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The Problem[s] With Patient Satisfaction Surveys

Measuring patient satisfaction and quality of care has become a much talked about topic lately. Due to changes in federal law, Medicare reimbursements paid to hospitals are now tied to patient satisfaction scores. These new laws give hospitals even more incentive to improve patient satisfaction and experience – which, in theory, is a good thing. Doctors (and hospitals) should be subject to feedback and held accountable for their work. There are, however, problems with patient satisfaction surveys.

Dr. Christopher Johnson writes in a recent article that patient satisfaction surveys – as currently used – are “riddled with problems.” Dr. Johnson goes on to say, “they [surveys] don’t measure what they are suppose to measure and they can easily drive physician behavior the wrong way.” Dr. Johnson refers to his survey tools as made and facilitated by Press Ganey. Press Ganey is a massive corporation that provides hospitals and health systems full service patient experience solutions, in which Press Ganey writes, distributes, and collects the surveys and data. As such, hospitals using Press Ganey’s services essentially outsource all of their patient satisfaction and survey measurement. Dr. Johnson writes, “I’ve read the Press Ganey forms and the questions they ask are all very reasonable.” This quote raises a red flag that perhaps Dr. Johnson misses: Dr. Johnson is not, nor is anyone at his organization, writing the questions on their patient satisfaction surveys. It makes the most sense for those who are trying to benefit from collecting their own patients’ data to write their own surveys. Those closest to the patients and those working in the hospital are better suited to understand the different context and circumstances surrounding the measurement of patient satisfaction. Instead of a Press Ganey employee 800 miles away writing survey questions and processing the data; the doctors, nurses, and administrators should be more involved in the process of measuring quality of care. There is no such thing as a one-size-fits-all survey.

Dr. Johnson also speaks of the poor sample sizes used to collect the data; “[a]lthough the forms are sent out to a random sample of patients, a very non-random distribution of them are returned. Perhaps only the patients who are happy, or those who are unhappy, send them back.” This very well could be true, but it is most likely an easy fix. Again, each hospital knows (or should know) the best way to collect data from their patients. Generally, for most hospitals, the best way is with in-person paper surveys. Surveying the patient while still on site raises response rates and ensures that the sample size is more random than the one Dr. Johnson describes. Along with higher response rates, a patient’s memory of her experience is fresher when surveyed on-site and therefore the data is more accurate.

Dr. Johnson is correct in saying that patient satisfaction surveys “as currently used are riddled with problems,” but there are solutions to these problems. Understanding the quality of care provided by a doctor or a hospital or a nurse is too important to ignore or be discouraged by those obstacles. The healthcare world has been talking about measuring patient satisfaction for decades yet still have a long way to go. Getting rid of patient satisfaction surveys is not the solution. Acknowledging constructive criticism about the process and fostering open debate about improving patient satisfaction is the solution.

Is Patient Satisfaction Overrated?

A recent article on Forbes.com asked an interesting question: is patient satisfaction overrated? The question is an important one and warrants more discussion. The article (found here) uses Dr. House, the rude but extremely effective fictional doctor from the Fox television series “House,” to analogize that perhaps patient satisfaction doesn’t always equal quality health care. The author – Steven Salzberg – attempts to make the point that while Dr. House is abrasive and his patients do not have the best experience, they do receive the best care. Salzberg writes that even though large scale reforms in healthcare are pushing the importance of patient satisfaction, better patient satisfaction scores are not necessarily correlated with better care. Essentially, instead of giving patients what they want, doctors should give them what they need. Salzberg doesn’t just use the “House” analogy; he cites a study that shows higher patient satisfaction rates being tied to higher costs and higher death rates.

AutoData agrees with some of the author’s points and disagrees with others. AutoData couldn’t agree more with the premise that doctors must give their patients what they need as opposed to simply what they want. And we are not disputing the study Salzberg cites (though we’re unsure of the context and specifics of the study). However, Salzberg asserts that measuring patient satisfaction in general is the overall problem; AutoData believes the problem is in how patient satisfaction is measured.

“For patients who think a nice doctor is a good doctor, this might come as very disappointing news,” writes Salzberg. If surveys are asking patients questions like, “Was your doctor nice?” or “Did they communicate well with you?” or “Did you have a nice time?”, of course these metrics are hollow and should not be correlated with better care. But that doesn’t mean patient satisfaction doesn’t work, it means the provider of care must change how and what to measure. In other words, identify the data that will lead to better care and measure for that. Collecting data which shows that the care administered was superior will not always be the same as the data that shows the patient had a good time (AutoData discusses this in a post about the differences between patient experience and patient satisfaction here).

Salzberg also touched on the infamous standardized hospital survey, HCAHPS. He writes that Dr. House would fail this survey with flying colors, which is probably true. A one-size-fits-all, nationally standardized survey doesn’t make sense to us either. Hospitals and health clinics operate under different circumstances and contexts serving different demographics; measuring them against each other under one standardized survey is asinine. Hospitals have different objectives, goals, and ideas about delivering quality care, so why limit the ways they measure satisfaction and experience? Let the hospitals be in charge of the data they collect, ultimately it will lead to their success or their demise. The most encouraging trend AutoData has seen over the last 4 years is the consumeraztion of health care (AutoData wrote about it here). Due to advances in technology and the internet, healthcare consumers have been given a more powerful voice and as a consequence will continue to have more choices in care providers, ultimately forcing health systems to provide higher quality care. Therefore, it’s arguably more important than ever for health systems to measure patient satisfaction and experience. If the health system effectively listens to their patients through patient experience measurements, they can improve their service, advertise their superior service, and ultimately grow.

Salzberg’s article narrowly misses the point. It isn’t that patient satisfaction is overrated or unnecessary, but health systems must adapt to measure and collect the right kind of data. The right kind of data is data that will improve their care, not data that assesses whether a doctor is nice. When the right kind of data is measured and collected they can use it to persuade potential consumers to choose them as their provider of care. In that case, measuring the right kind of patient satisfaction is grossly underrated.

Is there a difference between patient satisfaction and patient experience?

If so, how should both be measured?

“Patient experience and satisfaction is the No. 1 priority for healthcare executives, according to the HealthLeaders Media Industry Survey 2013—above clinical quality, cost reduction, and many other burning issues.”

In the constantly evolving healthcare landscape, one thing is clear: delivering quality care is paramount. As the above quote suggests, patient experience and patient satisfaction are coveted key indicators of delivering quality care. The quote – from an article in HealthLeaders magazine, found here – goes on to explain why patient satisfaction and experience is the number one priority for healthcare execs:

“With the emergence and acceleration of both Medicare-approved and commercial accountable care organizations, there is a new sense of urgency for some health systems to improve their patient experience, particularly because it is one of 33 benchmarks Medicare-approved ACOs have to meet in order to qualify for the incentive payment.”

The quotes provoke a few interesting thoughts. The obvious one is that patient satisfaction and experience have never been more important. Yet, another thought begs the question: is there a difference between patient satisfaction and patient experience? Although closely related, there are certainly a few nuances differentiating the two.

Hospitals have the well-known HCAHPS – a core set of pre-determined survey questions – that they rely on to measure patient satisfaction. HCAHPS has proved successful at measuring patient satisfaction but it doesn’t necessarily get to the heart of patient experience. “Patient satisfaction and experience are closely tied together, but they are not the same,” says Press Ganey CEO, Patrick Ryan. Ryan goes on to explain:

“‘It [patient experience] is much more than just patient satisfaction,’ he says. ‘The confusion that some folks come into the industry with is that patient satisfaction is about keeping people happy, but it couldn’t be further from that because when people enter the health system, they’re coming in at one of the most complex and stressful times in their life. And what they want most from the experience is communication and understanding of what their condition is, the path to the best possible health they can achieve, and a way in which to coordinate that with their clinicians and staff to ensure that they get there.”

While HCAHPS’s standardized questions work for measuring patient satisfaction, measuring patient experience doesn’t work with one uniform set of questions. It requires multiple surveys with a variety of questions attempting to measure a variety of different topics and experiences – something that HCAHPS doesn’t do. The best way to find out if a patient is experiencing good communication from nurses and doctors or whether the patient fully understands her condition is not with a standardized 32 question survey. Those types of experiences are best measured with specific, detailed questions in the context of each situation.  “Real change begins to happen when physicians, nurses, and staff hear the voice of the customer, the voice of the patient,” Kevin Gwin – VP of communications for Ardent Health Services – is quoted saying in the article, “and you’ll have incremental improvement that turns into transformational change.”

In order for a hospital to take incremental improvement and turn it into transformational change, they must understand the difference between patient satisfaction and patient experience. Perhaps more importantly, they must understand the difference in measuring the two. In the end,  greater patient experience will translate into greater patient satisfaction which in turn will lead to a higher HCAHPS score.

Health System Finds Success With ‘Ad hoc’ Surveys

In a reoccurring segment on our blog,  we’d like to highlight another customer’s success with our software. The customer we’d like to highlight is a unified health system of physicians, hospitals, and communities located in and serving a large metro area in the Midwest. This health system has state of the art neo-natal, obstetrics, and perinatal care centers which offer a variety of different services for pregnant women, newborns, and families. Year after year, this health system consistently delivers the most babies in their respective state.

They have used AutoData’s survey scanning software for nine years and counting.

“We use the software for all of our ‘ad hoc’ surveys,” says a planning manager for the health system’s Corporate Planning and Business Development group. Whether it’s a one-time survey or a monthly survey, they use Scannable Office to gather and measure important information for many different projects within the health system.

“As an example,” he says, “our Primary Stroke Center is a ‘Joint Commission Certified Center for Excellence’ in treating stroke patients, which requires abiding by a certain set of standards.” One standard set forth by the Joint Commission is to provide patient feedback. “We use Scannable Office to create the survey and mail them to discharged stroke patients.” They receive the evaluations back from the patients, scan the surveys using Scannable Office, tabulate and create reports on the data, and then send that information to the Primary Stroke Center. The information is then analyzed and studied by the stroke center which assists in providing education to patients and focuses on secondary prevention.

On top of being a Certified Center for Excellence, and as mentioned above, the health system is a leader in neo-natal, obstetrics, and perinatal care. A key part of the system’s high quality care in those specialized areas is the wide array of maternity classes they offer. “We also use Scannable Office to evaluate all of our maternity care classes,” says the planning manager, “the data we collect is turned into trend charts for analysis and to communicate how to improve our classes.” Consistently striving to improve their programs and classes contributes to the great success their hospitals have experienced.

They also use our paper scanning software within their residency programs. Providing patient feedback on the residents is an integral part of how the health system teaches, and subsequently produces, great doctors. The data collected from the patients is used to give each resident a scorecard reflecting their work, giving the future doctors the opportunity to examine their strengths and weaknesses.

Further, the health system uses Scannable Office for at least a half dozen other surveys. The planning manager has found that Scannable Office serves a great niche function in his hospitals. “While we outsource all of our health system’s patient satisfaction surveys due to sheer volume, we have found Scannable Office gives us the flexibility and autonomy needed for successfully administering the dozens of ‘ad hoc’ surveys across our hospitals.”

AutoData’s software’s ability to allow its user to have full control over the creation, distribution, and reporting of surveys has helped numerous customers improve organizational processes, cut costs, and most importantly, provide higher quality care.

Ten No-cost Ways to Improve Patient Satisfaction

Our goal in writing this blog is to provide you, the reader, with valuable insight (at least we hope its valuable). Most of the time, we offer our own perspectives on relevant issues. But sometimes, others offer great advice that we would be remiss not to share with you. This is one of those times.

The blog over at www.physicianspracitce.com has an insightful recent post outlining “Ten no-cost ways to improve patient satisfaction.” The post reiterates the importance of measuring patient satisfaction, but goes on to give 10 simple –yet effective – tips on how physicians can improve patient satisfaction. Check out the full post at the below link!

 

http://www.physicianspractice.com/blog/ten-no-cost-ways-to-improve-patient-satisfaction

Using surveys at assisted living facilities to increase quality of care

There are currently 735,000 men and women residing in assisted living housing in America.[1] Over the next 20 years, as baby boomers continue to age and leave the workforce in droves, the number of assisted living residents will spike. Recent questions surrounding patient safety and the quality of care administered at these facilities have been raised in the media, most recently highlighted by an investigative series done by PBS’s Frontline.

A large concern surrounding the problem of patient safety at these facilities is “[t]oo often, families don’t have the information they need to protect their loved ones residing in assisted living facilities,”[2] says National Association of Professional Geriatric Care Managers’ President, Julie Gray.  One of the best ways for facilities to get that information into the hands of those families is through measuring their own quality of care and resident satisfaction. The best way to measure care and patient satisfaction is by surveying residents, employees, and families.

Pioneer Network – a non-profit organization which advocates for positive change in eldercare – released a helpful guide outlining what families should look for when searching for the right assisted living facility.[3] The guide is not only extremely helpful to families looking for the right facility, but it is also helpful for the facilities themselves. It serves as a reminder of the importance of constantly evaluating the care an assisted living facility provides. The guide suggests families ask specific questions about “person-directed care and what the assisted living community is doing, if anything, with person-directed care.” The guide lists specific questions to ask: how do you welcome a new resident?; do you measure resident satisfaction each year?; do you provide training for your staff on how to provide person-directed care?; etc. As obvious as it may seem, care facilities should be asking themselves the same questions about the care they provide. Further, the guide suggests that facilities survey family members of the individual residing at the facility.

Assisted living facilities will increase their quality of care and patient satisfaction by asking their residents, employees, families, and themselves, the right questions. The best way to ask and answer the important and specific questions put forth above is through custom tailored surveys. Facilities are in the best position to know which questions to ask. When facilities have the ability to custom tailor their own surveys to ask those specific questions and to freely edit those surveys, they put themselves in a position to gather more accurate and valuable data.

Feel free to contact AutoData to find out how we can help assisted living facilities create custom tailored paper and web surveys to  improve your care, and most importantly, improve the overall quality of life for your residents.



[1] “New Survey from National Association of Professional Geriatric Care Managers Offers a Roadmap to Protect Growing Number of Seniors http://www.prweb.com/releases/2013/9/prweb11083496.htm

[2] See id.

