What do patients expect from healthcare organizations

Today we have a special guest writing in our blog. It is José María Iribarren, Patient Experience Director of the Spanish Healthcare Service in Navarra. Usually in this blog we approach to patient experience from a close and micro point of view; an ethnographic approach. For this reason we find it interesting to know if somebody with broad perspective, a macro perspective, someone who has managed needs and complaints of thousands of persons describe coincidences. Indeed, Iribarren writes how information is one of the key pillars of patient experience, above comfort and hospitality; without denying the importance of the latter.

José María Iribarren Gasca, Patient Experience Director at the Spanish Healthcare System in Navarra
José María Iribarren Gasca, Patient Experience Director at the Spanish Healthcare System in Navarra

By José María Iribarren, Patient Experience Director at the Spanish Healthcare Service in the Navarra region

 Is it possible to define a ranking of patient expectations? Since we like pyramids so much. Can we find in healthcare consumption basic or essential expectations? Can we order them by importance?

Few would doubt to choose a well done surgery than having wifi in the room, if we get radical. But if we go in depth into the different kinds of expectations, are we sure what makes really the consumer experience in healthcare?

This post is not a scientific analysis on patient expectations, but I  would like to open a debate and research line based on my experience as patient Experience Director in Navarra.

Using quantitative materials (surveys and complaint statistics) as well as personal events like conversations with patients, particular experiences, specific complaints I do dare to make a first proposal of 4 kinds of patient expectations, we could of course enrich and categorize.

  1. Healing
  2. Organization and accessibility
  3. Communication and information
  4. Comfort

We at the healthcare systems have the mission to attend patient needs in the best possible way. And if anything is evident to me is that healing is, of course, the basis of a hypothetical patient’s expectation pyramid. And this expectation is so important that any failure in the other kind of expectations is forgiven or forgotten if this expectation is fulfilled.

Organization and accesibility
We can ask ourselves if healthcare organization and accessibility are not included in the former point, healing. Indeed it is like that. For instance a wrong waiting time can have a negative impact in the healing process. Yet there are other cases where an organization or accessibility that can be improved have a lower impact in patient experience. I would like to describe two examples.patient knowledge

At organizations that are based on care processes and not on patient, the fact that care is divided by departments (when different services participate) may not influence the patient’s medical evolution. Yet, a change towards a more integrated approach will probably impact in a powerful way the perception of quality by the patient.

We can find another example in processes that we might consider “not severe”. A person may need to wait one year for a bunion operation. The waiting will be long and unpleasant and will produce a negative perception. But a successful result will mitigate this perception.

interactionCommunication and information
Recently I had the opportunity to listen from two different people that went through difficult health situations with a happy end the same words: “to me it is indifferent who the physician is and if he is unpleasant or not as long as he cures me”. Would these people say the same if the end was not happy? Would in that case the physician’s personality be determinant in the perception of care?

The truth is that 90% of complains have their origin in communication and information problems, that are worsen by a medical result that does not meet patient’s expectations. We work with a science that is not exact and where results can be always negative. Here communication is the key element that shapes the user experience. It is the factor that prevents or produces complains or even litigation.

But don’t let us see communication as a “preventive” tool;  when communication works (which includes also  proper information) it is the ultimate tool to produce an excellent patient experience. Including in many cases a better follow up of the case and improved healing.


A hospital is not a hotel
A hospital is not a hotel

Comfort is important; there is no doubt about this point. Clean facilities, appropriate hospitality or a pleasant temperature have impact on healthcare quality and onn patient perception about the service. But, how? In a definitive manner or acting like the gift’s ribbon? In a society where consumers are more and more demanding, comfort becomes increasingly important. Yet, in a moment were public investments decreases, how important is really comfort for users? And is this importance higher in private than in public healthcare?

Other needs and categories
Now that we have presented the issue, can you think, dear reader, on other needs? Can we establish categories for these new groups? I am convinced that this is possible and I am convinced that if we can find out the real needs of patients we would have an excellent tool for planning, projects, training, innovation and investments.

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