We’ve all had that moment where we’re tasked with triaging our brand’s reputation due to some negative customer feedback. It may come in the form of reviews, or survey data, or even a single story recounted to an employee. In health care, it can come from HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) data. But HCAHPS have their limitations, and may not be providing the information you need to uncover how the experience is falling short, and where efforts are best spent to improve your brand’s image. How do you make the case for going beyond HCAHPS to understand your brand experience?

As the health care industry evolves, many organizations are placing higher importance on the patient experience, even making it a part of their brand and business strategy. This makes capturing patient feedback and understanding their experiences critical to delivering on your brand promise. Most organizations already receive HCAHPS data. But if you’re using HCAHPS as your only source of information about the patient experience, you’re only getting part of the story. Patients have so much more they want to share with you.

HCAHPS were designed with a specific purpose in mind: standardizing the assessment of the inpatient experience to enhance hospitals’ public accountability and transparency of the quality of care. With the objective of enabling “apples to apples” comparisons of hospitals, HCAHPS were developed to support consumer choice and reimbursements, not to inform hospitals on how to improve the experience. It’s intended to complement data collected by hospitals and health care systems, not replace it—which can create a disconnect when it comes to patient experience.

HCAHPS do matter, but as a part of the broader patient experience story.

Instead of trying to read between the lines of your HCAHPS scores, you should dig deeper into the patient experience to uncover the underlying causes of dissatisfaction. By understanding how to deliver a better overall experience across care paths, and addressing those needs throughout the patient journey, improved patient satisfaction will follow.

The limitations of HCAHPS for understanding patient experience include:

  • Only captures feedback on hospital in-patient care, overlooking the breadth of offerings and care paths offered by hospitals and health care systems
  • Can be administered up to six weeks after discharge, so the experience may not be fresh on the patient’s mind when taking the survey
  • Depending on the size of hospital rated, sample sizes can be too small to be statistically reliable
  • Uses archaic collection methods—phone and paper—which can bias response rates
  • Focuses on frequency (how often and consistently specific touchpoints are delivered), not quality (how well the patient feels it was delivered) or satisfaction (whether it met their needs and expectations)
  • Focuses on specific, predetermined touchpoints (like doctor and nurse interactions and pain management), which may not reflect the full patient journey
  • Scales force respondents to choose a positive or negative response, instead of allowing for neutrality

Additional patient experience work can go a long way toward truly understanding where your brand shines, and where your opportunities for improvement lie.

Here’s what HCAHPS have missed about the patient experience:

The full patient journey

HCAHPS focus on the inpatient experience, but this point of care occurs within the context of the broader journey, and needs to be captured to understand the complete patient experience. Each touchpoint and step in the journey—from making an appointment to billing—influences how patients perceive your brand.

Need state and priorities from the patient’s perspective

Patient needs and expectations are constantly evolving. Patient-centric drivers like individualization, empathy and collaboration have been rising in importance as patients take on a more active role in their care, but these metrics aren’t measured by HCAHPS.


Our perceptions are heavily influenced by how experiences make us feel. To fully understand a patient’s experience, we should explore not just whether functional needs were met, but the emotional needs as well.


If a patient’s overall experience was good or bad, why do they feel that way? Patients don’t have the opportunity to explain their ratings, only to provide the frequency of meeting pre-defined needs and overall satisfaction with their experience.

Ease of navigation

How easy the journey is to navigate—from getting into the hospital to the billing process—can impact a patient’s overall satisfaction, but isn’t assessed by HCAHPS.

Other touchpoints and facilities

As a part of what we do, but not all of what we do, we should look beyond hospital inpatient care to understand how we’re delivering on our patient experience.

Outcomes (from the patient’s point-of-view)

Quality and “success” of outcomes is one of the most important drivers of choice and satisfaction, but HCAHPS don’t investigate whether patients feel like their needs were addressed or issue resolved.

Do you want to know how one health system uncovered over 2,100 patient experiences in one month?   

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April 5, 2018 By Monigle