1. Step Aside HCAHPS—The Other
Questions Hospital Executives Should
Be Able To Answer
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2. The two axioms to remember are:
1. HCAHPS are a necessary but not sufficient way of measuring
whether patients will ever return to your hospital.
2. HCAHPS do not measure the ‘unsurveyed’; outpatients,
discharged patients, former patients and prospective
patients
Step Aside HCAHPS
A remarkable experience for every patient
every time
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3. Hospital should have a global patient experience strategy that
creates a remarkable experience for two groups of people.
• Patients—how do you get them to come back and to refer
others
• Non Patients—how do you create a remarkable enough
experience to get them to become customers
You cannot get people to come back who never came.
Step Aside HCAHPS
A remarkable experience for every patient
every time
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4. Someone’s experience of your hospital begins and ends with
access.
• If the hospital cannot even provide meaningful responses
when someone calls to schedule an appointment, it may not
matter how noisy the hospital is because that person will not
become a patient.
Step Aside HCAHPS
A remarkable experience for every patient
every time
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5. The patient’s experience is an individual experience, however
it is reported and managed as though it is ubiquitous.
• A patient’s experience is made up of both their clinical and nonclinical
interactions with the health system. That experience is greater than the
one defined by CMS.
Total Quality of a Person’s Encounter (TQE)
TQE = Patient Experience (HCAHPS) + All Other Interactions
Things to Know About Patient Experience
A remarkable experience for every patient
every time
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6. Total Quality of a Person’s Encounter (TQE)
A remarkable experience for every patient
every time
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Pre Hospitalization Post HospitalizationHospitalization
HCAHPS Experiences
Non Clinical Experiences;
patients, family, friends,
parking, food service
Website, patient portal,
call center, CRM,
social media, scheduling,
admissions, 2nd opinion,
referrals
billing, collections,
claims, scheduling,
therapy, appointments,
Unsatisfied prospects
leave w/o buying
Unsatisfied patients
don’t return or refer
Hospitals ignore much of an individual’s experiences and the opportunities to
increase their satisfaction, the dark blue areas.

7. The hospital with the highest HCAHPS score probably does
not have the highest TQE score.
• Patient Experience, HCAHPS, focuses on improving patient
safety and quality
• Patient satisfaction focuses on improving patient retention
and patient referrals, in other words, sustainability.
Things to Know About Patient Experience
A remarkable experience for every patient
every time
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8. To increase TQE, hospitals should be able to answer these
questions:
Question 1:
What are your hospital’s patient touchpoints before,
during, and after hospitalization
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every time
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9. To increase TQE, hospitals should be able to answer these
questions:
Question 2:
Which patient touchpoints are most frequented
A remarkable experience for every patient
every time
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10. To increase TQE, hospitals should be able to answer these
questions:
Question 3:
Which patient touchpoints have the greatest impact on the
Total Quality of the Patient’s Encounter
A remarkable experience for every patient
every time
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11. To increase TQE, hospitals should be able to answer these
questions:
Question 4:
What percentage of your hospital’s patients does it retain
A remarkable experience for every patient
every time
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12. To increase TQE, hospitals should be able to answer these
questions:
Question 5:
What percentage of your hospital’s patients refer other
patients
A remarkable experience for every patient
every time
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13. To increase TQE, hospitals should be able to answer these
questions:
Question 6:
What is the lifetime value of a patient over 25 years
($200,000 to $250,000)
A remarkable experience for every patient
every time
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14. To increase TQE, hospitals should be able to answer these
questions:
Question 7:
What is the ROI of a patient’s family
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every time
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15. To increase TQE, hospitals should be able to answer these
questions:
Question 8:
Do more people visit your hospital’s website every day than
visit your hospital
A remarkable experience for every patient
every time
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16. To increase TQE, hospitals should be able to answer these
questions:
Question 9:
Can people access your hospital whenever they want on
whatever device they want
A remarkable experience for every patient
every time
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17. To increase TQE, hospitals should be able to answer these
questions:
Question 10:
What percentage of people call your hospital that you never
hear from again
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every time
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18. To increase TQE, hospitals should be able to answer these
questions:
Question 11:
What percentage of people visit your website that you never
hear from again
A remarkable experience for every patient
every time
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19. To increase TQE, hospitals should be able to answer these
questions:
Question 12:
What are the biggest gaps with access
A remarkable experience for every patient
every time
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20. To increase TQE, hospitals should be able to answer these
questions:
Question 13:
Does the hospital have an effective definition of TQE for its
health system
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every time
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21. To increase TQE, hospitals should be able to answer these
questions:
Question 14:
Why did the hospital’s patients choose your hospital
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every time
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22. To increase TQE, hospitals should be able to answer these
questions:
Question 15:
Why did prospective patients choose a different hospital
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every time
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23. To increase TQE, hospitals should be able to answer these
questions:
Question 16:
Why did patients choose not to return to your hospital
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every time
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24. To increase TQE, hospitals should be able to answer these
questions:
Question 17:
What could the hospital change to create ‘patients for life’
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every time
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25. To increase TQE, hospitals should be able to answer these
questions:
Question 18:
What percentage of patients who call the hospital have their
needs met during the call (this answer may astound you)
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every time
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26. To increase TQE, hospitals should be able to answer these
questions:
Question 19:
What is being said about your hospital on the internet
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every time
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27. To increase TQE, hospitals should be able to answer these
questions:
Question 20:
What touchpoints should the hospital be benchmarking
regarding TQE
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every time
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28. To increase TQE, hospitals should be able to answer these
questions:
Question 21:
Does the hospital’s website allow people to accomplish what
they want (how do you know)
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every time
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29. To increase TQE, hospitals should be able to answer these
questions:
Question 22:
What is the ROI of the hospital’s business development and
sales and marketing group
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every time
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30. To increase TQE, hospitals should be able to answer these
questions:
Question 23:
What are the top three things your hospital could do to
improve family experience
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every time
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31. To increase TQE, hospitals should be able to answer these
questions:
Question 24:
Are patients able to accomplish every task online that they
could accomplish if they came to the hospital
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every time
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32. To increase TQE, hospitals should be able to answer these
questions:
Question 25:
Can patients accomplish these same tasks at any time on any
device?
A remarkable experience for every patient
every time
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33. To increase TQE, hospitals should be able to answer these
questions:
Question 26:
Who designed the hospital’s patient experience strategy, the
hospital or the patients
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every time
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34. To increase TQE, hospitals should be able to answer these
questions:
Question 27:
What would your patients change to improve TQE
A remarkable experience for every patient
every time
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