I have been reading the book ‘If Disney ran your hospital – 9 ½ things you would do differently’. It’s a different and interesting take on how to put patient experience at the centre, written by someone who has experience working both within the US hospital system as well as at Disney.
While patient ‘loyalty’ is probably not as important (or relevant) in the NHS, there are some really useful insights, especially around how to get meaningful feedback from patients.
Some key points below:
- The importance of perceived levels of staff courteousness (and more importantly compassion) as a key indicator for patient loyalty
- How results can be skewed by ‘pressuring’ patients to provide feedback, senior employees asking for feedback (patients are more likely to provide honest feedback to relatively lower level employees) or lumping together ‘very satisfied’, ‘satisfied’ and potentially other responses together (only ‘very satisfied’ makes a difference)
- It’s important to provide internal suppliers within a hospital (i.e. catering, facilities management, etc) useful feedback that can support service improvement
The NHS introduced the Friends and Family test, based on the concept of the Net Promoter Score, back in 2012. The key question was ‘How likely are you to recommend our service to friends and family if they needed similar care or treatment?’ After a bunch of criticism on its relevance and reviews including the one by the Policy Innovation Research Unit (PIRU) at London School of Hygiene and Tropical Medicine, the question was changed in April 2020 to ‘Overall, how was your experience of our service’.
Considering the results for May 2021, the key observations I made were:
- ‘Very good’ and ‘Good’ responses are reported combined as ‘Positive’. ‘Poor’ and Very poor’ are combined as ‘Negative’
- Only 20% of inpatient patients completed the survey, it was even worse for outpatients where only 7% completed the survey
- Online methods (including ‘Electronic’ means) accounted for only 21% of inpatient replies and 15% of outpatient replies. SMS made up 38% of inpatient replies and a significant 65% of outpatient replies
What if we can capture meaningful feedback, that is actionable, where more patients participate and which provides more ‘real-time’ information across various internal departments within hospitals?
I believe it’s time to rethink everything about what we ask, how and when.
What if:
- There were multiple ways patients (or family / carers visiting) can share feedback easily and in a timely manner? We can present the option to complete via bedside ‘TVs’ and (existing and new) kiosks within hospital including at relevant places such as in the canteen and in the waiting room for CT scans
- There were options to (slightly) modify the question asked based on the location and give the option to provide their details (if they wish only) so that it’s easier to make feedback actionable? Having devices in specific locations (i.e. in the canteen) and capturing the time provides options to ‘narrow down’ feedback and make it more meaningful without compromising patient privacy (and allowing them to remain anonymous)
- We automate analysis – segment feedback as relevant to different hospital department, focus on ‘very good’ and ‘very poor’ as appropriate (instead lumping together as ‘positive’ and negative’) and use techniques such as Natural Language Processing (NLP) to analyse free text questions – and make the insights available in a timely manner to departments so they can identify opportunities for improvement?
Very happy to hear your comments below or feel free to email me to share ideas – janak@usehealthdata.com