Risk Management Tools & Resources


Patient Satisfaction Surveys as a Quality Improvement Tool for Healthcare Practices


Laura M. Cascella, MA, CPHRM

Providing high-quality, optimal care has been a long-standing goal for healthcare leaders, practitioners, and nonclinical staff. Although this focus is not new, the increased emphasis on patient-centered care and the shift to value-based payment models in recent years have cast new light on the importance of patient satisfaction.

Survey Planning Tip

Healthcare practices should review state regulations and managed care contracts to determine whether any surveys currently are being administered or whether any requirements are in place for conducting patient satisfaction surveys. The Centers for Medicare & Medicaid Services (CMS) develops and administers the Consumer Assessment of Healthcare Providers and Systems (CAHPS) family of surveys and other patient experience surveys. Please note, however, that CMS differentiates between patient experience and patient satisfaction. To learn more, visit the CMS CAHPS webpage.

Measuring patients' perceptions of the quality of care and services they receive can offer healthcare practices valuable information and data on which to build quality improvement (QI) initiatives. One common mechanism for assessing patient perceptions is through the use of surveys. Patient satisfaction surveys can collect critical patient feedback, allow practices to gather and trend data over time, and offer opportunities to improve communication between healthcare providers and staff and among providers, staff, and patients.

Survey Planning

Some healthcare practices contract with vendors that develop patient satisfaction surveys, facilitate data collection, and/or help assess data. Other healthcare practices devise their own tools based on their specific needs. In either instance, careful planning is necessary to ensure patient satisfaction surveys are well-designed and implemented.

A crucial element of planning is involving personnel who represent various functions in the practice — e.g., managers, administrators, clinical staff, and support staff. A representative group can generate helpful insight, identify important metrics and areas of focus, and encourage staff support and buy-in for patient satisfaction initiatives.

Some initial considerations for planning include establishing goals for the effort (i.e., what the practice hopes to accomplish) and determining what indicators to measure, how to measure them, and how to review and act on the data. For some healthcare practices, the goal might be assessing overall experience at a high level, such as issues related to:

  • Accessibility (e.g., ease of scheduling appointments and wait times)
  • Communication (e.g., courteous interactions and clear verbal and written instructions)
  • Quality of care (e.g., whether providers were attentive to patients’ needs and addressed their concerns)
  • Overall impression (e.g., professionalism from practitioners and staff members, cleanliness of the waiting area and exam rooms, and the overall level of comfort for the patient)

Other healthcare practices might want to use patient satisfaction surveys to hone in on specific functions or processes. For example, a practice that has implemented a new electronic check-in process or patient portal might want to assess patients’ views about the technology and identify areas for process improvement. Similarly, some practices might want to target areas in which they have received recent or repeated complaints, such as communication or logistical issues.

One important strategy to remember is that surveys do not need to be extensively long or highly complex. A simple 5-question survey, for example, can still deliver important information. Further — regardless of survey length — developing clear, logical, and easy-to-understand survey questions will likely encourage more participation and more consistent metrics. The survey planning team should keep in mind whether the questions and response formats (e.g., rating scale, dichotomous, multiple choice, rank order, or open-ended) will generate meaningful and actionable data.

Planning for patient satisfaction surveys also should take into account how the survey will be administered and how results will be shared. Surveys can be distributed or conducted in various ways, such as via mail, email, text, over the phone, or immediately following the patient encounter. The planning team should consider the patient population and what method(s) will encourage the most participation and provide the most reliable results. Some practices might want to offer two methods — for example, encouraging patients to complete a survey following their appointments, but offering an email version for patients who decline because of time constraints.

Ensuring patient anonymity also is important, and the planning team should consider confidentiality when developing the survey and determining how to administer it. One potential strategy for surveys administered at the practice is to have patients drop completed surveys into a locked box. If the survey will be sent via mail, electronically, or conducted over the phone, patients should receive written or verbal assurance of the confidentiality of their responses.

Evaluation and Follow-Up

After surveys are administered and healthcare practices have collected and compiled ample data, practice leaders and managers should determine how to share the information with practitioners and staff members. Options might include sharing results during team meetings or on an individual basis (depending on the types of questions and responses).

Assessing results should be approached as an opportunity to improve quality and patient experience rather than a punitive or critical exercise. Leaders, practitioners, and staff members can work together to devise QI strategies and benchmark survey results over time. This approach will help them to determine the efficacy of interventions and identify best practices.

In Summary

Although patient satisfaction surveys require a commitment of time and effort for healthcare practices, gauging patients’ perceptions is an important element of patient-centered care. The feedback generated from satisfaction surveys can provide meaningful insight, help identify potential problems and service gaps, and sharpen the focus of QI initiatives. Effectively implementing satisfaction surveys and acting on their results will demonstrate healthcare practices’ commitment to patient experience and high-quality care.

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