The Landmark Blog

Don't Lose Your Patients: Healthcare and Patient Satisfaction Surveys

My first real career goal, the first one I really worked at, the first... "When I grow up I want to be..." was a stunt man.  I had a fascination with Evel Knievel (had his action figure and motorcycle...it's not a doll), as a teenager I loved Super Dave Osborne, and in my youth, I idolized Lee Majors in "The Fall Guy."  If a kid in elementary school could really work toward a career, it was me, I was serious about it.

I had a best friend who egged me on as frequently as he could.  He was my "Agent and PR man" (we were in grade school).  We spent many a day on his Idaho farm practicing for my stunt man career.  I'd dive headfirst off his fifteen foot high haystack to the ground and land in a small pile of loose hay.  Under his watchful eye, I learned how to gracefully "roll out" of falls from high places, backflip out of swings, fall out of trees, and ride pigs.  I even crashed his motorcycle and lived to tell the tale (it was the first time I had ever ridden one.)  Stuntmen need to be able to ride horses, motorcycles, and snowmobiles.  I learned how to do those things from my "Agent".

We often got into trouble, but along with the trouble came plenty of crashes, burns, scrapes, sprains, bruises, and at one time, a broken bone (or two).  The home I lived in while growing up was in the country and had a revolving outside laundry line.  You'd place your wet laundry on the lines, as the wind blew (the wind always blows in Idaho), the lines would spin around in circles, and your clothes would dry faster...ingenious.  My parents had a clothes dryer so the revolving laundry line was unnecessary for its original intent.  As youth looking for an adrenalin rush, my friends and I took down the long extensions (keeping the stronger short "arm" that spun) and tied a rope to the apparatus.  We also tied an old inner-tube to the rope and would sit in the contraption.  Someone would push, while the rider sat in the inner-tube and spun.  You'd swing around in circles a million miles an hour horizontal to the ground and get dizzier than you could imagine.  I'm sure you see where this is going.

One morning while waiting for the school bus, a friend and I were messing around on the "swing".  My friend was a year older than me and kind of a big guy.  He was able to really get that thing rotating very quickly.  In the corner of my yard was an old tractor tire that my mom had converted into a plant box to grow strawberries.  That morning, we swung especially fast, the rope broke, I went airborne, and when I landed my arm slammed into the tractor tire.  My arm hurt pretty badly so I went in the house to tell my mom what happened and that my arm hurt.  When she took off my coat, you could tell my arm was broken because it was shaped like the tread on the tractor tire.  We headed to the doctor's office and found it was broken in two places through both bones.

Each year, hundreds of thousands (millions) of healthcare patient satisfaction surveys are completed ranging from patients that have broken bones or been to the doctor for a cough, to long-term home health and hospital stays.  Patients with terminal illnesses are surveyed and in some cases surveys are done with the families of those that have passed.  Discovery Research Group conducts a large number of these healthcare related satisfaction surveys, health services satisfaction, or patient satisfaction surveys each year.  We work with some of the largest healthcare research organizations to conduct this work for hospitals and health plans, and work directly with some of the small or middle sized clinics and local companies who do not have the research budgets to implement the full scale healthcare research initiatives that these large healthcare research organizations provide.

I was in a conference session several months back with a number of researchers who were interested in healthcare research.  When the speaker surveyed the audience about how many were doing healthcare work on a large scale there were very few of us.  I was a little surprised that our expertise in this patient satisfaction survey arena was as unique as it was.  Along those lines, here are ten suggestions for surveying healthcare respondents (especially patients and participants) the next time your research calls for it:

• Be sensitive to the patient being surveyed.  But, focus on being unbiased in the process.  It's a fine line.
• Be painfully aware of HIPAA and privacy related issues.  And, monitor the entire process from front to back (interviewers, online methods, IVR, etc.) for compliance to law, rules, and training agendas.  Include the sponsor of the survey in the compliance plan.
• Find an effective way to juggle the need for good response rates with the need to be sensitive to respondent’s ailments.  It can be difficult.
• Consider multiple methods of collection. Multiple survey methods will help maximize response rates and provides the patient with different ways to vocalize their experience.
• Avoid barriers in survey programming that cause a choppy interviewing process (too many screens before "actual interview", surveys that are too long, survey process that doesn’t make sense, not enough information, too much information, etc.).
• Track your patient sample closely, down to the respondent level.  Healthcare research is very rigorous and a reporting at the patient level should be available for every sample record, without compromising the patient's personal information.
• Provide detailed instruction to technical and interviewing staff on the information that can and cannot be disclosed to the household while getting patient on the phone, while speaking with family members, while interview is completed, etc.
• Clear answers to frequently asked questions (FAQs) are very important.  Provide information on how to answer the difficult questions that will inevitably come up (Where did you get my name?  How do I reach someone at the hospital?  Who should I talk to about…? Why are you interviewing me when I’m sick?  I'm feeling like...should I go to the doctor?).  There is a lot of sensitivity surrounding healthcare related issues and the probability of escalation increases when staff is unable to answer patient questions clearly and concisely.
• Help lines should be established for verifying the legitimacy of survey calls.  Also, make a decision in advance on how to approach the "feedback" you’re provided that is directed to the practitioner, the survey sponsor, the research company, etc.
• A lot of patient and healthcare survey work is done using telephone methodologies for privacy related issues.  Be careful of the dialing times.  Don't dial too late or too early in case the respondent is still recovering.  Also, try dialing at different times during the day and on weekends.  With recovering patients this is critical as they are often in appointments, home during the day, and sleeping earlier and longer.

This is NOT an inclusive list for interviewing patients.  Feel free to add additional recommendations to this post.