving patient satisfaction.

However, many in the industry (and we’d certainly agree!) believe HCAHPS’ methodology needs to be updated. Although feedback is collected, understanding and taking action on that feedback to improve patient satisfaction continues to be a challenge for many healthcare organizations.

Website and app feedback

Digital is increasingly important across the patient journey, from evaluating providers based on their websites to interacting with services through a provider’s app, or accessing health advice and information long before someone even needs treatment.

And as with any digital service, satisfaction can be a useful metric to help drive repeat visits, loyalty, and when it comes to providers, improved acquisition too.

It starts with understanding the various patient journeys for your digital properties and mapping out the points at which to gather feedback.

As well as understanding how satisfied the patient was with the interaction, make sure your surveys ask about the key drivers — these are the factors that influence their satisfaction.

Take booking an appointment online for example. You might start by asking how satisfied they were with the overall experience, and have follow up questions that ask specifically about different points along that journey, for example:

• availability of appointments
• times/days available
• communication

By doing this, you’re able to not only track how you’re doing but identify what areas can be improved to have an impact on overall satisfaction. Similarly, for dissatisfied patients, offering an open text follow-up question gives them a chance to tell you in their own words what you can do to improve their experience.

Download our digital experience playbook

Customer care improvements

From call centers to online chat, and even social media support, most healthcare providers will have a ‘customer care’ function that serves not only to resolve patient problems but to provide proactive help and support.

These are great places to gather feedback and drive improvement. Whether that’s in the moment through follow-up questions after a chatbot interaction to email or IVR surveys sent to patients after a phone call, they can be a rich source of insights.

As well as an opportunity to understand and resolve individual issues, organizations can use the feedback to identify macro-level opportunities for improvement by identifying trends and patterns from a larger population and then feeding that data back into a wider patient experience program.

For example, a patient may phone to complain of an issue with a prescription which an agent can help resolve immediately. But if that is a common issue, your customer care leaders can spot it, and trigger actions at an organizational level to tackle the root cause.

The result is a better experience for the wider patient population, and reduced costs to your contact center by resolving an issue that was costing you considerable resources to resolve each time someone called to raise it.

Read more: The Ultimate Guide to Customer Care

Telehealth appointments

Patients are increasingly utilizing telehealth services, and providers routinely ask for feedback at the end of a session to understand the experience.

There’s a lot of reasons to gather feedback here, and many of them fall outside of patient satisfaction — for example, feedback on the clarity of information shared by the clinician, how well they explained your options, etc. — but like any digital service, you can use satisfaction to gather product insights.

For example, asking users at the end of an e-consult how satisfied they were with the technology and then digging into key drivers around the user experience, the quality of the stream, the log-in process, etc.

These interactions are key moments at which you might want to take a more ‘consumer’ lens to understand patient satisfaction and identifying actions you can take to improve it.

Read more: The Future of Telehealth: How to Deliver the Right Experience

How to improve patient satisfaction 

While the ultimate goal should always be to improve the overall patient experience, the actions you take as a result of your satisfaction surveys will likely play a key role.

Measuring satisfaction is just the starting point. In order to improve those individual reactions, you need to be able to take action on the feedback you receive.

That means having the systems in place not just to gather feedback from patients, but to analyze it at scale and identify the right next steps to take.

Similarly, setting up a closed-loop follow-up system is essential. This is commonplace in consumer industries and becoming increasingly popular in healthcare, too.

A closed-loop system is how you’re able to take action both at an individual and organizational, level. Say for example a patient gives a low CSAT score for your website’s appointment booking service and says they were unable to complete their scheduling. Their satisfaction survey will add to your pool of insights about how you can improve the service, but with the right technology in place, it could also trigger action for a team member to get in touch with the patient to follow up and help them complete their scheduling.

The satisfaction score in this example is the signal, the patient’s way of saying ‘hey I need some help here’, and by having the tools to act quickly to help them complete their journey, you can resolve a bad experience.

Essential tools to improve patient satisfaction

We’ve seen already that there are a few common elements across any satisfaction survey that you need to have in order to use it effectively:

• Real-time feedback at the moments that matter
• Analytics to be able to identify insights
• Tools to enable action at an individual and organizational level

A best-in-class survey platform will help you do much of that. But as we’ve seen, satisfaction is only a small part of the story when it comes to healthcare — you need to be able to understand the holistic experience across the entire patient lifecycle as well as all the factors that influence patient perceptions along the way.

That means you need to be able to pull all that feedback, from satisfaction surveys and other patient feedback, into a single platform to get an end-to-end view of the experience. And what’s more, you need to combine it with operational data to understand how those experiences impact the organization’s critical KPIs.

And finally, you need to bring it together with employee experience data — after all, the organization’s culture, and the engagement, quality, and commitment of its people have just as big an impact on a patient’s perceptions as anything.

That’s where a patient experience platform comes in. You can gather feedback from patients across multiple channels, whether it’s email surveys after an appointment, through your app or website, or through social media and online review sites.

What’s more, you can incorporate your HCAHPS surveys into the same platform, whether that’s a vendor uploading mail-in responses or using voice analytics to automatically incorporate your telephone surveys.

At Qualtrics, we’re an approved vendor for HCAHPS, so you can bring your HCAHPS surveys into the same platform that’s trusted by the world’s leading healthcare organizations to improve the patient and staff experience at every touchpoint.

It means you have everything on a single platform, and with powerful analytics, and automated actions you can drive improvements across the entire system to provide a better experience for patients at every touchpoint.