Here is an insightful article I read on Quirks a while back.  It’s related specifically to the healthcare arena but can apply to all industries who use market research to measure customer or patient satisfaction.  All factors directly or indirectly influence one another – employees, patients, marketing efforts are all dynamics that impact satisfaction.  I will be on vacation in sunny Florida all of next week, but expect more entries when I return.


Article ID: 20040603

Published: June 2004, page 42

Author: Nancy Cook

Title: Take it to a Higher Level – Effective Patient Satisfaction Requires Multiple Survey Instruments

Broadening the scope of market research through the use of multiple survey instruments can provide a more accurate picture of overall patient satisfaction and greatly enhance patient satisfaction results for the health care industry.

Patient satisfaction has become a routine measure of quality for most hospitals. Almost all hospitals administer some form of patient satisfaction survey, realizing that there is a direct correlation in quality of care and patient satisfaction. Because of this vital link, some hospitals now offer recognition and reward programs for improved patient satisfaction scores.

The results of patient satisfaction surveys will likely become another publicly reported quality indicator of health care facilities. The Agency for Health Care Research and Quality (AHRQ), in collaboration with other federal agencies, is in the process of developing a national standard for assessing hospital patient experiences. The survey tool is one measure included in a Quality Initiative, jointly promoted by three prominent health care trade organizations: the American Hospital Association, the Association of American Medical Colleges, and the Federation of American Hospitals.

Patient satisfaction surveys alone don’t improve quality

In other industries, customer satisfaction is measured by how closely expectations are met. Results are analyzed and service is improved.

The process is no different for the health care industry; however, expectations are of a much more personal nature, are sometimes subtle, and are often more difficult to define. Most hospitals routinely conduct patient satisfaction surveys that involve a series of rating questions about attributes specific to the patient’s hospital stay – from registration to discharge.

For health care facilities that want to improve on their service and level of patient satisfaction, it’s imperative that they know exactly what their customers expect. This includes both service and clinical expectations. Further, they must be willing to create a culture that embraces and strives for continual improvement in the quality of all the services offered to patients.

Aside from the obvious, such as improved level of medical care, reduced wait-time in the emergency room and fewer mistakes with medications, hospitals need to determine what is most important to patients. Is it friendly nurses and physicians, appetizing food or comfortable rooms? While quality of medical care is certainly the most important factor, health care professionals must look beyond providing the most up-to-date technology and care if they want to achieve the highest level of satisfaction among their patients.

Routine patient satisfaction surveys are a valuable tool for gaining a good understanding of what patients expect and how well the hospital is meeting expectations. However, other organizational assessments should not be ignored. In fact, taken together, multiple survey instruments will have a far greater impact on improving quality than the patient satisfaction survey alone.

Low employee satisfaction equals low patient satisfaction scores

Routine patient satisfaction surveys pinpoint areas for improvement but often fail to uncover other areas that should be addressed. As part of a total satisfaction assessment program, hospitals and health care facilities should conduct annual employee satisfaction surveys. Research has shown that satisfied employees care more about the quality of their work and therefore, provide better customer service than dissatisfied employees.

Employee satisfaction surveys can help to identify administrative policies that may be undermining the ability of hospital staff to be responsive to their patients. Correcting such issues will directly impact patient satisfaction.

Physician satisfaction surveys will reveal if their needs are being met in terms of resources, services, technology and communication. If physicians are unhappy with hospital administration, availability of services or level of technology, their frustration will ultimately impact patient satisfaction and the hospital’s ability to remain competitive.

Employee and physician satisfaction surveys also provide the benefit of improving recruitment and retention. Hospitals with a reputation for satisfied employees and physicians are more likely to recruit and retain individuals of the highest professional standard. Once again, patient satisfaction comes out the winner.

A competitive advantage

Community assessment surveys rate image and brand awareness, gauge the community’s satisfaction with health care providers and reveal patient expectations. Usually, these measures are not directly correlated with patient satisfaction; however, being aware of preconceptions and perceptions among the general public will give a hospital a competitive advantage. After all, these respondents may be past or future patients who will measure the facility based on their own experiences and expectations.

A health care facility can also pinpoint the key indicators for patient satisfaction. In other words, the very attributes that are most important in the selection of a hospital or health care facility can be specifically determined. These key indicators should be given a greater weight in the analysis of satisfaction.

The community assessment survey identifies the manner in which a health care facility may establish, build or change its desired image. In addition, the hospital learns where it stands relative to the competition and is enabled with the means for a solid branding strategy.

What does this have to do with patient satisfaction? A solid marketing campaign that successfully characterizes the nurses at Hospital A as being caring and sensitive will create this image. People will recall the image when they interact with the facility and the satisfied employee will demonstrate that this is, in fact, a reality. The patient’s expectations are confirmed and the resulting satisfaction rating is, therefore, high.

In-depth research translates into quality improvement

Key indicators of satisfaction should be researched in more detail. For example, assuming quality of nursing care is a key indicator of overall patient satisfaction and carries more weight than the cafeteria food, a health care facility would be wise to invest in more detailed satisfaction research among the nursing staff. Focus groups or one-on-one interviews can yield a greater depth of information about issues critical to patient satisfaction.

Survey research among patients, employees and physicians often corroborates evidence of a specific problem area. Undertaking in-depth research regarding the issue will increase the likelihood that the problem will be resolved by employing the best possible solution.

Research has recently focused on hospital environment as a key indicator of quality of care. The Pebble Project, an initiative implemented by The Center for Health Design, documented that facility design does indeed improve quality of care, financial performance, community perception and staff retention. Improved patient satisfaction would no doubt follow along with these indicators.

A hospital or clinic investing in new facilities or redesigning existing facilities should first determine the aspects of design that are most important and preferred. This should involve input from employees, physicians, visitors and patients. Photos of prototypes can be presented to a focus group and evaluated in terms of function, comfort and aesthetics.

Assuming that a baseline measure is taken, follow-up research can validate or challenge claims of improved satisfaction among employees, physicians and patients as well as assess the impact on community perceptions.

Broadening the scope

Health care delivery is becoming increasingly competitive and consumers are more involved in the selection process than ever before. Thus, it is imperative that hospitals adopt a more sophisticated approach to market research as a vital component of the marketing function.

When hospitals take a proactive approach by expanding their market research initiatives, they are making a commitment to improving patient satisfaction and quality. Patient satisfaction surveys, alone, only scratch the surface.

Health care providers must look beyond the routine patient satisfaction survey and consider broadening the scope of their market research. Implementation of a total satisfaction program will significantly boost patient satisfaction scores and demonstrate a provider’s true commitment to quality.