Patient Satisfaction: Improving and Increasing Responses

Patient satisfaction is a process, not an outcome. Satisfaction is not an endpoint but is something a healthcare facility works on and strives for the entirety of time working with a patient. Other than improving the patient experience, positive interactions with patients are tied to reimbursement, patient retention, and, in some circumstances, clinical outcomes.

For new ideas to increase patient satisfaction ratings, healthcare administrators and administrations are looking to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score system. The HCAHPS system scores illustrate the HCAHPS survey results, including information on a wide range of patient experience data—communication practices, cleanliness, staff responsiveness, and more. This information is then configured into an HCAHPS score for the healthcare facility and can be used to assess the hospital’s Medicare reimbursements. For example, the better the HCAHPS score, the higher the reimbursement from Medicare.

This resource guide serves to increase your understanding of factors that play into the patient experience and satisfaction scores, promotes the use of this information to implement systems for improvement, and conveys how to transform your operations to boost your patient satisfaction and survey responses from patients.

Improving Patient Satisfaction

For many healthcare providers, the answer to improving patient experiences and satisfaction is held in open and empathetic conversations regarding their patients’ care. Patient satisfaction can be improved without compromising the quality of care provided. Healthcare administrators who wonder how to improve HCAHPS scores can utilize the following steps:

  • Develop Rapport and Make It Personal
    • When patients are unsure what to expect of their appointments, fear can often interrupt their ability to retain crucial medical information during their visit. When healthcare providers spend time conversing with their patients before any medical treatment, a sense of trust is established to remedy any fears the patient may have. For more information on establishing trust with patients with Limited English Proficiency (LEP), please refer to our How to Build Trust Among Patients With Language Barriers resource under the Optimizing Engagement with Patients section on our website. Once the patients feel secure with their provider and conversations, this can promote confidence and a sense of empowerment over their health. Critical components of these confidence-making conversations are maintaining eye contact with your patient as you discuss their health and using their name to make the discussion as personal as possible. Taking notes while maintaining eye contact might be difficult, but actively listening or utilizing a scribe can make this more feasible.
  • Educate the Patient
    • Please refer to our Communication in Healthcare and Discharge Planning write-ups in the Optimizing Engagement with Patients resource section of our website for more information on educating your patients on new conditions or diagnoses. Communicating effectively with your patients is imperative for their wellbeing and an increased understanding of their health condition.
  • Ensure Cleanliness of Your Facility
    • The environment in which your patients receive care should be safe and sanitary. Cleanliness in every area of your healthcare facility, including the waiting room, protects your patients and can ease their stress. Sanitation and cleanliness are also vital areas evaluated on the HCAHPS survey.
  • Upgrade Outdated Technological Systems
    • Small updates to appointment scheduling websites or platforms, waiting room signage and systems (iPads, desk check-in), and nurse/healthcare provider call buttons can significantly improve patient satisfaction ratings. When systems are upgraded, this should be accompanied by training held for staff on utilizing these new systems.
  • Punctuality
    • When healthcare providers are punctual to appointments, they illustrate respect for their patients’ busy lives and schedules. However, if you find that your facility is consistently behind schedule with appointments, you may need to reassess your scheduling systems and staffing needs to ensure you can get to see patients promptly.
  • Setting Expectations
    • Healthcare facilities and providers can set expectations by designating a section of their website to resources, updated clinic/hospital news and calendars, patient portals, printed collateral, and an FAQ page that includes information on how to refill prescriptions, contacting the office after hours, and scheduling appointments.
  • Listen
    • Although this sounds elementary, listening to surveys, reviews, social media comments, pulse surveys, and the HCAHPS survey can reveal what sincerely needs to be revamped or tweaked about your healthcare facility. In addition, by listening to many sources, you place your hospital in a better position to gain a comprehensive understanding of your patients’ experiences.

