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How Well Do Patient Satisfaction Surveys Predict Patient Loyalty?


When it comes to satisfaction surveys, the U.S. healthcare system is still catching up with other industries — and it still has a long way to go before such surveys can accurately predict patient loyalty.  


Problems with Patient Satisfaction Surveys

Most hospitals and health systems use the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) to understand patient satisfaction. But HCAHPS doesn’t assess every aspect of the patient experience. For example, the majority of the 32-question survey addresses nursing care, notes The Atlantic.

In addition, the HCAHPS survey doesn’t give the level of detail needed for hospitals to predict how patient satisfaction affects business goals, such as patient retention and loyalty, points out McKinsey on Healthcare.

Many leading hospitals and healthcare systems have also adopted the Net Promoter Score (NPS) survey, but it, too, has flaws in a healthcare setting: “A net promoter score still won't necessarily correlate with quality, and it will only offer a macro view of a patient's actual experience, which doesn't help executives make targeted improvements,” writes Len Schlesinger, the Baker Foundation Professor at Harvard Business School, in Athena Insights. 

Further, customer satisfaction is not the best way to predict loyalty, Schlesinger writes. “Extreme responders” — those who select 1 or 5 on a 5-point scale — behave predictably, either returning for care or never coming back. But patients who select an option in the middle have much more unpredictable and complex motivations and behaviors.

And factors outside of quality of care, ranging from the patient’s mood at the time of the survey to market structure and competitive dynamics, could influence patient behavior much more than what happens inside the hospital walls. In fact, some healthcare facilities with high rates of patient satisfaction actually have below average health outcomes.

In addition, in my previous 20-year career at Procter & Gamble, I learned that satisfaction does not necessarily correlate with loyalty. Value is a key driver for loyalty, so if a consumer is satisfied with a product or service’s performance, but doesn’t feel it delivers sufficiently for the price paid, then loyalty is not cultivated.  

The equation for Value is [Brand Equity + Performance]/Price, where Brand Equity is everything the product/service stands for (the consumer’s expectations) and Performance is the degree to which the product/service lives up to those expectations.

Price is a little challenging in healthcare as price transparency is not often present. However, patients know what they’re paying out of pocket in addition to insurance premiums and other costs they must personally bear.

Long story short: if a patient satisfaction survey does not address Value, it isn’t likely to predict loyalty.


How to Improve Patient Surveys

Because of the above limitations of patient satisfaction surveys, many healthcare organizations are creating their own patient experience surveys that go beyond measuring whether patients are “satisfied” to providing actionable insights for improving health outcomes.

McKinsey recommends that hospitals and healthcare systems develop surveys that:

  • Link patient satisfaction with desired business outcomes, such as repeat visits, and research the types of questions that will enable them to measure patient satisfaction in a way that ties into those objectives.
  • Identify the strongest influences on patient satisfaction throughout the entire patient journey — as well as the role that price, service offerings, referrals, and brand play in healthcare decisions — and measure performance in each of those areas.
  • Uncover operational insights to help frontline staff to make changes that will the customer experience.

It’s important to ask questions that focus not only on the patients’ feelings about the services they received, but also on their overall experience and quality of care. Healthcare providers can accomplish this simply by slightly altering the wording of questions.

For example, instead of simply asking patients whether their wait time was satisfactory, surveys should ask a more specific question regarding the length of wait times. Surveys should also give patients a chance to offer the healthcare provider specific feedback that they can use to improve services.


How an Automated Patient Engagement Platform Can Help

Creating and sending out patient experience surveys may seem like a daunting task, but an automated patient engagement platform can help. PatientBond, for instance, allows you to send surveys to any number of people for whom you have contact information, and at any frequency you choose.

Because PatientBond uses psychographic segment-specific keywords and messaging in its communications that designed to resonate with each patient’s core beliefs and personality, patient response rates range from 55 to 60 percent across PatientBond communications. PatientBond’s flexible platform also allows organizations to execute more than one type of survey targeting different populations.

Effective patient experience surveys are essential for measuring quality of care, patient loyalty and other important characteristics of your organization. Is your organization investing the necessary resources into a tool that will allow you to do just that?


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