Patient SatisfactionPatients are at the center of the medical practice, and with the emphasis on coding, billing, revenue, and all the other changes to come in this upcoming year, we believe that it is important that organizations don’t forget to focus on the one thing that can not only make or break their practice….but impact their revenue stream….patient satisfaction.  Due to several changes brought about by healthcare reform, patients as consumers will be more empowered than ever.  With transparency protocols being set into place the patient will now have access to cross compare pricing across facilities for the first time ever.  With the implementation of healthcare ratings, they will also have access to knowing how your hospital or practice stacks up against the competition.  Finally, reimbursement can be directly tied to the satisfaction rating of the patients that you serve, and low patient satisfaction rating can decrease the amount of reimbursement a facility receives.  Unhappy patients will equal an unhealthy bottom line.  So, how can you begin to address patient satisfaction, and make your healthcare organization respond positively to this newly empowered group of healthcare consumers?  Here are 10 places to get started in increasing your patient satisfaction ratings:

1. Know you current satisfaction rating across multiple dimensions to establish a baseline for improvement

You won’t know where you are unless you ask.  In order to establish an effective baseline for patient satisfaction you need to begin with creating a patient satisfaction survey, and you need to be sure that you are getting respondents. Most accrediting organizations insist upon surveying at least 25% of your patients, however many organizations fall short of getting this percentage of respondents.  Make getting patient satisfaction responses from at least a quarter of your patients your first goal, and get creative in gathering the information by allowing people multiple opportunities to respond.

  • Allow patient satisfaction surveys to be filled out at the time of appointment during check-out or as part of the discharge process, and make this a priority.  If a patient leaves without completing the survey your response level will decrease by 80% so take advantage of getting feedback when the patient is at your facility
  • For returning patients, incorporate the satisfaction survey into regular check in documentation
  • Send follow up emails post appointment with links to online patient satisfaction surveys immediately after a patient is seen
  • Offer incentives for filling out the survey, such as reward cards or a percentage off of the co-pay at the next visit – get creative to get to your 25%

2. Make sure that you gather details in your survey, and be prepared to drill down in the analysis

Some surveys are just too general to impact any real change.  Every effective patient satisfaction survey should allow for some level of detail so that you can conduct meaningful analysis and bring about real change for your patients.  This is especially important for facilities that have multiple departments.  If your survey is too broad you may have one department with exceptionally low ratings, and another with exceptionally high ratings but without the detail you will not be able to target areas for improvement.  It is also important to be able to drill down into survey detail by provider.  This will allow you to focus resources and training on those staff which have low ratings to create more dramatic improvement.  With this in mind, remember to also keep it brief.  The best surveys will have some general information to be filled out (you can pre-fill this by department or provider to make the survey easier for the patient with information such as procedure or visit type and provider) as well as an open ended area where the patient can provide some general insights.  The survey should never take more than 5 minutes to complete, but those offering incentives can have an 8 minute completion time for surveys and still get good results in the number of respondents.

3. Don’t just rely on patients, also rely on staff

Staff may have additional insight on how your organization can improve satisfaction, be sure to gather this insight quarterly in an anonymous manner.  Front desk staff can be especially helpful in providing information on common complaints that they hear from patients which may not have made it into your survey.  Gathering information from multiple sources and multiple perspectives will allow you to have a better feel for overall satisfaction that goes beyond the paper and electronic survey.

4. Focus on the front desk, and appointment scheduling staff

Front desk staff, and those who schedule initial appointments are your first point of contact with new and existing patients, and customer satisfaction should begin here.  Make sure that your staff are personable, well trained, responsive, and go above and beyond for the patient. First impressions do count, and interaction with these staff members is the first impression that a patient gets of your facility or practice so ensure that it is a good one. Deeply involve these staff in customer satisfaction initiatives, and pay careful attention to survey responses that address inadequacies in this area.

5. Examine your patient wait times, both for appointment setting, and in the waiting room

Nothing lowers patient satisfaction more than inappropriate wait times.  This applies to how long it takes to make an appointment with a provider, as well as how long a patient actually waits in the facility before being seen.  According to Kevin, MD A study found that the average patient wait time is 24 minutes.  This is unacceptable for patients, and those facilities which have the highest satisfaction ratings have an average patient wait time that is no longer than 15 minutes.  Here are some ideas to trim down patient wait times at your facility or practice:

  • Implement wave scheduling, or modified wave scheduling instead of traditional scheduling – this will allow your healthcare organization to not only maximize the number of visits per day, but decrease wait times for patients and allow open slots for same day visits.
  • Don’t let front desk processes hold up your patient flow – pay particular attention to what time the patient arrives, and when they are brought back to be seen, and make it your goal to decrease this time by eliminating time consuming or inefficient processes. (allow for online registration for appointments, and allow paperwork to be filled out before the patient presents for an appointment either at the time of scheduling or via an online mechanism)
  • Don’t overbook.  Let me say this again….Don’t overbook – practices and facilities often overbook to compensate for no-shows.  There are a variety of ways to more effectively deal with missed appointments which will not have your providers overtaxed and your patients dissatisfied.  Overbooking should never be a strategy
  • Patients calling for an appointment should always be able to get one within one week.  This is the golden rule of scheduling.  Patients who need a same day appointment should also have the ability to schedule these.  If your patients have to wait more than a week to be seen, or cannot get a same day appointment when they need one this is a sure sign of scheduling disorganization.  Consider evaluating your capacity for new patients, and work with other providers to create a referral network so that if you are unavailable there is still someone there that a patient can see in an emergency situation.
  • If a patients wait time will exceed 15 minutes, communicate with the patient.  It happens to even the best practitioners, emergencies come up and sometimes wait times will exceed 15 minutes, but do you let your patients know?  Front desk protocols should be put in place when a provider is running behind schedule to provide patients with updates on when they will be seen, and delay notifications can improve satisfaction even if the wait time is longer.

6. Don’t underestimate the aesthetics of your facility

Would you rather spend your wait time here?

Would you rather spend your wait time here?

There has been much research conducted on the way that the look and feel of a waiting room psychologically impacts your patients.  What does your waiting room say about your organization?  Is it clean?  Is there something to do which will occupy a patients time while they wait?  Here are some great recommendations and resources on how the “look and feel” of your facility can have an impact on the patient:

  • In this post by Susan Labarre, six recommendations are offered to improve the waiting room including; comfortable seating, manageable queues, healthy food, welcoming signage, clear medical records, and offering a communal space
  • In this post, the fact that a poorly designed waiting room could be costing you patients is explored
or here?

or here?

When getting a feel for the effectiveness of your waiting room, walk in your patients shoes.  It is surprising how many providers have never actually spent any time in their own waiting rooms.  Have each provider spend 30 minutes in the waiting room and record their observations.  Was the seating comfortable?  Was there something there to occupy their time?  Was the room clean? (this is a big one). Pay particular attention to how to carve out special places in the waiting room for certain patients.  Is there a distinct seating area for those who may be contagious?  Is there a place for children, or activities that can engage children while they wait?  Take a second look at your waiting room from the patients perspective and determine where you can make improvements.


7. Get personal with your patients

One of the best ways to ensure that you get great patient satisfaction ratings is to provide a personal touch for your patients.  One of the best ways to do this is with a follow up call to patients post any major visit or procedure.  If your patient came in for something other than a routine check up, provide a personal follow up call with them to see how they are doing.  This has been 100% proven to boost patient satisfaction ratings of providers, and can offer some offset benefits.

  • Follow up calls can allow you to determine if a patient is progressing as planned, or may need to come in for another visit and can help avoid poor outcomes
  • Follow up calls aid in increasing medication adherence.  Was your patient able to get their prescription filled (are there any barriers here, such as cost?), are they taking their medication, are there any side effects? A short conversation with a patient post visit can greatly improve not only patient satisfaction, but medication adherence and will help you eliminate barriers to patient treatment while instilling loyalty in your patients.

For any major medical procedure, or any treatment which takes place in the hospital setting follow up calls should always be conducted.  If the physicians availability does not allow for this, a nurse practitioner should be tasked with making these calls and documenting their outcomes in the patients chart.  For primary care providers this is an excellent strategy to provide the kind of care that patients seek and creates a provider patient bond that will keep your patients loyal to your practice.