There are also several ways to improve patient satisfaction by supporting your healthcare teams:

  • Investing in High-Quality Onboarding
    • Healthcare facilities should adopt customized onboarding processes to support each new staff member’s skill-level and knowledge gaps. This approach to comprehensive onboarding is known to increase employee satisfaction, engagement, retention, and more holistic care. Please refer to our New Employee Integration 1 write-up under the Optimizing Leadership section of our website for more information on integrating new staff into your hospital’s culture.
  • Promoting Lifelong Learning
    • Healthcare systems and best practices are continuously evolving. To stay on top of these updates, healthcare providers should have access to holistic continuing education courses that increase their knowledge and ability to provide high-quality patient care.
  • Understand Internal and External Stressors
    • Burnout is a serious problem that many healthcare facilities and providers are experiencing today, especially with the COVID-19 Pandemic. When providers feel underappreciated or overwhelmed, it can be challenging to provide the same high-quality care they were providing for patients before. When you support the overall wellbeing of your healthcare professionals, you are actively investing in the maintenance of positive patient experiences. Refer to our write-ups on Addressing Physician Burnout (Optimizing Workforce) and Top Recruiting and Retention Strategies for Rural and Underserved Communities (Optimizing Leadership).

More resources on improving patient satisfaction ratings and experiences:

Increasing Responses to Patient Satisfaction Surveys

Patient surveys are imperative for assessing patient satisfaction levels and evaluating how to change your facility for the better. Unfortunately, low response rates on these surveys can skew the results very positively or negatively. By making these surveys accessible and convenient, you are more likely to receive more responses. Qualtrics recommends the following steps to increase your patient survey response rate:

  1. Calculate your survey response rate and completion rate:
    • Response Rate = (Number of people who completed the survey / Total number of people you sent it to) * 100
    • Completion Rate= the percentage of people who finished the survey once they started it. The completion rate is an important metric, as it allows your facility to assess whether the survey is too long, how easy the survey is to complete, if there are too many open-ended response questions, and can answer other important questions.
  1. Look at the benefits of a high response rate
    • High response rates directly impact the quality of your data and mean increased sample size of your targeted population. Conversely, when your sample size is small (i.e., your response rate is low), there is an increased chance that your responses are not representative of your population of interest. For example, if your facility utilizes an online survey platform, it could be alienating an entire geriatric population who would otherwise respond. Another example is sending out a survey during a significant religious holiday that did not capture responses from a large group in your community.
  1. Look at which factors affect survey response rates
    • The Survey Itself
    • Respondent(s)
      • Level of Motivation to Respond
      • Level of Interest of the Respondent in the Survey
      • Whether the Respondent Has Completed Surveys with You Before
      • Panel Membership (those who are panel participants are more likely to respond than those who are not)
      • The Quality of the Recruitment Process
      • Invitation Email Wording (if applicable)
      • Demographic Factors
    • Recruitment and Survey Management
  1. Increasing Your Survey Responses
    • Use Incentives to boost the probability of survey completion. Make sure to use your survey budget wisely by giving small incentives for each respondent rather than a significant incentive for a few, straying from raffles, explain how their feedback will be used and who will see it, and tell them why you chose them for the survey.
    • Use a survey panel and pre-select respondents who volunteer to answer surveys. This can be used as a time and energy saver, as you will not have to go looking for respondents each time a new survey is released.
    • Use cognitive dissonance by reducing dissonance. This works by framing and shaping the survey to align with your patients’ beliefs about themselves. For example, a carefully made questionnaire or cover letter might allude to a person’s self-perception of being caring and helpful.
    • Ask for feedback immediately. Feedback on surveys is 40% more accurate within 24 hours of receiving care at your healthcare facility.
    • Keep the survey short and purposeful. On average, surveys that take more than 12 minutes “bore” respondents and decrease response rates significantly. This is particularly important if there are no incentives for participating.
    • Be honest about the survey. For example, be honest about the length of the survey and the amount of time it takes to complete it. It is best if the survey is no more than 9 minutes long if being completed on a mobile phone. Also, stray from progress bars on online survey platforms, as patients will respond better if there are human-like text cues, such as “Nearly there! Just a few more questions.”
    • Make it personal. Customize your surveys with information that you already know about your patients. This small personalization can boost response rates significantly—up to 48% in some cases. For example, “Hello, [name], we hope you found your visit with Dr. [name] satisfactory today. Would you mind if we asked you some questions about the quality of your experience with us today?”
    • Send gentle reminders. If you have not heard from a patient, sending between one and three reminders using new language each time is professional. It is essential to understand the line between spam and a gentle reminder to complete the survey. Adding reminders to your survey management to-do list can boost your response rate by up to 36%.

More resources on increasing patient satisfaction survey response rates: