Does the Office of Patient Experience Matter in Improving Delivery of Care?

Abstract

T his research examines the performance benefits of the Office of Patient Experience (OPX), a new administrative innovation in the health care industry. OPX is an independent structure within a hospital, having its own annual budget and full-time staff, and is responsible for improving patient experience during the hospital stay. We specifically investigate the effectiveness of OPXs in improving experiential quality (EQ), measured as the quality of interactions between hospital's caregivers and patients. In addition, we look at how the operation of these offices help hospitals manage variability during the delivery of care, which introduces additional challenges to maintaining high EQ. Specifically, we investigate the impact of variability in care delivery introduced due to two factors-patient case mix index (CMI) and resident intensity. CMI is an indicator of patient acuity and their care burden on hospitals while resident intensity is measured as a ratio of residents to beds at a hospital and is a proxy for variability introduced due to disruptions in caregiver teams due to the presence of residents who are getting trained at the hospital. Our empirical analyses involve tracking the operation of these offices across 3615 US acute care hospitals for the years 2007-2014. To account for endogeneity, we used an instrumental variable fixed effects regression model with a least absolute shrinkage and selection operator (LASSO) on the first-stage to identify and select the strongest instruments. Findings suggest that the OPX is associated with 1.95% higher EQ for each year of its operation. Furthermore, we find that an OPX is more effective in improving EQ for hospitals that deal with high CMI patients (6.5% for high vs. À0.3% for low) or high resident intensity (1.8% for high vs. 0.9% low). Moreover, we find evidence of operating efficiencies associated with OPXs, with a 1.4% reduction in operating cost for each year of its operation. Preliminary evidence also suggests that Chief Patient Experience Officers (CXOs), leaders of OPX, with medical backgrounds (i.e., MD or nursing degree) are more effective at improving EQ. Finally, we validate our findings through interviews with OPX and hospital staff at a prominent teaching hospital with an active OPX.

Public policy and operations management

“…Hospitals that focused on process management tended to improve clinical quality, but sometimes at the expense of experiential quality. State legislation initially exacerbated this trade‐off by focusing only on clinical quality, but, over time, legislation led to improvements in both quality metrics (see also Sharma et al (2020)). Another example is also from healthcare: Lee et al (2020) found that reducing government payments to hospitals with poor outcomes led to both intended and unintended consequences.…”

Sustainable process improvements: Evidence from intervention‐based research

“…We added this performance dimension because, in healthcare contexts, especially those that involve high patient–caregiver interactions, patients' perceptions of care are not always compatible with their health outcomes (Berry Jaeker & Tucker, 2020; Kang, Shah, & Dowd, 2017). At the same time, patients who report higher satisfaction levels would better absorb and use information about post‐surgery care, increasing their chances of better health outcomes (Nair, Nicolae, & Narasimhan, 2013; Sharma, Chandrasekaran, & Bendoly, 2020). Thus, we analyzed the impact of the process redesign by comparing before and after scores on the HCAHPS (Centers for Medicare and Medicaid Services (CMS), 2019) for the kidney transplant unit, and with respect to a control group.…”

Benchmark and performance progression: Examining the roles of market competition and focus

“…In addition, hospitals have also set aside resources for patient experience management, such as the Office of Patient Experience (OPX) with designated budget and staff (Merlino & Raman, 2013). The creation of OPX and similar patient experience units allows hospitals to identify and implement best patient experience practices, to analyze HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) and other patient sentimental data, and to provide training to physicians and staff members to fix problems with patient experience (Sharma et al, 2020). From the OL perspective, accumulating patient experience data allows hospitals to map the patient journey better and standardize touchpoints across the continuum from initial consultation to inpatient stay to post-discharge and follow-up visits (Minemyer, 2018).…”