The ‘patient experience’ is both a buzzword and a legitimate criterion of evaluation for healthcare providers.

It is part of a current suite of patient-oriented approaches - along with ‘patient journey’ and ‘patient engagement’ - trying to provide subjective depth to statistics and the hospital-wide understanding of healthcare. But what is the relevance and impact for nursing practice?

Experience Is Not Satisfaction

The survey remains the most widely used tool to find out what patients think about their care. The responsibility for collecting this information often falls to nurses, with many being asked to suggest the questions. However, what patients experience is not the same as whether they are satisfied and potential surveyors need to be clear about what type of response they are looking for and why.

Experiences are drawn from factual responses about what happened while care was provided. Questions are answered with a ‘YES’ or ‘NO’. For example: 'Did you receive information about your procedure?' These types of questions gain contextual meaning when combined with similar questions such as, 'Was the information easy to understand?' and 'Were you given an opportunity to ask questions?'

In contrast, satisfaction is understood by asking about a patient’s subjective feelings. Questions are answered on a continuum using a Likert-style scale - ‘unsatisfactory’ to ‘satisfactory’ is one of the most common. For example: 'How would you rate the quality of your post-operative information?'

Satisfaction-based questions also need context. While a person may respond positively about the quality of the information, it does not make them aware that they were also supposed to receive information pre-operatively; their responses might have been different if they had known.

What Do Patients Say?

Ironically, despite surveys being used to improve quality and safety via enhanced clinical training, studies show that what most patients are concerned about has little to do with clinical knowledge (Sax Institute 2015).

Communication remains the patient’s most important concern; communication between staff and patients, and also their families and carers. Clarity of information is also important, as is a sense that staff are ‘open’ about their care, especially when complex treatments are being discussed.

Interpersonal skills are also valued. A health professional’s ability to empathise and display compassion and respect is highly regarded, as is their ability to display cultural competence when supporting patients from diverse cultural backgrounds.

Overall, patients’ concerns could be summed up through a single question: 'Would I want to be treated there again?'

The Personal Touch

Despite their answers, a patient’s experience often remains profound for them, even if it seems quite ordinary from the care provider’s perspective. A single, positive incident can colour the whole experience, and the impact of caring and compassionate individuals is a constant theme in healthcare narratives. Medical memoir remains a rapidly growing category of literature that chronicles patients - including healthcare professionals forced into the role of patient - as they reflect on their experiences.

Yet, perhaps one of the most reliable measures remains unacknowledged: a tiny card, blu-tacked to the nurses’ station window; inside, it just says 'thank you for caring'.

References

Australian Commission on Safety and Quality in Health Care 2012, Review of Patient Experience and Satisfaction Surveys Conducted Within Public and Private Hospitals in Australia: 2012, ACSQHC, viewed 9 October 2020, https://www.safetyandquality.gov.au/sites/default/files/migrated/Review-of-Hospital-Patient-Experience-Surveys-conducted-by-Australian-Hospitals-30-March-2012-FINAL.pdf
Australian Institute of Health and Welfare 2020, Australia's Hospitals at a Glance 2018-19, AIHW, viewed 9 October 2020, https://www.aihw.gov.au/reports/hospitals/australias-hospitals-at-a-glance-2018-19/contents/summary
Sax Institute 2015, Patient’s Experience in Australian Hospitals: 2015, ACSQHC, viewed 9 October 2020, https://www.safetyandquality.gov.au/sites/default/files/migrated/Patients-Experiences-in-Australian-Hospitals-rapid-review-of-the-evidence.pdf
McLeod, S A 2019, Likert Scale, Simply Psychology, viewed 9 October 2020, https://www.simplypsychology.org/likert-scale.html

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