Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Patient perceptions of the hospital experience

James Merlino, MD
Physician
October 26, 2014
71 Shares
Share
Tweet
Share

An excerpt from Service Fanatics: How to Build Superior Patient Experience the Cleveland Clinic Way.

Patients’ definition of their own experience is quite divergent. We ask patients for feedback, and the results are fascinating. We’ve found that patients often use the word experience in their comments: “I can’t believe how the experience in this hospital was.” “This place is amazing— everyone is so friendly and caring.” A patient remarked to our CEO on one of his leadership rounds, “Where do you find all of these angels to take care of patients?” Occasionally, patient comments are less complimentary:

“My experience was terrible!” Patients tend to define their experience based on an “in-the-moment” encounter or a specific significant occurrence. Regardless of the quality of the entire journey, it will be the one or two great — or bad — events that will define a particular patient’s experience.

Patients’ perceptions, and, therefore, their patient experience definitions, are also influenced by the people around them. Once, when he was chairman of the department of thoracic and cardiovascular surgery before becoming CEO, Cosgrove was summoned urgently to a patient’s room after surgery. The operation had gone well, and he believed the patient to be recovering without incident. Concerned, he ran to the room, finding the patient visiting with family and doing fine. A family member implored Cosgrove to look under the bed, where she pointed out dust bunnies. She asked the world-renowned surgeon, “How can this hospital provide top care if you can’t even clean the floors?” Cosgrove was stunned. Why were the family members evaluating the organization’s quality on dust bunnies when their loved one had a successful outcome from a difficult operation? He was getting firsthand insight into how patients judge our overall effectiveness based upon seemingly minor things that they readily understand.

I once rounded on one of my patients, and in the room were several family members. They knew of my role in patient experience and immediately wanted to relay a terrible experience they had had in our hospital cafeteria. They went on to describe, “We waited at the counter and the employees just ignored us. People down there were not helping us. The cashier person was rude. She was too busy talking to her partner.” The patient, who had not even been in the cafeteria with his family members, piled on, “Yeah, that is no way for a hospital cafeteria to function.”

I thought this patient’s experience so far had been very positive. He had a good medical outcome, the nurses and I were attentive, and he was happy with our interactions. Does the bad experience of a family member in the cafeteria impact the patient’s perception of his experience while in the hospital? I am not sure anyone knows the answer for certain. However, to ignore the possibility would be to diminish the impact of family dynamics on perceptions and opinions. We must assume that occasionally the patient’s personal and family experience in the hospital environment outside of the patient’s room will impact survey results. There may also be a disconnect between patients’ perceptions and how care was delivered. One patient wrote to our organization, “Your hospital is really bad. They hurt me.” Those are tough words for a health care professional to hear.

Yet often, when we review a dissatisfied patient’s medical record and discuss the experience with the team that took care of him or her, we discover that, in fact, the outcome was very good, it met our standards of medical care, and all the members of the team thought that they were going above and beyond what was required to ensure that the patient and family experience was exceptional. When I asked this particular patient what he meant by “hurt,” he expressed disappointment at having to undergo treatment in the first place. We were not being judged on the care or the caring; we were being evaluated on the patient having the disease — a battle we could never win, but a very important illustration of how some patients think. Often patients’ definition of “quality” is not our definition of quality. Patients relate to things they understand, and that drives their perceptions.

Patients frequently use their experience with service quality to define their perception of the health care they received. If you ask patients to tell you “What is it about your stay that made the experience great,” they often zero in on a specific item such as “The doctors explained things well and were very nice,” “The nurses were very attentive,” or “The building is new and clean.”

This global grab bag of comments demonstrates the challenge: If the patient experience can mean anything, then how do you define it as an organization and, more important, how do you fix it? Patients have widely varying perspectives, and it is unreasonable to hold patients to a single definition of how they think about the patient experience. The patient experience can mean anything, can differ from patient to patient,  and is highly perspective — and experience-based. A patient will define the experience from his or her unique vantage point, which is often determined by a single good or bad event. This is what patients remember.

James Merlino is chief experience officer, Cleveland Clinic and author of Service Fanatics: How to Build Superior Patient Experience the Cleveland Clinic Way

Prev

Want to know why residents don't chose primary care? Read this.

October 26, 2014 Kevin 38
…
Next

Ebola presents a new paradigm from the ER

October 26, 2014 Kevin 3
…

Tagged as: Hospital-Based Medicine

Post navigation

< Previous Post
Want to know why residents don't chose primary care? Read this.
Next Post >
Ebola presents a new paradigm from the ER

More in Physician

  • Finding your ideal work-life balance: tips for prioritizing personal life and achieving professional success

    Zahid Awan, MD
  • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

    Harvey Castro, MD, MBA
  • 7 ways to beat burnout: a guide for health care professionals to reduce stress and reclaim their passion

    Marie Livesey, DO
  • Heartwarming stories of cancer patients teaching us about life and the human spirit

    Johnathan Yao, MD, MPH
  • We need a new Hippocratic Oath that puts patient autonomy first

    Jeffrey A. Singer, MD
  • The meaning of death in medicine: the role of compassionate care in end-of-life patient care

    Ton La, Jr., MD, JD
  • Most Popular

  • Past Week

    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Nose-brain connection: The surprising link between allergies and mental health revealed

      Kara Wada, MD | Conditions
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • Medical errors and the power of apologies [PODCAST]

      The Podcast by KevinMD | Podcast
    • Finding your ideal work-life balance: tips for prioritizing personal life and achieving professional success

      Zahid Awan, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • 7 ways to beat burnout: a guide for health care professionals to reduce stress and reclaim their passion

      Marie Livesey, DO | Physician
    • The unjust reality of racial disparities in pediatric kidney transplants

      Lien Morcate | Conditions
    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 33 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Long COVID Cognitive, Depressive Symptoms Tied to Brain Inflammation Marker
  • 'Practice Changing' Trial on Activity Recs After Prolapse Surgery
  • What's With the Buzz Around NAD+ Injections?
  • Standing, Walking After Major Surgery Tied to Less Risk of Post-Op Complications
  • Tenapanor Improves Abdominal Symptoms in Patients With IBS-C

Meeting Coverage

  • Tenapanor Improves Abdominal Symptoms in Patients With IBS-C
  • Benefits Found for Hand OA Drug Treatments
  • MRI-Based Screening May Detect Prostate Cancer Earlier
  • New Model Aims to Study Intestinal Fibrosis in Crohn's Disease
  • Hypertension Tied to Worse Survival After Surgery for Upper Tract Urothelial Cancers
  • Most Popular

  • Past Week

    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Nose-brain connection: The surprising link between allergies and mental health revealed

      Kara Wada, MD | Conditions
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • Medical errors and the power of apologies [PODCAST]

      The Podcast by KevinMD | Podcast
    • Finding your ideal work-life balance: tips for prioritizing personal life and achieving professional success

      Zahid Awan, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • 7 ways to beat burnout: a guide for health care professionals to reduce stress and reclaim their passion

      Marie Livesey, DO | Physician
    • The unjust reality of racial disparities in pediatric kidney transplants

      Lien Morcate | Conditions
    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Patient perceptions of the hospital experience
33 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...