Using patient experience surveys to understand patient satisfaction trends

In July 2023, the Beryl Institute, a global community of healthcare professionals and experience champions committed to transforming the human experience in healthcare, released the 13th edition of the PX Pulse Survey. The report, which uses patient experience surveys to explore healthcare consumer perspectives in the United States, found that only 41% of consumers believe that healthcare in America is “good” or “very good.”

The report also highlights an important trend: patients’ perception of healthcare quality ratings have been dropping since 2022 and are now 5% lower than December of last year. Patients’ perception of the overall care experience also dropped 4% since March, returning to the lowest rating received since the Beryl Institute started tracking. 

So what’s behind this trend and — more importantly — how do we turn it around?

In 2008, the University of Utah Healthcare System (U of U Health) consistently received low rankings and negative feedback from patients about the care they received. Citing everything from lack of professionalism and poor communication to long wait times for scheduling appointments and lack of care coordination, patients made it clear that U of U Health wasn’t meeting their needs — or their expectations.

In response, U of U Health leadership launched a major initiative to completely revitalize the system’s organizational culture and improve the patient experience. The 7-year process was underpinned by a single driving idea: medical care can only be great if the patient thinks it is.

While some healthcare professionals might quibble with the idea of evaluating the quality of care based on such a subjective metric (we’ve all had patients who, no matter what we do, are never satisfied), it’s important to note that patient satisfaction and patient experience are not the same thing.

Assessing the patient experience evaluates whether a particular component of healthcare, such as clear communication with a provider, actually happened or how often it happened. Evaluating patient satisfaction investigates whether a patient’s expectations about a health encounter were met. Two people can receive identical care, but rate it differently because of their differing expectations.

Today, the U of U Health is consistently ranked in the top 10 in the nation for quality healthcare and is known as a leader in providing compassionate, coordinated, and expert care for its patients. 

The secret to U of U Health’s success? 

Patient experience surveys. 

A patient experience survey gathers feedback and insights directly from patients about their experiences, preferences, and level of satisfaction along every touchpoint of their healthcare journey. These surveys, which can take many forms, give healthcare teams valuable insight into which parts of the process are going well and which parts need improvement. When used correctly, a patient experience survey can help you optimize operations for your independent medical practice. 

Patient experience surveys offer private healthcare practices many benefits, including:

Asking your patients direct questions about their experiences at your practice provides very specific feedback about every aspect of your healthcare delivery model. This information enables you to address patient concerns swiftly and adequately to prevent patient attrition or negative online reviews. 

Patient experience surveys are crucial for identifying areas where your practice needs to further evaluate and rethink how you deliver services. Well-designed patient experience surveys pinpoint specific aspects of care delivery that may need attention at your practice, such as:

This type of meaningful feedback allows your team to focus on specific areas that need attention, saving time and resources. 

Surveys promote patient-centered care and tailor healthcare delivery to individual patient preferences and needs. Gathering patient feedback helps healthcare providers and organizations better understand and respond to the unique requirements and expectations of their patients.

How often have you ended a conversation with a patient thinking that you both were on the same page about the plan of care and next steps, only to find out later that wasn’t the case at all? Patient experience surveys can be a great way to evaluate the effectiveness of communication between your patients and your team. This information can pinpoint exactly where communication breaks down and improve the clarity and effectiveness of communication channels.

Want to engage your patients more in their own healthcare? Asking them to complete a patient experience survey is a great way to involve them in their own care processes and empower them to advocate for their own needs and expectations. When patients believe their opinions and experiences matter, they often become more actively involved in managing their health.

Some patient experience surveys include questions designed to provide insights into the impact of healthcare interventions on patients' lives. These types of surveys help healthcare professionals assess changes in a patient's quality of life, symptom management, or adherence to treatment plans and contribute to more proactive and holistic care. 

Many healthcare organizations use patient survey data to benchmark their performance against national or industry standards. This allows them to see how they compare to peers and identify areas where they may excel or lag behind

While healthcare providers in private practice may not use patient experience surveys for this purpose, many healthcare accreditation bodies and regulatory agencies require hospitals and healthcare systems to collect and report patient feedback as part of their compliance processes. Meeting these requirements is essential for maintaining accreditation.

Designing an effective patient experience survey involves several steps to gather, analyze, and act upon the feedback collected. Follow these 8 steps to create and execute the perfect patient experience survey at your practice. You can also refer to this patient experience survey template for further ideas.

Clearly define the objectives of your survey. What specific aspects of the patient experience or practice operations are you trying to assess or improve? Perhaps your goal is to: 

Having clear goals will help you design relevant survey questions and interpret the results effectively.

