Experts point to the challenges: not only is there a lack of consensus in how to best measure patient satisfaction, but there are also different opinions as to what are the right steps providers should take to improve the patient experience

In today’s healthcare industry, “Patient Satisfaction” is high on the list of phrases likely to be heard in any medical facility, including in pathology groups and clinical laboratories. With recent and ongoing changes to the way that providers are paid, patient satisfaction as a measure of quality will only gain in importance.

But if there is consensus that it is important to monitor patient satisfaction and use that data to guide efforts to improve how patients view their care, there is certainly no consensus on the most effective ways to measure patient satisfaction. Nor is there much consensus on how providers, including medical laboratories, should use patient satisfaction data to improve the patient experience.

This challenge is addressed by Deirdre Mylod, PhD, who pointed out in a PatientEngagementHIT article, “The exercise is not to make consumers happy. The exercise is to reduce patient suffering.” Mylod is Executive Director of the Institute for Innovation, a nonprofit research collaborative that publishes relevant and practical findings concerning patient satisfaction that help healthcare organizations deliver better care.

Patients Rate Services in Many Ways

Multiple studies have shown that there is a wide variance in how patients rate services. For example, in a study published in Quality Management in Health Care (QMHC) titled “Patient Satisfaction: How Do Qualitative Comments Relate to Quantitative Scores on a Satisfaction Survey?,” researchers found that there are significant differences between the comments that patients make compared to the quantitative data obtained through surveys.

The most current trend is toward real-time monitoring of patient satisfaction. It’s an important trend because one of the chief complaints regarding patient satisfaction expressed by care providers is that they don’t know patients are unhappy until they have already left the facility.

Deirdre Mylod, PhD (above), Executive Director of the Institute for Innovation, says it’s wrong to think of patient experience as being separate from quality. “When we say patient experience, it’s not in addition to quality, it’s not if we have time after we’ve gotten care right,” she said in the PatientEngagementHIT article. “Patient experience is that safety and quality. It is what patients think of their care. It’s how efficient and effective care is.” (Photo copyright: Institute for Innovation.)

Marisha Burden, MD, Chief of Hospital Medicine at Denver Health Medical Center, in a Modern Healthcare article, said, “Too often, in medicine, we give very delayed feedback—and when you give only a monthly or quarterly report, it’s hard to change things quickly.”

Patient Feedback Impacts Hospital Ratings

Burden and several colleagues conducted a study published in the Journal of Hospital Medicine, titled, “Real-Time Patient Experience Surveys of Hospitalized Medical Patients.” In the study, the researchers used four questions from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to determine whether daily patient feedback would impact the percentile rankings used in the survey. The four questions they chose involved communication from:

• Doctors;

• Doctors listening carefully to patients;

• Courtesy and respect of doctors; and

• An overall hospital rating.

The HCAHPS survey is a national, standardized survey developed by the Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). The CMS uses the HCAHPS (pronounce “H-Caps”) survey to make payment adjustments. The survey includes a total of 32 questions.

The changes in the HCAHPS percentile rankings were notable. In their published article, the researchers reported that:

• Communication from doctors: 60th percentile versus 39th;

• Courtesy and respect of doctors: 88th percentile versus 23rd;

• Doctors listening carefully to patients: 95th percentile versus 57th; and

• Overall hospital rating: 87th percentile versus 6th.

They concluded that daily feedback seems to improve the patient experience.

Patient Satisfaction Data Could Affect Your Facility’s Reputation

There’s more at stake than payment adjustments from CMS. Hospitals, clinical laboratories, and other healthcare organizations grow and thrive based on their reputation, and with the public’s growing reliance on social media for healthcare shopping, reputation is more important than ever. For example, HCAHPS results and patient satisfaction star ratings are published on Medicare’s Hospital Compare website, as well as on other sites.

Many software companies offer products that enable hospitals and other healthcare organizations to collect real-time patient satisfaction data. For example:

• EveryPatient;

• Opinionmeter;

• Humm Systems; and

• RateMyHospital.

The wide variety of tools for collecting patient data can be both good and bad. On one hand, organizations are more likely to find tools to suit their specific needs. On the other, a lack of standardization can make measuring progress difficult.

A study published in Oman Medical Journal in 2014 titled, “Patient Satisfaction Survey as a Tool Towards Quality Improvement,” found that there is a lack of standardization. The researchers questioned the reliability and validity of survey instruments produced by disparate private companies. They concluded that patient feedback is a critical tool for improvement.

Most Doctors Like the Clinical Laboratories They Use

In addition to nationally, publicly developed survey instruments, such as HCAHPS, and those offered by private vendors, there is a third type of patient satisfaction surveys—those that are developed by organizations with a specific purpose in mind, such as determining physicians’ satisfaction with clinical laboratories.

A 2014 study published in the College of American Pathologist (CAP) Archives of Pathology and Laboratory Medicine, conducted by Shannon McCall, MD, Associate Professor, Department of Pathology, Duke University Medical Center; and Larry Massie, MD, of the University of New Mexico School of Medicine Department of Pathology, revealed that, by and large, most physicians are happy with the labs they use.

In fact, 95% of the physicians surveyed for the study said they would recommend the labs to others. “I think most laboratories are respected and that physicians are supportive of the laboratory, and I think that speaks highly of the laboratory community in general,” Massie said in a CAP Today article.

In hospital settings, it is clear who the customers are—it’s the patients. Things, however, become more complicated in medical laboratories because both patients and ordering physicians are the lab’s customers. Pathology lab personnel must consider both perspectives.

When it comes to customer satisfaction, pathology groups and medical laboratories would do well to follow the lead of hospitals in ensuring patients are happy with the services provided, and to use patient satisfaction as a tool for improvement. Payments, reputation, and future growth could depend on it.

—Dava Stewart

Related Information:

Why Patient Satisfaction is More than “Making Patients Happy” 

Patient Satisfaction: How Do Qualitative Comments Relate to Quantitative Scores on a Satisfaction Survey?

Real-time Monitoring Key to Boosting Patient Satisfaction

Real-time Patient Experience Surveys of Hospitalized Medical Patients

Patient Satisfaction Survey as a Tool Towards Quality Improvement

Physician Satisfaction with Clinical Laboratory Services: A College of American Pathologists Q-Probes Study of 81 Institutions 

How Satisfied Are Physicians with Labs? Study Digs Deep