Policy Considerations and Looking Forward

Practices can launch efforts to improve the patient experience even before community-wide performance measurement and reporting has begun. In fact, initiating such activities can, over time, create greater demand for comparative performance data through community-wide initiatives.

Many practices that have quality improvement (QI) infrastructures in place for clinical processes and outcomes, however, do not recognize the need for similar investments in improving the patient experience. Among those that do, some do not tackle the goal of improving patient experience with the same systematic approach to QI that they use for clinical measures. To address these challenges, practices need greater support in understanding how to improve the patient experience, since this dimension of quality tends to be less familiar to clinical professionals, especially physicians.

Moreover, CG-CAHPS results are a necessary but insufficient ingredient for improving the patient experience. While high-quality comparative data from CG-CAHPS are vital for periodically monitoring performance, other patient feedback tools are needed to “drill down” to identify specific problems and strategies for addressing them. These tools include rapid-cycle surveys, focus groups, patient comments, and walk-throughs.

Patient input into the improvement process is also vital for improving the patient experience. Two types of patient engagement have emerged among the Alliances—embedding patients directly into quality improvement teams (i.e., as "patient partners") and patient and family advisory councils. Both provide practices and health systems with the patient perspective and enhance quality improvement efforts. 

Success at improving patient experience scores will require interventions and strategies at both the “macro” (i.e., organization) and “micro” (i.e., individual process) levels. In many ways, this work is more difficult than traditional efforts to improve clinical processes, as success requires changes in work patterns and behaviors among clinicians and staff members who need to become more patient centered. Critical success factors include the following:  

• Engagement and buy-in from leaders, who must be committed because they care deeply about patients and families (not just about incentive payments and public image).
• An organizational culture that prioritizes the patient experience and QI activities.
• Dedicated QI support structures with adequate resources, including a dedicated leader or team to review results, develop improvement plans, and coordinate activities.
• Nurse and physician leaders who are motivated to partner with improvement teams.
• Strategies for engaging patients and families in the improvement process.

Some organizations have these factors in place and consequently have succeeded in meaningfully improving the patient experience. Examples of successful improvements efforts can be found in many of the Alliance communities.[1]