If the federal government is placing an emphasis on customer service in healthcare, then healthcare organizations should be following suit, right?! To be sure, the Centers for Medicare & Medicaid Services (CMS) publicly reports the results of its patient experience surveys, and some surveys affect payments to CMS providers. Some CMS surveys are used in Value-Based Purchasing (Pay for Performance) initiatives. So, instead of solely paying for the number of services provided, CMS will also pay if an organization receives high marks for delivering quality services.
A Closer Look at CMS Experience Surveys
The patient experience surveys administered by the CMS ask patients (or the patient’s family if he/she is not able to respond) about their experiences with the entire healthcare continuum, including hospitals, home healthcare agencies, doctors, and health and drug plans. The surveys focus on how patients experienced or perceived key aspects of their care. This can include how well the patient felt their doctor(s) and nurses communicated and listened to them, how well the patient understood their health plan and medication instructions, and how well the overall coordination of their healthcare needs was delivered.
Securing high marks on CMS patient experience surveys depends largely on a healthcare organization’s understanding of basic customer service principles and their ability to integrate these principles into everyday practice. The remainder of this article will focus on what healthcare organizations must understand and implement from a customer service perspective with the ultimate goal of improving operational efficiencies and thus patient experience scores.
When it comes to patient experience surveys, many healthcare organizations have very little insight as to why patients graded them as they did. If you’re like most institutions, you probably have limited knowledge of patients’ end-to-end experiences as they navigate through their care. So, how do you gain this insight and improve upon shortfalls? One proven and effective strategy is retaining researchers and consultants to followup with patients who have taken the CMS surveys. Some healthcare providers have had researchers followup with patients, asking why they’d answered each question the way they had. With this information, organizations can then identify patterns and opportunities of improvement. Although there are upfront costs associated with this approach, it can prove to be a wise and fruitful investment.
If you’re not quite ready to take on this endeavor, there are other, more readily available strategies. Studies and examinations of organizations that have received very poor scores on CMS surveys have yielded some interesting findings. Such studies have involved researchers observing, evaluating, and asking questions to both patients and employees regarding the entire journey of care.
The studies on CMS surveys have found that there are indeed consistent themes among patients and there are specific strategies companies can consider to improve the patient experience:
- Ensure that conveying comfort and reassurance to patients is a top priority among all healthcare staff. Most patients in hospitals and long term healthcare settings do not want to be there. They are often afraid, confused, and anxious. Patients and their families seek reassurance that the team taking care of them understands the patient’s needs and understands the situation they’re in. CMS survey data reveals that organizations who receive poor scores don’t do a good job providing this reassurance. This can be as simple as healthcare staff acknowledging a patient’s concerns and fears. To be sure, employees can’t be expected to provide answers and resolution every time, but they can provide a sense of caring and comfort to the patient. This act alone, if it’s consistently enforced and implemented among an organization, can improve CMS survey scores.
- Clarify roles and what it means to provide an exceptional patient experience. If you want to see CMS survey scores improve, there must be a clear understanding that the patient experience is a strategic priority. Moreover, healthcare professionals must understand exactly what their roles and responsibilities entail to deliver that experience. From housekeeping to food service to nursing staff—everyone must understand that they play a critical role. Organizations can help clarify roles and expectations by providing individualized coaching sessions and by sharing broad, holistic definitions that are communicated throughout the company. “The patient experience encompasses everyone and everything encountered from check-in until discharge” is one example.
- Keep in mind that clear and consistent communication often means a happier patient. Survey data reveals that patients dissatisfied with their experience often want better communication—they seek up-to-date information about their surroundings and plan of care. When there is a lack of information or if the information patients are receiving is inconsistent, they are left feeling in the dark, and that no one is taking responsibility for them. Organizations can address this by staying more on the side of over-communication. It doesn’t hurt to provide updates on small, routine procedures and protocols. Additionally, make sure the patient is always given an opportunity to ask questions and ensure that doctors and nurses are communicating with one another before they speak to a patient.
- Be aware of your demeanor. Studies on CMS surveys have found that healthcare staff’s demeanor is critically important. Patients tended to be more satisfied when the staff they interacted with had a positive attitude. Some patients cited that they assumed their caregivers were unhappy with them or were hiding bad news from them when they had a non-friendly or non-personal demeanor. Simply being aware of your body language and facial expressions and always aiming to be pleasant can have a significant impact on scores.
- Focus on improved experience and care before they even walk through the door. A patient’s experience with your healthcare organization encompasses all interactions they have—before, during, and after their visit. You can help set a positive tone from the get-go by proactively reaching out to patients. Sending proactive notifications via email, text message or phone confirming appointments or providing other relevant updates and information provides patients with the kind of service that keeps them engaged and satisfied.
- Remember that happy employees are more apt to make patients happy. Have you ever been to a restaurant or retail store where the employees were happy to see you, and happy to serve you? Chances are if you have, you were thrilled with your experience. That’s because exceptional customer service and employee satisfaction go hand-in-hand. Plain and simple, if you’re experiencing poor CMS survey or customer service scores, you must take a look at employee satisfaction, as the two are deeply linked. Unhappy employees probably aren’t going to go out of their way to provide exceptional service. So, if you’re truly committed to creating an improved patient experience, take some time to tap into your employee landscape. Ask them how they feel about their job and the company, and more importantly, ask them how they think things could be improved. Contrary to popular belief, most employees won’t have drastic requests like large salary increases. Often times, they will suggest small, very reasonable enhancements, like more flex-time, a more organized work environment, and verbal recognition.
When it comes to improving CMS Patient Experience Survey scores, strategies like redesigning gowns, re-decorating rooms, and improving food services may also have a positive impact. However, at this time, there isn’t much data as to how effective these types of superficial efforts are at changing CMS scores. There is data and some research that indicates focusing on service and organizational strategies can indeed make a difference though. In fact, evaluating and implementing even just one of the customer service strategies outlined in this article could have a significant impact in a fairly short amount of time.