Healthcare employees could hold the key to a revealing new data set

Matthew Lawlor

Matthew Lawlor is executive chair of the Ceca Foundation, a not-for-profit that partners with hospitals and other healthcare organizations to recognize their exceptional caregivers and help improve the patient experience.

We live in a world that is utterly flooded with customer satisfaction surveys. If your email inbox is anything like mine, it is chock-full of unread requests for feedback on many of the goods and services you have tried in the past days, weeks or months. In our ever-digital universe, feedback is data. We all know how powerful data can be—especially in the healthcare industry. Indeed, it is extremely important that health system and hospital executives understand where there might be room for improvement in their organizations. Truth be told, an understanding of performance can be a matter of life and death, or quality of life, for patients.  So it is a good thing that we have the 29-question HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems), aka “H-caps” survey. It is also valuable when healthcare leaders look to the tried-and-true metric of the Net Promoter Score (NPS), which questions patients directly on how likely they would be to recommend a facility to family and friends. Nonetheless, I believe both measures, and many other satisfaction metrics, are missing something critical—employees. Healthcare leaders who aren’t listening closely to their employees are passing on the chance to gain insight from workers sitting in the front-row seats of their organizations. Some healthcare leaders have started using what is called eNPS—or “employee Net Promoter Score”—to measure employee workplace satisfaction. The eNPS typically asks: “How likely are you to recommend XYZ Hospital as a place to work?” This can speak to an organization’s workplace culture as an employer, but it doesn’t really provide insight into patient experiences.  Patient experience data matters tremendously. Today’s healthcare consumers have many choices, after all. With players like Walmart, CVS and others entering the healthcare space, there’s more competition than ever with many entities offering varying levels of convenience and quality. Health system leaders and hospital executives need strategies for leveling up their game for patient satisfaction, as well as their safety and the quality of their care.  Why not ask healthcare employees a new question: “If the need for care arises, how likely are you to recommend your healthcare organization to family or friends?” This twist on NPS—which was created out of necessity shortly after our organization’s founding—turns employees into patient experience proxies. We call it the “caregiver Net Promoter Score” or cNPS. We administer cNPS as part of an anonymous, web-based survey, which takes no more than a few minutes to complete. Hospital executives and health system leadership teams could easily—and for a low cost—duplicate a similar system. Why ask workers? Employees are more keenly interested in the viability and reputation of their healthcare facilities than most patients. Plus, they know more than patients because they have daily, long-term, behind-the-curtain perspectives. In other words, when someone who knows how the sausage is made recommends the sausage or does not, it just means more.  The healthcare leaders we serve are often fascinated by cNPS data and how they measure up. After a baseline is established, healthcare leaders can set internal and external goals, track improvements and get a more complete picture of the patient experience. Executives can also gain insights by comparing their cNPS to their NPS scores.  Our organization has tracked cNPS performance data since our program launched eight years ago. Because we serve multiple hospitals and healthcare communities, we can also compare healthcare partner performance to a blind pool of other similar-sized members in our network. Healthcare providers outside our network may compare their blind scores with peers using trusted third parties such as those within their own healthcare systems or purchasing groups.  I urge healthcare leaders to experiment with the cNPS metric. There is an enormous upside in promoting teamwork and a consistent focus on patients. Above all, by collaborating with their workforces, executives can convey trust and respect.  Most of us who have witnessed the power of a healthcare employee’s “high-touch” care can appreciate how it humanizes and complements the “high tech” of modern medicine. Hidden below the surface is another benefit of caregiving excellence: Healthcare employees provide a unique window into the patient experience.  I firmly believe those healthcare leaders who seek out employee insights will be able to guide their organizations more strategically and sensibly to improved safety, better patient outcomes and overall excellence.