Determine how you will keep patient survey responses confidential and anonymous. Patients should feel comfortable providing honest feedback without fear of repercussions. Communicate clearly with your patients about how you will use and protect their data in accordance with applicable privacy regulations.

Keep the survey concise and focused. Patients are more likely to participate if doing so doesn't take too much of their time. Ensure that the survey is user friendly, with a logical flow and easy-to-understand language. 

Best practice indicates using a mix of closed-ended (multiple-choice) and open-ended (text-based) questions to gather both quantitative and qualitative data. And it’s always a good idea to pilot test the survey with a small group of patients to identify any issues with wording, question clarity, or response options.

Ultimately, a survey must be reliable, with reproducible results, it should be be valid, measuring what it's supposed to, and it should take 10 minutes or less to complete. 

Consider using standardized and validated patient satisfaction survey tools, such as the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, to ensure reliability and comparability of results.

Determine the best method for distributing the survey, such as paper surveys, phone calls, email, or online forms. Consider using a secure patient portal if available. Establish a schedule for survey distribution that aligns with patient interactions, such as after appointments or at the end of care episodes. Ensure that patients have multiple opportunities to provide feedback, such as after appointments, through follow-up emails, automated phone calls, or through a secure portal. 

Maintaining confidentiality and anonymity of respondents is key to encouraging honest feedback, so it is important to use survey software or data analysis tools to compile and analyze the data. Consider using data visualization techniques like graphs and charts to make the results more accessible.

 Examine survey results to identify trends, patterns, and areas where improvements are needed. Pay attention to both quantitative data (numerical ratings) and qualitative data (comments and suggestions) to create a complete picture of your patients’ experiences.

To benchmark your results, compare your practice's survey results to industry standards or similar healthcare practices to gain insights into your performance relative to peers.

Once you’ve analyzed your data, use it to develop a detailed action plan. Prioritize areas for improvement and establish clear goals and strategies for making changes. Engage your staff and other providers in the improvement process and assign clear roles and responsibilities. Identify key performance indicators (KPIs) for improvements that are measurable and sustainable.

Establish a feedback loop with patients by informing them of improvements made based on their feedback. This reinforces the idea that their input is valued and leads to tangible improvements.

Transparency about the steps your practice is taking to address patient concerns demonstrates a commitment to patient-centered care and can help build patient trust. 

Remember: improving patient satisfaction is an ongoing process and it doesn’t happen in a vacuum. It’s important to regularly review and refine your survey instrument and improvement strategies based on your patients’ changing needs and expectations.

Continuously monitor the impact of your initiative by collecting ongoing feedback through follow-up surveys or other feedback mechanisms. KPIs play an essential role in measuring progress and tracking improvements in patient satisfaction over time.

Acknowledging and celebrating achievements and improvements in patient satisfaction along the way can help motivate your staff and reinforce a culture of patient-centered care. 

U of U Health identified 5 key patient experience domains:

These domains provide a starting point for developing your own patient experience survey. As you do so, customize and expand upon the following sample questions to create a comprehensive patient survey that addresses your unique needs and priorities. 

1. Overall satisfaction

On a scale of 1 to 10, with 1 being very dissatisfied and 10 being very satisfied, how would you rate your overall experience with our practice?

2. Appointment scheduling

How easy was it to schedule an appointment with our practice?

3. Wait time

How long did you wait before being seen by the healthcare provider at your last appointment?

4. Communication

Did your healthcare provider listen to your concerns and answer your questions during your last visit?

5. Information sharing

Did you receive clear information about your condition, treatment options, and next steps?

6. Staff courtesy

How would you rate the courtesy and professionalism of our staff, including receptionists, nurses, and support personnel?

7. Cleanliness and comfort

How would you rate the cleanliness and comfort of our facilities, including waiting areas and examination rooms?

8. Appointment availability

Are you able to secure appointments with your preferred healthcare provider when needed?

9. How likely are you to recommend our practice to friends or family members?

10. Suggestions for improvement

Do you have any specific suggestions about our services or your experience with our practice?

It’s important to note that patient experience surveys might not benefit all independent practices. For instance, low-volume clinics may not receive a sufficient number of responses for the answers to be statistically significant. Additionally, there can be significant response/recall biases, among other biases. Finally, it’s imperative that exceptional, evidence-based care should not be jeopardized in an effort to receive higher patient satisfaction scores. 

Patient experience surveys can’t fix everything that’s wrong with the healthcare system. But they can go a long way toward centering patients in care delivery and ensuring that your team is doing everything it can to provide exceptional service to everyone who comes through your doors.