Patient Experience Week 2021: A Healthcare Administrator’s Advocacy Guide

The shift from fee-for-service to value-based care is one of the most structurally significant changes to the US healthcare system in recent history. Under the value-based model, payment and reimbursement are directly linked to the quality of the care provided, and the patient’s experience of that care. But how does one measure patient experience, and how can healthcare administrators ensure that patient experiences are positive?

In 1995, the Agency for Healthcare Research and Quality (AHRQ) launched its Consumer Assessment of Healthcare Providers and Systems (CAHPS) program, with the purpose of advancing a scientific understanding of patient experience within healthcare. Today, that understanding is still evolving. Digital health tools, alongside the effects of the Covid-19 pandemic, are redefining what constitutes a patient experience. At the same time, patient experience has never been more important: by 2023, the Centers for Medicare and Medicaid Services (CMS) will count patient experience measurements even more than clinical outcomes.

Each year, Patient Experience Week (PX Week) falls on the last Monday in April; this year’s PX Week takes place from April 26-30, 2021. Sponsored by The Beryl Institute, an organization dedicated to improving patient experience, PX Week is an annual event that celebrates how healthcare staff impact the patient experience. For healthcare administrators, it’s a chance both to refresh their understanding of the patient experience and raise awareness of its importance.

To learn more about patient experience, and how healthcare administrators play a critical role in shaping it, read on.

Dr. Christina Gardiner has served since 2018 as a Professor in the Department of Healthcare Services Management at University of Maryland Global Campus, College of Business & Management. She is the President of Summit Healthcare Advisors and has over two decades of executive healthcare experience.

Dr. Gardiner has taught a variety of subjects including healthcare administration, public health, quantitative and qualitative analysis, finance, and business management. She has advised both private firms and nonprofit organizations on issues related to value-based healthcare, healthcare system competition, market allocation, patient safety, and health policy. She is known for being a trusted consultant, educator, and subject matter expert on complex healthcare systems as well as evidence-based interventions that support public health responses.

Over the past five years, Dr. Gardiner has conducted over 100 speaking engagements on topics related to value-based healthcare, public health preparedness, and neurological disorders. She also engages in public health projects such as large-scale nursing home evacuation preparedness, conducts Alzheimer’s research using artificial neural networks, and performs data analysis for nonprofit organizations and post-secondary institutions. Dr. Gardiner is actively involved with research on healthcare quality, safety, and costs, along with disease-specific conditions, leveraging healthcare information technology programming.

“Healthcare administrators should be the driving force of patient experience, creating a culture that places the patients at the center of care and interdisciplinary decision-making around one’s medical condition, while demonstrating to their teams the importance of striving for an excellent experience,” Dr. Gardiner says. “The leaders of the organization should have a well-defined strategy that supports a positive patient experience and positive employee engagement, as these two elements can significantly influence one another.”

Patient experience centers itself in organizational culture, and recruiting and retaining quality employees is a critical step for healthcare administrators in improving patient experience. In addition to engaging with staff and clinicians on the issue, healthcare administrators will need to analyze budget and business operations from a patient experience perspective. Defined processes for continuous engagement with patients, their families, and their communities are crucial.

Each patient deserves a positive patient experience, regardless of their race, ethnicity, gender identity, or socioeconomic status. Unfortunately, structural elements of the American healthcare system have resulted in health disparities and a lack of health equity.

“Health disparities and health equity are closely associated with one another, but are also separate components that must be addressed in the healthcare delivery process, and can influence patient experience,” Dr. Gardiner says. “Organizations should strive to achieve healthcare equity and eliminate healthcare disparities as part of their strategic priority.”

Healthcare administrators can address these issues in a number of different ways, including:

• Incorporating cultural competency training
• Instituting policies that address social determinants of health
• Increasing diversity in a facility’s leadership positions
• Partnering with other community stakeholders to address health disparities.

Over time, these moves can create a more equitable healthcare experience for every patient.

“Most healthcare settings have regulations that involve patient satisfaction, but patient satisfaction measures should not be confused with patient experience,” Dr. Gardiner says. “While healthcare organizations should know their patient satisfaction scores, these surveys are only one aspect to understanding patient experience, yet leaders should also consider patient satisfaction surveys as an integral element to value-based care.”

According to Dr. Gardiner, some of the key metrics for analyzing patient experience include:

• Outcome measures, such as clinical or financial outcomes to targets with improvements as well as commercial payers data
• Balanced measures related to the length of stay, wait times, or discharge times
• Process measures that may include care coordination, discharge processes, or patient education opportunities

“A best practice for healthcare administrators is to examine their patient satisfaction scores, analyze their culture related to patient experience, evaluate their strategy, and then create a patient experience scorecard to achieve their desired goals,” Dr. Gardiner says.

The Covid-19 pandemic has turned the healthcare world upside down. For the average person, this has meant more familiarity with services like telehealth and digital health services. But for healthcare administrators, the impact is both much more nuanced and much more widespread.

“Communication has been one of the most significant influences for patients during the pandemic,” Dr. Gardiner says. “The way providers communicate is difficult during this time, as masks and PPE make it challenging for patients to read their provider’s facial expressions and may impact the ability for patient’s to understand them, so clinicians and medical staff must have a heightened awareness of how their actions and information are conveyed. A communication strategy should be part of an organization’s approach that expands beyond basic educational information or care updates but involves processes to keep patients connected to their loved ones.”

From the way people speak behind masks to the way visitation policies can be switched to digital, healthcare administrators have been forced to completely rethink patient experience. Care access and coordination have created additional challenges: administrators need to design appropriate discharge plans that evaluate patient risk levels and ensure ongoing care is provided. At the same time, healthcare organizations need to ensure that their own employees are looked after with expanded wellness resources, peer support groups, and therapy options.

“Covid-19 is far from over, but while we wait to resume some of our normal care processes, establishing a plan that is based on best practices that are established along the way will be critical,” Dr. Gardiner says.

Patient experience is a continuously evolving concept in healthcare and one that’s of increasing importance for healthcare administrators. For continuing education, emerging research, advocacy efforts, and professional networking opportunities related to patient experience, check out the resources below.

• Agency for Healthcare Research and Quality (AHRQ): AHRQ is the lead federal agency charged with improving the safety and quality of America’s healthcare system. They develop the knowledge, tools, and data needed to improve the healthcare system and help Americans, health care professionals, and policymakers make informed health decisions. Get more information on how they view patient experience here.
• The Beryl Institute: The Beryl Institute is a global community of practice committed to elevating the human experience in healthcare. They offer continuing education, patient experience resources, networking opportunities, and patient experience events. To start, check out their Guiding Principles for Experience Excellence.
• Patient Experience Journal (PXJ): Read in over 200 countries and territories, PXJ is a peer-reviewed, open-access journal committed to disseminating rigorous knowledge and expanding the global conversation on evidence and innovation of patient experience. You can find a recent article about the effects of Covid-19 on patient experience here.