The 5-Star Patient Experience: What do Stars Have to Do With It?

May 15, 2015

In the beginning, there was only accreditation.

Then, there were surveys to measure patient satisfaction.

Then, there was a survey to measure the patient experience.

Now, there are 5 stars.

In April, the CMS instituted the 5-star rating, supposedly to make it easier for consumers to understand.  However, this oversimplification has substantial risk of misunderstanding and misinformation.

How can we logically reduce the patient experience from 31 HCAHPS questions down to a single group of 5 stars when the questions themselves have implications as long as an encyclopedia?

The results are in for how our hospitals are doing. Modern Healthcare reports that of 3,500 hospitals that have received a star rating, only 251 have been given the top, 5-star rating.

Does that mean that most of us will not be going to the best hospital?  What concerns me, though, is that hospitals are often not comparable to each other and certainly not to a hotel, which is where the rating system was first generated.

So, why isn’t the commonly used 5-star rating system effective in picking a hospital?

1. Cost

5-star hotels are more expensive. Healthcare insurance pays exactly the same, so cost isn’t a factor that dictates the type of “clientele.”

2. Comfort

5-star hotels are luxurious and have lots of amenities. Providing comfort and choice has been shown to improve healthcare outcomes, but that is very different than offering well-appointed environments or extra nice features.

3. Safety & Security

5-star hotels are expected to provide high levels of security and safety. The hospital 5-star rating does not even include issues such as morbidity and mortality, adverse events, or rate of infection.

4. Personalized Staff

5-star hotels have lots of people 24-hours a day to respond to the bidding of every guest.  And, the more money you pay, the better the service.  Waiting time for room service or housekeeping or anything is expected to be minimal.  Furthermore, in a 5-star hotel, no one is in a bad mood.

Hospitals are now consistently understaffed and, unless one is in ICU, the staff to patient ratio is challenging at best.  Waiting times remain too long for the patient who calls.  And, the moods of the staff are irrelevant to the work being done.

Key Take-Aways

The patient experience is a human experience. CMS is trying to mandate an excellent experience when the experience is not just about the place or the person. It’s about both.

Yes, there are hotel and hospitality service models that have come to support hospitals in achieving the best customer service model. However, a patient is not a hotel guest or a customer.  A patient is someone whose health is in crisis and whose bargaining power is sacrificed for life-saving efforts of people they do not know.

The patient experience is informed by what precedes it and what follows.  And, it includes every other healthcare event in the patient’s and his or her family’s life.

The 5-star hospital rating system is pushing patients to select hospitals according to a system that looks familiar, but is not the same at all.

What do you think?

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