Patient Satisfaction Surveys A Fundamental Tool in Hospital Marketing

Patient Satisfaction Surveys A Fundamental Tool in Hospital Marketing

About Analytica Consulting Analytica is a consulting company We assist healthcare providers for their quantitative studies and data management issues Our consultants have a strong background in mathematics, market research, quality management and hospital management Founded in 2001 by Marc Feuerstein marc.feuerstein@analytica.be +32 0476 / 875.162 http://www.analytica.be/ (in eternal construction) Activities in hospital marketing Surveys & healthcare-related market research Patient & Market Segmentation Data-based Marketing Understanding patient (and doctor) behavior Patient relationship management, hospital-patient dialogue

Context Belgian hospitals are supposed to to delivering services of the highest quality within available resources. Services must be designed around the needs of the customers, to ensure those services meet their needs Hospitals regularly measure and report on customer experience to government services Deliver Quality Improve loyalty? Increase referrals? Evaluate perception of quality manage reputation? Identify [perceived] Needs Measuring Experience Improve market penetration of a healthcare service within a group/demographic/pathology/etc Fact-Based Marketing = Measurement-Based Marketing

Best Practices: Many methodologies exists, but I will present the methodology developed by Harvey Picker together with the Harvard School of Medicine

Philosophy of an Alternative Approach for Patient Satisfaction The Eight Dimensions of Patient-Centered Care grew out of years of research by the Picker Institute and Harvard Medical School, thousands of interviews, and the experiences of caregivers and patients. Analysis of this industry-changing research showed that there are certain things, certain behaviors, that are instrumental to patients healing, feeling cared for, and having a positive patient experiences. Do not ask for satisfaction, but ask about the experience

Sampling Does my survey really represents the opinion of my patients?

Any Survey or Study Must be Representative! It is a loss of time and money if we are not sure that what we measure is a true reflection of the patient population Controlling representativeness is not something that makes the cost rise. Actually it is the opposite: it allows us to control costs because it allows us to know what (minimal) sample is needed for the survey to be representative Minimal effort for same level of representativity

Stratification is a technique for controlling representativity Stratification is the process of dividing members of the population into homogeneous subgroups before sampling. The strata should be «MECE» (pronounce «messy» - mutually exclusive, commonly exhaustive). every element in the population must be assigned to only one stratum All together, the sample represents the population

Patient Satisfaction Surveying =/= Patient Feedback Gathering Patient Satisfaction Surveying Patient Feedback Gathering Patient Satisfaction Surveys (PSS) are based on scored questions A classical PSS always includes a «pivot» question. Examples: What is your overall satisfaction of the hospital s services? Would you recommend our hospital to your family and friends? Patient feedback questions such as: Please tell us one thing that we could have done that would have enhanced your experience What was the most memorable experience that you had in our clinic? Why will you (not) be referring friends and family members to this clinic? One is based on quantitative analysis, the other on qualitative analysis (sometimes text mining if both approaches are mixed) Patient satisfaction: easy and inexpensive Patient feedback (through open ended responses): harder and way more expensive Why? Complexity of Measurement and Analysis Feedback gathering is useful to develop hypothesis

Channels All Channels can be Used for PSS or Patient Feedback Gathering Survey Channels Mailing A Telephonic Survey: cfr Survey taken in the one-day care clinic at 2A gives excellent results and is realized by nurse Live Survey with Psychologist, for specific sensitive (or complex) topics (ex: breast cancer patients) Online Survey for the 16-65 age strata To a list of patient names and contact details which had been randomly selected within each strata; Important: we want to have a number of valid results per strata Important: Certain surveys must be anonymized

Case Study 1: France 1/2 General Patient Satisfaction Survey

Case Study 1: France 2/2 General Patient Satisfaction Survey From 2011, all healthcare providers (clinics, hospitals, cancer clinics...) will use a common questionnaire that will measure the satisfaction of hospitalized patients 36 indicators L'accueil aux admissions Informations sur les médicaments La propreté de la chambre Etc Closed questions only («very", «quite", «a little" ou «not" satisfied). This survey will be téléphonic, anonymous on random patients It should cost 1 600 euros per year and per hospital, according to the «Ministère de la Santé» (if the predefined questionnaire is used and the staff trained) Will non participating hospitals be sanctioned? The power of média, via publication of the many rankings in the press, radio and TV media, will count more than financial sanctions

