Community Health Network has expanded its patient experience survey strategy beyond traditional CAHPS surveys to capture a more comprehensive view of the patient journey. Recognizing the limitations of post-transactional surveys, they now focus on understanding all points along the healthcare experience. By partnering with Qualtrics, they collect data on care access, emergency department experiences, and more, using insights to drive operational changes. Additionally, they employ patient segmentation to promote health equity. This holistic approach aims to enhance healthcare quality and patient satisfaction.
Patient experience surveys have played a transformative role in capturing the sentiments of patients and guiding efforts to improve healthcare quality. However, at Community Health Network, the traditional Consumer Assessment of Healthcare Systems and Providers (CAHPS) survey has limitations when it comes to enhancing the patient journey of care.
While CAHPS surveys are undeniably essential and have various functions, including informing value-based payments and populating CMS Care Compare websites, they are not suitable for addressing all aspects of the patient experience, according to Dr. Patrick McGill, Chief Transformation Officer at the non-profit Community Health Network, which operates over 200 clinics and hospitals nationwide. CAHPS surveys primarily focus on individuals who have completed an episode of care, including those who successfully obtained an appointment, visited the clinic, and received treatment.
Dr. McGill pointed out in an interview with PatientEngagementHIT that these surveys have limitations. “When you think about it from just a post-transactional survey standpoint, that doesn’t tell you anything about the journey,” he said. “First off, it just tells you the winners, right? It tells you the experience that people who kind of ‘won’ because they were able to get an appointment, they had the appointment, they were able to get to their appointment.”
Recognizing the need to improve the comprehensive patient experience, Community Health Network expanded its patient survey approach to capture a broader range of care experiences.
Dr. McGill questioned, “But what about all the other people? And what about all the steps that it took them to get to that experience?”
In the United States, it is not uncommon for patients to go without care, with approximately 100 million people lacking a usual source of primary care, according to February 2023 figures from the National Association of Community Health Centers (NACHC). While Community Health Network doesn’t have specific data on how many individuals attempt to schedule appointments but cannot, they are actively working to understand this issue better. They are engaging with patients who do not end up booking appointments to inquire about the reasons behind their decisions and the conditions under which they would be able to schedule one.
Furthermore, the organization is determined to uncover specific barriers to care access faced by the populations it serves, comprehensively assessing various elements of the patient care journey.
Dr. McGill emphasized, “The value for us when it comes to patient experience data is that longitudinal journey, in understanding all the points along the patient experience, not just the post-transactional and not just the care that they had. That stuff is very important to us. We want patients to have excellent care, but we want their entire experience, all of their interactions with us, to be excellent.”
In 2020, Community Health Network partnered with Qualtrics, a survey firm, to revamp its patient experience survey strategy. The organization shifted its focus away from solely relying on post-transactional surveys like CAHPS and began incorporating surveys that capture different aspects of the healthcare journey.
For instance, the organization has been reevaluating patient care access, considering metrics such as the third-next available appointment, schedule capacity, and the time it takes to receive care. However, Dr. McGill realized that these metrics did not effectively capture the voice of the patient. For instance, if a patient called on a Tuesday to schedule an appointment for the following Monday, the data would indicate a wait time of six days, which may appear high. However, this might not reflect the organization’s ability to meet patient needs. Therefore, Community Health Network introduced an access survey that asks questions like whether the scheduled appointment met the patient’s needs and if not, whether it was due to the patient’s or provider’s schedule, aiming to use the data to make operational improvements.
Additionally, the organization has implemented patient experience surveys in the emergency department, a setting known for poor patient experience scores, often due to long wait times. In 2023, researchers reported that ED wait times could reach nearly 6.5 hours. By collecting data on the drivers of poor experiences, particularly communication issues, Community Health Network aims to improve the patient experience by setting clear expectations for wait times.
As Community Health Network delves deeper into patient experience surveys covering various points in the healthcare journey, they use the insights gained to adapt their operations. This includes making changes based on patient feedback for clinicians in real time. Moreover, they employ patient segmentation to ensure equitable care delivery, considering factors such as race and ethnicity, to identify where additional resources and improvements are needed.
The ability to segment patient responses by race and ethnicity is a novel feature of their survey tools, aligning with their efforts to promote health equity. To support this, the organization has reviewed data fields in its Epic EHR system and provided training to administrative staff on discussing the collection of race and ethnicity data with patients during intake.
Looking ahead, Community Health Network plans to better understand non-response bias and continually track and monitor their response rates to identify gaps and areas for improvement.
Overall, the Community Health Network has recognized the limitations of traditional CAHPS surveys and has adopted a more comprehensive approach to patient experience surveys, aiming to improve healthcare quality and the overall patient journey.
