Some studies have shown how letting patients grade their doctors can lead to overtesting and overtreatment as doctors, hoping to improve their scores, bend to unreasonable patient demands, but a new study in the December issue of Academic Medicine links good patient satisfaction scores with good patient outcomes.
“What we underestimated was how being transparent with our scores would be such a force for cultural change within our organization—a catalyst for engaging physicians in patient-centered care and the glue to further cement the physician-patient relationship,” says University of Utah Health Care (UUHC) CEO and the study’s lead author Vivian S. Lee, MD, PhD, MBA.
The UUHC’s “exceptional patient experience” initiative was launched in 2008 with the mantra, “medical care can only be truly great if the patient thinks it is.” The effort culminated in 2012 when UUHC became the first academic medical center in the country to put its patient reviews online, complete with unedited comments and an accessible five-star ranking.
The University didn’t initially set out to go public with its scores. The original goal was to improve service and patient care. In 2008, UUHC was saddled with patient complaints about delays in the scheduling of appointments, poor communication, and lack of professionalism, among other things. Federal patient satisfaction scores placed the system in the 34th percentile nationally, and its quality metrics were average compared to other teaching hospitals.
“What began as a patient satisfaction initiative evolved into a model for physician engagement, values-based employment practices, enhanced professionalism and communication, reduced variability in performance, and improved alignment of the mission and vision across hospital and faculty group practice teams,” the study authors write.
Over the past 7 years, patient satisfaction has markedly increased. Half of UUHC providers now rank in the top 10% when compared to their peers nationally, and 26% rank in the top 1%. Neither the quality nor the cost of care has suffered. In fact, for 6 years running, UUHC has placed in the top 10 of the University HealthSystem Consortium’s rankings, a comparison of the nation’s teaching hospitals based on quality and safety. What’s more, UUHC has managed to bend its cost curve even as costs nationally continue to rise.
Employee satisfaction also improved, revenue and patient volumes are up, and malpractice litigation declined, resulting in a drop in premiums.