Patient experience is the individual’s perception of how a healthcare institution treats them on their journey through illness or injury. Research shows that patient-centered care not only improves the quality of healthcare services, but also the patient’s well-being and health outcomes, and this has resulted in an increased focus on patient experience. Despite its established importance, accurate measurement of patient experience remains a challenge. Applying their experience and knowledge of the hospitality industry, Dr. Maksim Godovykh and Dr. Abraham Pizam at UCF Rosen College of Hospitality Management are developing a broader and more scientific approach to measuring patient experience.
Patient experience is an important component of healthcare, and an increased focus on patient experience is part of a move towards patient-centered care. In essence, the patient experience describes what receiving healthcare feels like for the patient, as well as the patient’s family or carers. It is the complex combination of factors that can include the individual’s interactions and communication with their healthcare providers, but also the non-clinical staff’s responsiveness and politeness, the quality of evening meals, the cleanliness and environment of waiting areas and patient rooms, and any other services available within the healthcare institution.
In recent decades, patient experience has been recognized as an indicator of high-quality care alongside the provision of clinical excellence and patient safety. This has made it a key element in modern healthcare performance, with healthcare providers aiming to raise the standard of care by providing a more holistic patient experience. To achieve this, it is important to evaluate and measure patient experience using a number of metrics.
WHY PATIENT EXPERIENCE MATTERS
A positive patient experience increases the levels of patient and family satisfaction, improves the perceived quality of healthcare services, and therefore creates a relationship of trust and loyalty between the healthcare institution and the patient. However, in addition to improving the environment and increasing the status and prestige of healthcare institutions, a great patient experience has more importantly been shown to improve patient safety, patient well-being, and treatment outcomes. Several recent studies support this by demonstrating that hotel-inspired facilities and services increase the patient’s perceived feeling of well-being. Additionally, compassionate care, empathetic interactions, and even acts of hospitality have been shown to have positive effects on patient well-being and treatment outcomes. Improved health outcomes will eventually also lead to shorter hospital stays and reduced readmissions.
This connection can often be explained directly, such as in the case of the facility cleanliness ensuring fewer hospital infections, but it could also be supported by the fact that a less anxious patient is potentially more receptive to certain aspects of healthcare. Patient experience also affects the connection between patients and staff. Clinical and non-clinical staff that can offer their patients a positive experience have a higher morale and job satisfaction. Consequently, this helps them to provide better services which, in turn, further improves patients’ satisfaction. Positive patient experience can also make patients feel more empowered and help them play a more active role in their own healthcare.
A HOSPITALITY-INSPIRED PHILOSOPHY
This paradigm shift towards patient-centered care has resulted in a shift towards improving patient experience—making changes that reduce waiting times, improve communication with healthcare staff, and offer options of digitalized services. Recent studies show that patient experience within the healthcare sector can be significantly improved by applying principles and practices borrowed from the hospitality industry. These practices—which have been successfully used to deliver high-quality guest experiences in the hospitality industry for decades—offer a valuable bridge between healthcare and hospitality. This hospitality-inspired philosophy has led to changes in healthcare institutions, including those inspired by the customer-relationships model, such as improved booking interactions, increased courtesy of staff, and the addition of flexible services and luxurious experience options to the hospital stay. Important changes also inspired by hospitality include improving the workplace climate and upgrading the architectural and esthetic design of the facilities.
To ensure that patient experience is fully understood and open to improvement, it must be accurately evaluated and measured. Dr. Maksim Godovykh and Dr. Abraham Pizam at UCF’s Rosen College of Hospitality Management have reviewed the potential approaches to measuring patient experience in healthcare and call for bridging between hospitality and healthcare. Their aim was to investigate whether a more comprehensive approach to measuring patient experience could yield a more accurate assessment.
EVALUATING THE PATIENT EXPERIENCE
Despite the recent positive changes in healthcare, traditional methods for measuring patient experience are considered subjective and inaccurate. Common approaches for understanding the patient’s perspective and evaluating patient experience include patient-reported experience measures such as patient satisfaction questionnaires, online surveys, reviews and ratings on social media, in-depth interviews, and direct communication with patients and their families. However, patient-reported experience measures have limitations, primarily because they rely on factors such as social desirability, prior knowledge, the patient’s mood at the time of responding to questions, and subjective interpretations of the patient’s health status. These measures may also reflect the satisfaction of the patient’s immediate needs rather than the actual outcomes.
Patient experience is subjective and dynamic, which means it can change over time and is affected by a number of factors. That is why Godovykh and Pizam believe that the only way to accurately assess it is to employ a combination of patients’ self-reported evaluations and several specialised metrics. These metrics include the longitudinal experience sampling method, a test that allows for a long-term assessment of the healthcare experience by asking patients to answer questions and share their views at scattered time points after their engagement with the healthcare institution starts. In addition, psycho-physiological techniques can also achieve a broader understanding of patient experience. These are scientific tests that help study the interactions between mental or emotional reactions and the body’s functions, such as heart and nerve function. More specifically, they might include measuring galvanic skin response, heart rate and its variability, blood pressure, muscle activity, and changes in the size of the eye pupil, yielding further information on the intensity of positive and negative patient experiences. Additionally, analyzing brain activity with functional MRI (fMRI) scans can also be effective in capturing patients’ emotions and experiences. All of these methods can be used in a complementary fashion to capture different aspects of the patient experience and help overcome any biases related to self-reported approaches.
Other useful tools for measuring the deeper patient experience include qualitative approaches such as ethnography—the study of patients’ experiences within a specific cultural setting, and the guided tour approach—an interactive method of learning about the patient’s experience during which they have to lead researchers through the hospital environment and describe how they are feeling while doing so.
The latest advances in information and communication technology, such as language processing and machine learning tools, open up the way for creating new tools for measuring patient experience. These tools are used to analyze patients’ comments and reviews on social media and other online interfaces during the different phases of their engagement with the healthcare institution, providing more objective information on their experience.
A MULTIDIMENSIONAL APPROACH
According to Godovykh and Pizam, a combination of patient-reported measures as well as the more subjective outcome metrics offer a broader understanding of patient experience in the healthcare sector. This strategy leaves less room for inaccuracies and biases, since it assesses the complex interactions between the patient and the institution on multiple levels.
The reliability of such strategies can be further evaluated in future studies that will incorporate patient surveys, interviews, experiments, and online analytics to help study the patient’s interactions with the healthcare institution on multiple levels, as well as in different settings defined by factors such as the patient’s age, gender, personality traits, and cultural background. In the future, healthcare providers could implement these strategies to more accurately measure patient experience and make any changes required to improve the facilities, quality of care and, importantly, treatment outcomes.