8. Bust through patient barriers

One of the primary emphasis to creating high quality outcomes in the treatment of patients is the elimination of patient barriers.  Depending on your patient population these can differ greatly, but here are some examples:

  • Cost can be a huge barrier to care – provide resources on how patients can obtain healthcare coverage in your office, and be able to refer them to help lines or online resources.  When it comes to medication and procedures, make sure you have an understanding of the patients financial situation.  If a patient is paying out of pocket for care, you may want to consider which medication you prescribe to help them manage healthcare costs.
  • For Medicare patients provide information to social resources in your office, some patients may struggle to get to appointments due to transportation or may not understand how to navigate the healthcare system.  Provide information and programs which are local to these patients and may be able to help
  • Many patients struggle to make appointments because of the operating hours of an organization.  Consider having availability for evening or early morning appointments a few days a week to accommodate busy working professionals, in the pediatric practice this can be useful for patients who need to be seen, but whose parents do not want them to miss school
  • Referrals- many patients do not have a primary care provider, others may struggle with behavioral health issues, but have no designated behavioral health provider.  Be prepared to have a referral network to assist your patients in getting the specialized care that they require.  As an offset benefit, establishing this referral network should ensure that you get access to new patients as well, and can help multiple providers collaborate when it comes to total patient care.

9. Communicate with your patients through a variety of mediums that suit all demographics

Communication is key to patient satisfaction, and great communication should be emphasized within the healthcare facility as well as outside of the healthcare facility.  Pay attention to how your patient likes to communicate, and respond appropriately.  Technology can be a great advantage in improving patient communication as well as breaking down barriers to care and creating an optimally efficient patient flow.

  • Ensure that your healthcare organization has an effective easy to navigate website that provides the patient the information that they need.  A great idea is to have a FAQ section on your site that provides common answers to the type of inquiries that your patients get the most
  • Put common forms on your site so that patients can download them and fill them out before coming in for their appointment, also encourage the use of online registration for your patients
  • Utilize email campaigns and social media to provide outreach to your patients and get the word out about upcoming initiatives for your practice.  Are you offering flu shots?  Is it time for annual exams?  Is there a special health prevention initiative that your organization is undertaking?  Promote these activities to your patients in a variety of ways to get optimal engagement and enhance the overall patient experience.
  • Ask yourself this question…..Do I have three ways in which to communicate a message effectively to each and every one of my patients?  The answer should always be yes.  Don’t wait to inform patients of things when they are in your office, communicate frequently with mailed newsletters, online newsletter, phone calls, email campaigns, and through social media.  Get the maximum exposure for your organizations initiatives by including all demographics and their preferred correspondence method.

10. Make Payment a Piece of Cake

If you want to maximize reimbursement, make it easier for patients to pay you, and offer financial counseling or other solutions for patients that may need additional help or resources.  Let patients know what the cost of care will be before they get to your office, for primary care.  In the hospital setting, allow patients the opportunity to speak with someone in the finance department prior to a major procedure so that they understand estimated costs, insurance coverage, and can develop a payment plan which meets their needs before a procedure is performed.  For emergent situations, ensure that a follow up call is provided to the patient going over the cost of their recent visit, and establish payment plans or allow them to work with a counselor to determine how to get their care paid for most effectively through their insurance carrier.  Here are some additional ideas:

  • Don’t wait for a patient to show up to collect co-payments, collect co-payments from patients via telephone at the time the appointment is made to ensure prompt payment, and to decrease no-shows
  • If you don’t collect payment up front, collect payment at the time that the patient presents for their appointment – make sure to inform the patient of cost before they get to your office, as well as what type of payment you expect at the time of care
  • For large, or costly procedures, work out a payment plan with patients before they come in by scheduling them an appointment with a dedicated finance counselor at your facility.  If the first interaction your patient has with your billing department is when they are behind in payments, or when it has gone to collections it is not an efficient process.  Financial counseling for major procedures can assist a patient in understanding what their insurance will cover and what it will not, and will help you to determine a payment schedule that meets the needs of the patient post procedure so that they are more likely to stick to it.

Don’t let your patients experience healthcare sticker shock, make the payment part of visits easy can greatly improve patient satisfaction and simultaneously keep your bottom line healthy!


BHM has experience assisting provider, payer, government, and hospital organization improve the financial and clinical aspects of their organizations.  To find out how BHM can assist your organization click below for a complimentary one hour consultation, or email us at

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