Patient Experience: The Metric You Can't Ignore

It feels like the era of patient experience has arrived. Never before has this complex intangible been so widely discussed and scrutinized. We all know the rules about a welcoming waiting room and a helpful and polite receptionist. But what about the trickier aspects of managing your patient’s experience with your office from the first phone call to the post-exam follow up?

We know that patients are increasingly likely to be outspoken about negative experiences they’ve had versus positive ones, especially on social media networks like Facebook, Twitter, and other online forums. And with a strong emphasis on patient experience elements contained in the Medicare Accountable Care Organization program, Meaningful Use Stage 2, NCQA Patient-Centered Medical Home criteria, and other private accountable care delivery models, the scrutiny is quickly becoming more intense. Physician practices have an opportunity to make a good impression so that patients don’t have to exercise their right of choice.

What Is Patient Experience?

The term “Patient Experience” is defined by the Beryl Institute as “The sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.” Over the years I’ve heard many stories that can be woven together to conceptualize the potential impact of the patient experience nicely:

A patient was treated by his primary care physician for an injury incurred while jogging. The PCP referred the patient to a specialist for a consult. The patient attempted to make an appointment but was told the wait time was four months — certainly not helpful given his current level of pain. The patient called the PCP for another recommendation and was successful in booking the appointment. The patient let the primary care office know the date and time of the appointment.

The patient arrived for his appointment at the specialist office and was greeted by an unfriendly receptionist who gave him a hassle about not having his information forwarded over in advance of his appointment. Apparently they had not received any information about why the patient was referred and a referral had also not been processed. The patient called the primary care office asking for the proper information to be sent over immediately. Once he was with the specialist in the exam room, he mentioned another compounding injury. The specialist told him he could only evaluate him for the one condition and that he would have to schedule another appointment for the second condition as he was extremely busy and didn’t have time. The patient noted that he really liked his PCP but was very unhappy with the lack of coordination. Unfortunately this was not the first time information was not handed off to a consulting physician.

The patient also noted that he was unhappy that the specialist didn’t have time for him given that he felt the two issues were related. The patient felt that he was not cared for in an appropriate manner and had hoped that his PCP would have referred him to someone who had time to treat him and also consider all of his concerns. He had taken time off from work and would now have to take more time off for the remainder of his concerns to be addressed. This patient had enough and ultimately decided to change primary care physicians and follow up with a different specialist.

Impact of an Unhappy Patient

In this fictional story, the patient’s experience resulted in a loss of business to both the primary care physician and the specialist. If surveyed, the patient certainly would have scored the experience in a less than favorable way. In a situation where metrics, pay-for-performance, or other payment incentives come into play, experiences like these would certainly impact the metrics and any associated incentive dollars. Regardless of incentive plans, this patient changed practices ultimately resulting in a potential loss of revenue to the practice. Additionally, this patient clearly was willing to talk about his experience and that alone is enough to influence other patients in their decision to seek care with either of these practices.

What types of things can a practice do immediately to improve patient experience?

1. Listen to your patients. Encourage your staff to listen to the patients, they are your greatest source of information as to their experience and perspective of how well the system works and ease of transition across the care continuum.

2. Look out for access issues. Keep your ear to the ground and know what the wait time for appointments is with the physicians you refer to. Someone may be going on vacation and thus have a longer wait time for an appointment. That information is helpful to know.

3. Proactively facilitate hand-offs. Encourage your staff to be proactive in facilitating handoffs. Make sure that the proper information is shared and the necessary steps are taken to ensure easy transition of the patient across the care continuum.

4. Reflect internally. Take a moment to consider the patient experience within your office, talk with your staff and work together to address process impediments and come up with a plan to provide the best possible patient experience locally.

The patient experience is clearly becoming a necessary focus in the business of medicine; however, it lends itself well to what physicians and their staff do best, providing great care for patients in an efficient manner.

Contact the Physician Practice Resource Center at pprc@mms.org or (781) 434-7702 for more information on how to improve patient experience in your practice.

—Kerry Ann Hayon
PPRC Manager
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