Healthcare Practice Strategies – Summer 2012 - Why You Should Be Gauging Patient Satisfaction

With reform on the horizon and pay-for-performance on the rise, the “patient experience” has taken on added significance. In fact, the Patient Protection and Affordable Care Act requires Medicare to include “an assessment of patient experience and patient, caregiver and family engagement” on Medicare’s Physician Compare website by January 1, 2013.

Medicare already has begun requiring hospitals to report patient survey data to receive full payments, and experts say that some measurement of patient experience is likely to be integrated into a pay formula for physicians by 2015.

Given the amount of money hanging in the balance, physicians certainly have a very good reason to gauge patient satisfaction.


Fortunately, a variety of resources exist to help gauge patient satisfaction — whether you are interested in asking a few basic questions about the patient experience or are interested in an in-depth analysis and benchmarking. An easy way to embark down the do-it-yourself-surveying path is simply to use an existing survey as a guide.

The Department of Health and Human Services’ Consumer Assessment of Healthcare Providers and Systems Clinician & Group survey (or CG-CAHPS) might be a good model to start with. 

The questions on the CG-CAHPS survey were developed with help from the American Medical Association and other interested parties. All questions are answered on a scale ranging from “always” to “never.” For example: “In the last 12 months, how often did this doctor show respect for what you had to say?” 

In addition, a number of vendors and resources are available for practices with budgets to support a paid survey solution, including:

  • ( offers monthly patient satisfaction reports for practices interested in receiving quantitative feedback from their patients.
  • Press Ganey (, an industry leader in healthcare performance improvement, provides a robust survey offering. This includes CG-CAHPS Insights, which is specifically designed to help prepare practices for national implementation of the Clinician and Group Consumer Assessment of Health-care Providers and Systems survey.
  • The American Medical Association has partnered with Press Ganey to create an affordable online patient satisfaction survey service called RealTime ( The cost is $65 per month for AMA members.
  • Survey Monkey (, a popular and easy-to-use online survey system, is just one of many free and low-cost tools available on the Internet.


While the patient experience involves many variables, the key issues are quantifiable. Plan your patient satisfaction survey around these cornerstone issues:

Quality of Care: Is the patient satisfied that the medical care sought has resolved or helped with his or her need or problem?

Access: Was the patient able to get through on the phone? How easy was it to make a timely appointment? How long did he or she wait in the office? Be sure to ask about even the little things, like ease and cost of parking.

Interpersonal Interactions: Are the doctor, nurse and assistants caring, concerned and compassionate? Is the receptionist courteous? What about the business staff and others?

Communication: Did the patient receive clearly understandable instructions or health information materials? Did the doctor clearly explain medical and treatment terms? Is it easy for the patient to get test results or a callback from the office?

Doctor-Patient Interaction: Does the doctor listen and answer all questions? Did the doctor spend enough time with the patient, or does he or she have the appearance of being late or rushed?


Creating a survey, soliciting feedback and compiling the results is only half the battle. The other step is actually using the data to drive improvement. Once you have some insight into your patients’ perceptions of their care experience, it’s time for action.

In fact, doctors who consciously try to improve their patient interactions are sued less often. According to a study funded by Press Ganey and published in the public health journal Medical Care, physicians with low patient satisfaction scores were more likely to be involved in malpractice lawsuits. Consider the following three action steps:

  1. Make the changes. Inevitably, your satisfaction surveys will point out some deficiencies. Review what you find with staff at least monthly. You might even post the data in your practice’s common areas to provide an incentive for your staff. Take pride in areas of strength and work on raising scores over the next month. Data can also be compared before and after improvements are made to determine its effectiveness.
  2. Market the results. If your patients say they appreciate that they can always get same-day appointments and are not kept waiting once they arrive, then lead with that in your advertising and marketing efforts. And be sure to share with patients the changes you are making in response to their feedback. Post information in the waiting area about survey results and what changes are being made based on their input.
  3. Don’t forget your staff. Research has shown that satisfied employees provide better service. So, consider conducting annual employee satisfaction surveys to identify administrative policies that may be undermining the ability of staff to be responsive to patients. Correcting such issues will directly impact patient satisfaction.



The easier you can make the entire survey experience, the better response rate you’re going to have. And better response rates mean more statistically meaningful data. Consider these survey tips:

Keep it simple. Carefully craft just five or six questions with a basic scoring mechanism (e.g., a 1-to-5, poor-to-excellent rating). Include at least one open-ended question with space for written comments.

Remain objective. The National Committee for Quality Assurance now recognizes the importance of objectivity in satisfaction measurement and requires that satisfaction data used for health plan accreditation purposes be collected by an outside survey vendor.

Keep it standardized. There’s a reason for standardization: Changing questions significantly makes it difficult if not impossible to track performance over time.

Make it chronological. Start questions at the point where the patient’s visit begins, or even before. How long did it take to find parking? How long was the wait before the patient was seen by a nurse? How did the front desk staff treat the patient? The questions can continue through the visit right to asking about follow-up care.

Get the doctor involved. Patients are loyal to their physicians and are quick to do what’s recommended. Having the physician directly encourage patients to complete the survey (such as via a personal note on the survey instrument) is a powerful means of driving response.

Put it online. Paper questionnaires are easily discarded or lost, and today’s smart-phone-toting patient is already predisposed to providing information online. So ask patients to visit either an online vendor survey or the practice’s website after their appointment. Another option is an in-office kiosk. This could be as simple as setting up an older computer in the waiting area and bringing up the survey for patients to complete right there.


Healthcare Practice Strategies – Summer 2012 Issue

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