Case Study 2: St Pierre (Belgium) Patient Satisfaction Surveys as a Powerful Hospital Marketing Tool Situation: XXXX decides to use a PSS to convey a marketing message XXXX uses (partial) results of a satisfaction survey for communication purposes What is your opinion on the average score? Do you have the feeling to have the opinion of the patients regarding that topic? Contradictory messages: «Parait normal à long [ ] majorité des patients [ ] mais raisonnable» is playing with words, playing with figures The press communiqué gives no figure except an overall score which seems «good» for the «commoner» but questionable for professionals They use terms like «normal à long», «raisonnable», «majorité», «favorablement noté», etc The hospital blurs its message in order to communicate on its willingness to work on things. This is clearly a case of hiding figures for trying to achieve a good marketing results

Eight Dimensions for Patient Care

Dimensions of Care Core Dimensions of Care = TOPIC Supplementary Dimensions of Care By definition, all hospitals provide services along the eight core dimensions, whether They are aware of it or not. Some services or prestations related to specific pathologies Involve Supplementary Dimensions of Care (SD)

General Model for Patient Satisfaction General Patient Satisfaction can be Described by 8 Dimensions Physical Comfort Continuity and Transition Family and Friends Information and Education Overall Quality of Care Emotional Qupport Coordinatio n of Care Patient Preferences Access to care Supplementary Dimension of Care might be in scope in specific studies (cancer, fertility clinic, etc ) * Not counting a drill-down aspect

Dimensions of Care Access to Care Access to the location of hospitals, clinics and physician offices; Availability of transportation; Ease of scheduling appointments; Accessibility to specialists or specialty services when a referral is made; and

Dimensions of Care Coordination of Care Coordination of clinical care; Coordination of ancillary and support services; and Coordination of front-line patient care

Dimensions of Care Information and Education Information on clinical status, progress and prognosis; Information on processes of care; and Information to facilitate autonomy, self care and health promotion

Dimensions of Care Physical Comfort Pain management; Assistance with activities and daily living needs Hospital surroundings and environment

Dimensions of Care Emotional Support Anxiety over physical status, treatment and prognosis; Anxiety over the impact of the illness on themselves and family Anxiety over the financial impact of illness

Dimensions of Care Families and Friends Providing accommodations for family and friends; Involving family and close friends in decision making; Supporting family members as caregivers; and Recognizing the needs of family and friends

Dimensions of Care Patient Preferences An atmosphere respectful of the individual patient. Involve the patient in medical decisions. Provide the patient with dignity, and respect a patient's autonomy

Dimensions of Care Continuity and Transition Provide understandable, detailed information regarding medications, physical limitations, dietary needs, etc Coordinate and plan ongoing treatment and services after discharge Provide information regarding access to clinical, social, physical and financial support on a continuing basis

Dimensions of Care Correlation Between Perceived Quality of Care and Each Dimension Physical Comfort Continuity and Transition Family and Friends Information and Education Overall Quality of Care Emotional Qupport Coordinatio n of Care Access to care Patient Preferences

Analysis of the Survey

Axis of Analysis Category of Patient Aspects of the Dimension Correlation to «Advocacy» (Overall Rating) Dimension of Care Analyses are possible across all possible dimensions

Drill-Down crossbars The horizontal crossbar is located at the position along the y-axis where the verage correlation to the overall indicator of all items listed in the legend would A) Legend vertical crossbar is located at the position along the x-axis where the average positive score of all measures of the legend B) Y-Axis: Correlation Coefficient C) Overall Indicator: The overall indicator is generally an overall rating of care (Overall Quality of Care), AHS or facility/service D) Priority Quadrants: top, high, medium and low priority. Top priority items are those which have a high correlation to the overall indicator (C), and a low positive score: E) Crossbars F) X-Axis: Positive Score = the score of a dimension

Drill-Down TOP PRIORITY! LOW PRIORITY!

Annex Example of a Survey Questionnaire Compatible with the HCAHPS methodology

Paper Questionnaires Do not reinvent hot water all hospitals have the same needs and often the same priorities There are way too many weak examples Recommendation: follow the guidelines of existing, proven methodologies to build good questionnaires Let us consider as a simple example a short extract of the HCAHPS recommendation for paper questionnaires

ETC

Annex 2 Some Analyses

Category of Patients

Core Dimensions of Care

Scoring of the Eight Core Dimensions

Correlation to Advocacy NB: This is a result for a specific Category of Patient

Thank you!