ExpertScan vs. Scannable Office: Part 2 – Reporting the data

 

In a prior post, we briefly explained the differences in creating forms with our two main survey scanning solutions – Scannable Office and ExpertScan. In this post, we will explain the other main difference between the two products: reporting the data.

An important reason customers choose to use our software is to clearly understand the data they collect. Whether it’s measuring patient care or customer experience, the data doesn’t mean much if you don’t understand it or if you can’t convey it clearly to others. In general, it’s much easier to convey raw data through visuals (bar graphs, pie charts, line graphs, etc.). This is where ExpertScan comes in handy.

ExpertScan has automatic reporting built into the software. When you scan in your form or survey, the software creates a handful of different reports on the data automatically. With the click of a mouse, a window pops up with a question-by-question breakdown and option to view the data in bar graphs, pie charts, trend analysis, etc.. ExpertScan also has tabulation rules that allow you to parse out certain types of data. For example, if you have a patient satisfaction survey which is used in multiple hospitals, ExpertScan’s reporting allows you to see the differences, question-by-question, between those different hospitals or even the different doctors. These reports can be easily converted to PDF files and disseminated to appropriate personnel. Further, all of the raw data scanned into your computer also gets saved in a separate Microsoft Access database.

While Scannable Office offers more options in form creation, it does not offer the automatic reporting features that ExpertScan has. With Scannable Office, the data can be uploaded directly to any ODBC compliant database – Microsoft Excel, Microsoft Access, MySQL, Oracle, Filemaker Pro, etc. Once in the database, one’s options to manipulate and report on the data are endless. However, the options are limited to the user’s experience working with any of the aforementioned databases.

Customers who come from smaller organizations or have less experience working in ODBC compliant databases love the automatic reporting ExpertScan provides. Customers who work in large institutions sometimes prefer Scannable Office because they have the personnel and resources to do much more analysis with the data in ODBC compliant databases.

So there you have it: A brief description on the differences in reporting your data (and previously – from creation). As stated, these are the two most distinct differences between ExpertScan and Scannable Office. But we’d love to chat with you about further nuances between the two! Feel free to contact us directly at any time!

NetE-nable Goes Mobile on Tablets

A tablet displaying a NetE-nable survey in an office

Tablets on the Rise

There’s no use denying it, tablet use is on the rise.  Whether it’s for personal use or business reasons, many of our customers and readers use them (you may even be reading this blog on your tablet).  Here at AutoData, we have noticed an increase in the amount of questions from customers regarding a survey solution for tablets and mobile devices.  The solution?  NetE-nable: the cloud-serviced web add-on to ExpertScan.

Tablets are quickly becoming more than just a novelty; they’re gaining popularity among users seeking more portability, ease of use, and simplicity over their current computer experience.  Whether you need to catch up on emails, read the latest news in your industry, or take meeting minutes, tablets are proving to be more and more valuable in the business world.
NetE-nable survey displayed on a tabletWith countless businesses capturing  data (whether it is a patient satisfaction survey, a safety practices/inspections form, a teacher evaluation, etc.), being able to use a tablet has many benefits over a traditional paper survey or form:

  • Eliminate scanning – By using the web for surveys you’re able to rid yourself of messy paper.  You also can avoid trying to decipher sloppy handwriting altogether
  • Instant data collection – The second the “Submit” button is clicked, data is populated and ready to be used and reported on.  No waiting around to go through the scanning process
  • Ease of access – Wherever you have a tablet (or web browser with internet connection) there you will also have access to your survey.  No more waiting for your survey to be printed or copied, forgetting them on your desk, or dealing with lost or out of order surveys

Tablet and Mobile Device Survey Solution

With our cloud-serviced web add-on, NetE-nable, AutoData has the solution to gathering data via tablets.  As pictured above, tablets using a NetE-nabled physician satisfaction survey can be filled out and instantly deliver data on tablets with a web browser and an internet connection.

Since we here at AutoData still strongly believe that paper surveys will always have a place in data collection, we offer the combination of both paper and web surveys into one database.  This is what separates us from the rest.  No need to give yourself (or your IT department) more Access/Excel work dealing with having separate databases.  AutoData provides you with the all-in-one solution.

NetE-nable survey displayed on a mobile phone

Have a device with a web browser and internet connection?  A NetE-nable survey will work!  Try out a sample survey on your device and tell us what you think.

Not an ExpertScan user?  Request a demo of our software as well as a live, screen sharing demonstration.  Watch the Learning Center’s ExpertScan with NetE-nable intro video for another look at our software.

 

Already using ExpertScan?  Contact us and request a free, 14-day trial of NetE-nable.

Already using NetE-nable?  Check out some tips and tricks from a previous blog post.