Indirect Bedside Care: Emphasizing Patient UX in an Evolving Healthcare Industry

Patient satisfaction has long been the bellwether of healthcare. The assumption has been that if doctors, nurses and support staff treat patients respectfully and cure or address the relevant health issues, the patients will have a good experience. This belief is not always accurate. Societal changes post-COVID-19, has spurred the separation between patient experience, which encompasses all patient interactions with the healthcare system, and patient satisfaction, which measures how well the patient’s expectations were met, has become more apparent. What has changed is the “retailization” of healthcare, in which patients view healthcare services through a consumer’s lens, which has led patients to desire more from their healthcare experiences beyond healing. In turn, it has become vital for healthcare facilities to increase their consideration of brand, customer service, aesthetics and other factors related to comprehensive well-being during a healthcare visit or hospital stay. Experience and satisfaction are intertwined but separate entities.

Patients are empowered with additional information and more choices, and their healthcare decisions
are profoundly influenced by their most recent personal experience or the recommendations of their social circles. Patients have become discerning and astute consumers. Consequently, the significance of patient experience as a key influencer of healthcare decisions cannot be overstated in today’s environment.

As such, the role of facility managers is evolving to meet the changing needs of the healthcare industry. Part of this evolution involves properly capturing data and making informed decisions that help to provide exceptional patient experience. While FMs traditionally collected data on the operations side, such as for HVAC, backup generators and lighting, it is now time to collect data on the softer elements of healthcare facilities. These softer elements include aspects like perceptions of cleanliness, comfort, family accommodations and numerous other factors that contribute to the overall patient experience. This shift in focus underscores the vital role that FMs play in shaping patient experience, and it is crucial for them to have a clear plan to address these elements.

The Importance of Patient Experience

Due to the significance and importance of the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS), “patient satisfaction” has been the healthcare industry’s focus. This can be problematic when the term is confused with “patient experience.” Satisfaction surveys are concerned primarily with healthcare outcomes, but with the industry’s ongoing retailization, patient experience covers a broader range of considerations.

Furthermore, designing for a patient-centric approach to healthcare leads to spaces that can support healing and well-being through natural light, noise control, privacy, restorative elements and comfort. Healing remains paramount, but managing a patient’s stress and anxiety is also important. The healthcare industry tends to catch people at low points, and easing the accompanying feelings and emotions through the design and maintenance of facilities can help create optimal outcomes.

Changing Roles of Facility Personnel

One of the most prominent trends in healthcare is the shift, both physically and culturally, toward a retail-type experience. People can now choose their medical services based on experience, as they would in a retail setting. Net promoter scores, long a valued metric in market research and retail, are now important in an environment where hospitals and other facilities hope to gain patients and popularity through word-of-mouth recommendations.

This evolving period of retailization also means plenty of change for FMs. Sustainability, reducing waste and emissions, improving efficiency and implementing additional cost-saving measures are now accepted as major portions of the role, while COVID-19 brought heightened safety protocols and preparation for future health emergencies to the forefront of discussions.

In addition, operating costs continue to rise, which places budgetary pressure on administrators hoping to improve patient experience by building new spaces or re-imagining existing settings. The onus falls on FMs who must reinvent their roles and rethink approaches to helping patients and their families enjoy the best possible experience without additional expenditures. Proactively addressing these issues means considering each aspect of a facility from multiple angles. For example, it is no longer enough to simply buy durable furniture — it is important to have furniture that is aesthetically pleasing and comfortable to accommodate people of different sizes and abilities.

One of the biggest mistakes FMs can make is underestimating the importance of patient experience and forgoing the importance of a comprehensive needs assessment. This evaluation is critical for successful capital planning and incorporates factors including:

• Existing assets: Gathering existing data and assessing the value and condition of the facility’s current features.
• Forecasting future demands: Determining the needs of the facility over a given period.
• Considering demographic trends: Examining data across different populations and considering the experiences of all healthcare community members.
• Regulatory requirements: How well is the facility keeping up with evolving trends in the greater healthcare space, specifically compliance with governmental and additional regulations?

With so many potential projects, prioritization is critical in an environment with limited resources. Engaging stakeholders across the organization is essential to ensure alignment with overarching strategic initiatives when deciding which projects to address immediately.

Capturing Experience-Related Data

Collecting up-to-date, accurate data is the FM’s greatest ally in determining which projects to prioritize to improve patient experience. Equally important is the integration of data from others across different roles throughout the facility to provide a comprehensive, no stone left unturned perspective to see how everything works together throughout the facility. The more data available, the greater the ability to:

• Remove bias. Incomplete data leads to overemphasis on specific elements of the patient experience, while thorough reporting allows decision-makers to see the entire picture and consider perspectives from throughout the organization before choosing a direction or initiative. With many stakeholders expressing different priorities across the organization, a lack of data can cause facilities to rely too heavily on individual opinions.
• Utilize evidence-based design. Just as evidence plays an essential role in patient treatment, it can also do so regarding patient experience. Collecting thorough data about beds, equipment, and other aspects of the healthcare environment allows for more scientific decision-making and the creation of evidence-based design.

How can FMs gather that data? They can collect more data points by asking the right questions and ensuring patients and families have ample avenues for providing feedback. The heavy reliance upon HCAHPS has created gaps in the data, with patient response rates at 25 percent or lower from 3,300 hospitals from 2018-2021. Even those responses do not adequately address patients’ relationships with their care teams and how those interactions impact their overall feelings about their experience in the hospital or facility. Only two of the 29 questions on the HCAHPS address the physical environment whatsoever: they ask about the cleanliness of the patient’s room and bathroom and whether the area around the room was quiet at night. Such a lack of relevant data does not paint a full picture of patient experience.

Metrics and key performance indicators (KPIs) can be scarce in directly evaluating patient experience and warrant further consideration. Metrics that address efficiency and effectiveness, such as cost per procedure, emergency department wait time, hospital occupancy rate and the average length of stay, all contribute to patient experience but require integration with other metrics to speak to overall patient experience.

Real-World Applications of Patient Experience

The healthcare industry is beginning to take patient experience into greater account, as evidenced by the work of organizations that definitively explain the difference between patient experience and what’s measured by surveys. Organizations must define patient experience as the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.

Today’s patients are increasingly choosing medical services based on their experience, which requires facility leaders and staff to recognize the difference between the patient’s experience and satisfaction. Everyone in the healthcare organization is responsible for crafting the patient experience. Creating the overall patient experience involves not only clinicians and staff but also those tasked with technology and the physical environment. In the end, though, facility managers are critical in manifesting a healthcare organization’s model of patient experience via the physical healthcare setting.  

This article was originally published by Facility Management Journal.

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