Recognizing the Importance of Patient Experience

4 min read

Recognizing the Importance of Patient Experience

Quality, Safety and Service, How They Stack Up

The Academy of Medicine (previously known as the Institute of Medicine) defines health care quality as "the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.1" Over 20 years ago, the Academy identified six key aims to improve healthcare system quality – safe, timely, effective, efficient, equitable, and patient-centered care. Since that time, each of these concepts has been defined, explored, and measured in a variety of ways. 

We are all familiar with the term ‘safety first’ but how does safety really stack up in hospitals when it is compared to other elements of quality, including patient experience? And more importantly, is it really a good idea to compare these key elements or even try to rank one as a higher priority than the other? The Academy identified six, not five, not four, so there they are all important.  

Over this past two decades, quality and performance improvement science has continued to evolve and tools for improvement have not only been implemented but have been pushed down to frontline providers. For many years, frontline personnel were held accountable for their processes (compliance) as well as their patient outcomes, while not being given the support and means to improve that data. But today, these individuals need not wait for a lean methodology specialist to guide them through a rapid improvement event or PDSA cycle. They take initiative and act on their data as soon as trends become available.

Hospital safety begins and ends at the point of care, and the level of care provided there, not only inhibits medical errors, but is also reduces hospital readmissions. 

The Centers for Medicare and Medicaid Services (CMS) consider hospital readmissions as a significant measurement of hospital quality that relates to reimbursement within federal programs. Let’s evaluate prevention of hospital readmissions a little differently.  

Is a hospital readmission a true patient outcome, or is it more of a failed hospital process or task? Patients are often readmitted because of a complication or exacerbation of symptoms. While sometimes this exacerbation is just progression of the condition, it can also occur due to patients incorrectly following post-discharge instructions or misunderstanding how to administer medications at home. This is where the connection between quality/safety and a positive patient experience becomes evident. 

Patients who highly rate their experience on a patient experience survey are not just indicating their happiness or likelihood to return, they are also indicating trust in those providing the care. When patients trust their team, they are more likely to heed instructions, call with questions after discharge, and attend follow-up appointments.  Patient experience science endorses the importance of ‘warm welcomes and fond farewells2 as part of the hospital patient experience, but every interaction throughout the admission can impact trust, and trust is the critical factor.  Besides admissions and discharges, creating solid patient rounding structures, processes, and outcomes assure that staff and leader touchpoints with patients achieve the goals of care and build on trust. Patient experience matters as a key part of the comprehensive patient plan of care.  

"A patient's experience comes from a blended perspective of quality, safety, service and cost. Striving for an excellent experience is about driving the positive patient outcomes," shared Katie Haifley, Co-founder and CMO, Nobl. 

Nobl works with hospitals and health systems to incorporate industry rounding best practices with their specific quality, safety and experience goals to create environmental assessments, rounding question sets, and more. Here are two specific tools that help to make the connection between planning, implementation, and meaningful rounding data. 

Unit-Level Focus Questions 

  • Unit-level focus questions offer nursing leaders the opportunity to query patients on safety or service concerns that are specific to their population. We recommend keeping certain questions standardized for the facility or division but setting up each area with focus questions that relate to key drivers in patient satisfaction, quality or safety. Using the Nobl Rounding Platform in conjunction with this best practice leaders can easily document the patient experience conversation without making patients/families feel that they are focusing on using a device or taking notes. 

    • Key Driver Focus: Environment Clean & Comfortable.

      • A clean and comfortable environment is important to your healing and rest. What has been your experience with the cleanliness of your room?  

    • Key Driver Focus: Quiet Environment.

      • A quiet and calm environment is important to your healing and rest. What has been your experience with the quietness of your stay? Display Type:  Button Row

    • Key Driver Focus: Fall Risk Awareness

      • All of us want you to heal and get home to your loved ones and to resume the activities you enjoy doing. Because your safety is our priority, can you share what we asked you to do to keep you safe from a fall? 

    • Key Driver Focus: Bedside Shift Report

      • We change shifts at 7 am and 7 pm each day. Around that time each day it's our goal that your nurse and new nurse come into your room to discuss your care and include you in that discussion. How do you feel we are doing with this process? 

    • Key Driver Focus: Patient Preferences and Personalized Care

      • One of things we do to provide great care is to incorporate your personal preferences. What is most important to you today and/or during your stay? Display Type: Checkboxes

Qualitative Patient Experience Reports 

  • Detailed reports provide question level responses, summaries of patient comments and even the frequency with which specific questions have received positive or negative responses, or even if leaders asked the question.  

Qualitative Patient Experience Reports


Even with these easy, interactive tools and customized features and questions, facilities must still consider organization accountabilities and communication beyond the activities at the bedside. Quality/safety and patient experience are often assigned to different teams within the healthcare organization, and this is a best practice by identifying a chain of accountability. But when those ‘chains’ become siloed, the synergy of everyone working together can be lost. Nobl believes that involving all stakeholders is important. This is demonstrated by the digital rounding map within Nobl Hourly, which turns hourly rounding into a team activity. The concept of team is also supported within Nobl Leader and Nobl Employee by connecting employee praises and coaching in both. Changing from one platform or rounding form with the click of a button supports a single leader completing different types of surveys or audits during a single patient encounter. Executive and department rounds are adjacent to nurse leader rounds and, with assigned permission, rounders can view the results of previous rounds many types of rounds or those within their chain of command. We also encourage PX Executives and Directors to have access to leader rounds on patients, so that concern trends, praises, and service recovery data can be reviewed through their unique lens.  

Every facility should be laser-focused on the six elements of health care quality and the touchpoints that create the comprehensive plan and execution of every patient encounter. 

Written by Teresa L Anderson, EdD, MSN, NE-BC, Nobl Chief Nursing Officer



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