Patient experience is emerging to be one of the main pillars of healthcare delivery today. Healthcare leaders now recognize that ensuring customer satisfaction can improve the overall hospital performance.

As per estimates from the Physician’s Weekly in the US, the lifetime value of a patient is almost $ 1.4 million – when a patient has a bad experience, he or she will go elsewhere thus reducing the potential revenues of a hospital. These patients can also influence other patients through poor word of mouth and online reviews. Better patient satisfaction on the other hand enhances the perceived value of the organisation. Thus, improving patient experience is a key lever in increasing the profitability of an organisation in the long run.

So how can hospitals ensure that patient experience gets embedded into their core processes? The experience of healthcare players like Fortis shows that it takes a complete re-engineering of the hospital processes to create better customer experiences. This means a comprehensive action plan, one that reflects on all key touchpoints.

Here’s a toolkit, based on the Fortis Healthcare’s journey, as shared by Daljit Singh - President, Fortis Healthcare - at Abbott Hospital Leadership Summit, 2017. The toolkit will help healthcare leaders revamp their process framework.

1. Starting point – recognise the need

One crucial question that comes up is when to start initiating the process changes. Customer response to hospital services stems from functional or emotional factors, and a situation involving either of these should be a trigger for hospitals to revaluate their processes. Daljit Singh brought up the example of emergency response. “We noticed that the ambulance response time varied from five to 45 minutes. The reasons were many – from non-availability of driver and no first-aid kit bag to absence of any assigned doctor. By taking care of these nitty-gritties, we were able to bring down the response time to under five minutes. “

At the customer engagement level, the situation involved an irate patient complaining on social media about his indefinite wait to meet a specialist. Singh pointed out, “It turned out that the specialist in question had to attend to a critical emergency case. But we realized that if we had communicated the same to the patient, he would have understood and we could have salvaged the situation.”

2.Immersion – Observe and evaluate

After recognising the need for change, the next step is to analyse the situation and understand the gaps. This means creating a list of all client-facing positions, closely studying their processes and evaluating all patient contact points across the hierarchy, from doctors and nurses to receptionists, guards, ward boys etc. This helps in understanding common reasons behind delays, errors and miscommunication in patient interactions. Some of the non-client facing processes, such as medical record documentation and IT, can also be examined as they can indirectly impact patient experience.

Fortis Healthcare examined about 160 non-clinical patient processes including admissions, discharge, change from ICU to general ward, emergency response etc. Based on the observations, the hospital put in place a self-sustaining system across all areas, which improved patient service, reduced hospital stays and resulted in a dramatic drop in complaints.

3.Assimilation – Collect and integrate

Recording and creating a database of complaints and patient grievances can offer insights into common problems. It can be done through direct interactions with patients and their caregivers and by studying feedback on all channels of communications, including social media. Moreover, through immediate response and action on feedback, the hospital reiterates its commitment to patient well-being. This could need a dedicated team/ personnel. At Fortis for example, the Head of Patient Experience has the tasks very clearly cut out – solicit and track feedback, document communications and seek and recommend corrective actions, besides other responsibilities.

In another example, Cleveland Clinic in US, a pioneer in prioritising patient experience, appointed a Chief Experience Officer. Its Patient Experience department plays a key role in the organisational chain across locations.

4. Implementation – Create, automate, outsource, standardize

  1. Create a system: Analysing and addressing patient of grievances requires a system for real-time monitoring of patient experience. Daljit Singh elaborated, “We introduced patient experience scores on a real-time basis to monitor services. Patient care executives are given tabs. The patient fills in the feedback on it which is processed automatically, and we get to see the results. This ensures that the resolution happens immediately.”  Feedback, when combined with a measurable evaluation system, can result in better efficiency. For example, metric systems like the Net Promoter Score (NPS) measure the customer’s overall satisfaction and his or her loyalty to the brand.
  2. Automate: Technology is central to improving patient experience. Automating processes such as admission, billing, discharge, ER operations, medical records documentation, drug supply and patient flow, reduces delays caused by manual errors. According to Daljit Singh, automation also makes the system more transparent, a plus for patient satisfaction. Fortis has also used technology to offer an easy interface of its services. For example, its Android based mobile healthcare app MyFortis serves as a one-stop information source on all Fortis doctors and healthcare services offered by the hospital network. Customers can search for specialists, book appointments and make payments through the app.
  3. Outsource: Hospitals can also save time and resources by outsourcing non-core processes.  For example, Fortis Healthcare outsourced its IT operations and recruitment processes. The hospital engaged IBM Healthcare Technology Support Solutions to provide a consolidated IT support solution for all its facilities. The centralized support improved efficiency, brought down costs and left the hospital employees free to focus more on patient care. Outsourcing HR processes, too, helped provide fresh perspectives.   Daljit Singh explained further, “We hired an HR consultant to think through the recruitment process and the focus was on not just competence, but also on communication, attitude, energy, compassion and empathy.” The idea was to ensure that everyone across the board was attuned to delivering better patient experience. Dr Mudit Saxena, MD & CEO of Ovum Hospitals and EX-CEO of Care Hospitals, talked about his initiative at an oncology centre in Bangalore where he outsourced processes such as logistics, catering (for home care) and delivery of medicines. The innovative system boosted both patient experience and revenues.  
  4. Standardise: It is important to standardise processes in order to achieve a self-sufficient system. For example, one of the first things that Fortis Healthcare did as part of its efforts was to go for standardisation. Singh said, “We decided that all Fortis hospitals would operate in the same way – the Fortis way, with consistency of processes so that there is a sense of seamlessness.“ He pointed out that by removing variables and making the system predictable, people can be trained to manage independently, and more can be achieved with less.  

These examples show that with well-integrated processes in place, patient experience can become an integral part of a hospital’s value offering.