Measuring to Improve or to Impress?
By Jerry Stone

Is your organization measuring patient satisfaction to improve, or, to impress? In Fred Lee’s book, “If Disney Ran Your Hospital, 9 ½ Things You Would Do Differently”, Fred mentions the need for healthcare organizations to measure to improve, not to impress. The irony is, the best way to ensure that your patients are favorably impressed, is to measure with the intent to improve, NOT to impress. Measuring patient satisfaction for any other reason other than to improve often backfires, resulting in patient dissatisfaction.

If you’re like me, you’re probably not impressed when organizations promote themselves saying things such as, “more than 98% of our customers were satisfied with our service”. After a quick deduction – “so that means 2% of your customers are unhappy and dissatisfied, and that’s ‘OK’”? Also consider, of the 98% that said they were “satisfied”, how many of those customers/patients were actually, marginally “satisfied”.

Just last week I had an opportunity to learn more about one particular patient’s recent visit to see their healthcare provider. This particular patient took the time to fill out the patient satisfaction survey, and, on the surface, it looked pretty good -- here are the actual results.

On a 5-point scale, with 5 being the best rating, of the 13 questions answered, the patient gave a 4 rating to eight questions, one question actually received the highest rating, a 5, and four questions received an average “3” rating. There were no unfavorable 2 ratings, and no very unfavorable 1 rating. Furthermore, often considered to be the most important question in terms of overall satisfaction, -- “Would you recommend us to friends and family” -- this patient gave the organization a 4 rating, the next to the best score. With an average score of 3.8 out of a possible perfect score of 5.0, this patient will most likely be viewed as being “satisfied” or perhaps as even being, “very satisfied”.

The patient’s real perception of their experience that day, in addition to their numerical scores, was summed up in a comment, which stated in part, “I will never come back here again”. Wait a minute; what could have possibly went wrong? The lowest score was a 3, and there were only four 3’s, eight questions were 4’s, and there was actually a 5! Yet the patient says they will never come back here again? One might conclude, “Obviously this patient does not know how to take a survey”! Unfortunately, that is not reality.

The reality is, averages and percentages often mask what’s really happening. Too many of us well-intended managers/administrators have been lulled into a false sense-of-security, thinking, “we’re doing OK, 98% of our patients are satisfied”. And if you’re normal, the next thing we do is ask, “how do we compare to other organizations like us, I’m sure we’re at least as good as they are, if not better…?” These kinds of questions are often symptoms of organizations that have, with very good intentions, been measuring to impress, instead of measuring to improve. More times than not, these organizations want to measure to improve, but have inherited the methods and systems passed on to them that do not allow them to measure to improve.

Measuring to improve, which by the way, will result in those favorable impressions we’re all striving for, requires a change in the way most organizations collect, analyze, communicate and otherwise, use patient feedback. Here are some of the critical success factors, and MedicalGPS’ 10-steps to; Measuring to Improve:

• Develop actionable questions
• Collect, analyze and review patient feedback near real-time
• Before aggregating patient feedback, review each patient’s response (“can’t be done” you say, let MedicalGPS help maximize the use of technology).
• Stratify patient feedback into Exceptional and Unacceptable categories
• Proactively review Exceptional and Unacceptable responses with responsible support staff as soon as possible following the patient’s experience (within several hours or a few days, not several weeks or months).
• Follow-up with patients’ requiring/requesting follow-up as soon as possible (the longer the patient waits for a response, the greater the likelihood that patient will not remain loyal).

When your organization receives repeated undesirable responses-

• Review policy and procedures
• Reaffirm policy and procedures are appropriate, or modify as needed
• Couch and Counsel support staff as needed.
• Benchmarking – focus on internal benchmarks and improvement trends. Discontinue, or minimally, limit external comparisons. External comparisons usually lead right back to, “we’re doing OK compared to…” which takes the focus off of measuring to improve.

If your organization desires to measure to improve, letting the improvements impress, we’d like to show you M3-Patient Experience™, MedicalGPS’ real-time patient feedback solution. Contact us for an on-line virtual demonstration.