10 simple tips to use NPS more effectively in healthcare


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This story is a version of a post published here.

Customer experience, undeniably, is important in any business today. However, in a healthcare business, its importance is accentuated manifold. It would not be incorrect to say that no other industry sees a closer bond between the customer and the service provider than the healthcare industry. Further, because this industry associates with its customers in their most vulnerable times, it is critical to provide an experience beyond the medical care that will alleviate the concerns of the patient.

In terms of financial gains, a report by The Deloitte Center for Health Solutions has demonstrated that hospitals with high patient-reported experience scores have higher profitability. It has also shown that hospitals with better experience levels earn disproportionately more than they spend compared to those with lower ratings. All this reiterates that improving the patient experience is vital to a healthcare organization.

The Net Promoter Score is a world-renowned metric to measure customer experience. Quite a few healthcare providers today use NPS to measure and improve the patient experience. However, because NPS isn’t as widely used in healthcare, there aren’t many guidebooks or best practices available for use of NPS in this sector. Here are a few pointers to use NPS more effectively in healthcare.

1. Make the questionnaire straightforward

I have noticed that the feedback forms in hospitals are often cumbersome. Questions on various departments, doctors, and facilities are all put into the form. In all of this, the Net Promoter question is, unfortunately, lost and deprioritized.

I strongly believe that only asking the NPS question is enough. The second question – one that asks respondents for the reason for the given score – helps get a goldmine of information from respondents. A deep analysis of the responses given to this question would most certainly give key insights into both, the positives and the negatives of the service received by respondents. Moreover, the NPS question is a simple straightforward question that is easy to respond to. This leads to greater response rate because there is a massive drop in the survey drop-off, which is an inherent problem with long cumbersome feedback forms. Hence, NPS gives substantial data and must be prioritized over a lengthy cumbersome feedback form.

2. Understand the essence of NPS

The essence of NPS is that it is an operational metric; it measures the effectiveness and efficiency of the organizational systems in delivering a delightful customer experience. NPS is designed for organizations to take quick action and, therefore, it should be used in correlation with a robust process that warrants prompt action on patient feedback.

Secondly, because NPS is based on the likelihood of getting a recommendation from the respondent, it is also a measure of the loyalty of a customer with a brand. In his book – The Ultimate Question 2.0 – Fred Reichheld presents an empirical study that establishes NPS as a leading indicator of the financial performance of a business. If the NPS is trending upwards, the business is on its path to better financial results and vice-versa. It is important to remember that the NPS is not a market research tool and hence healthcare organizations should avoid using it in that format.

So, just like all other businesses, healthcare organizations should use NPS as a measure of what’s working and what’s not working for the patient. They must use patient feedback as a radar to course correct and improve organizational performance.

3. Align the organization towards improving patient experience

When implementing any patient feedback system, it is important to align your employees with the purpose of collecting patient feedback.

What is your purpose for collecting NPS feedback?

I ask this question with every client I engage with. Most often, the top management wants to use NPS to measure and improve customer experience. What’s interesting is the difference in this perspective between the C-suite and the frontline employees. It is critical for the top management to align everybody across the organization with the purpose of collecting NPS. It must ensure that the purpose is to understand the drivers of patient experience and work on factors that can improve that experience. The management must convey the message that the team has to work towards delivering an exceptional patient experience and that NPS shall be used to measure how well they are doing their job. If the management fails to do so or, even worse, sends out the message that “Our NPS needs to look better than our competitor’s!” then they will see a great NPS, but their patients won’t be happy.

Is that the purpose you wanted to achieve?

4. Coach employees to improve response rate

The more the feedback you can garner, the more insights you gain. Quite often, employees in healthcare do not communicate with patients during the feedback process. A small investment in coaching your frontline staff on how to communicate with a patient regarding your feedback system could go a long way. Let me share examples of how two different organizations collect patient feedback:

In the first hospital, a Patient Relations Executive (PRE) hands over a tab-based feedback form to the patient after the discharge intimation is received. Along with handing over the tab, the PRE informs the patient and his attendant about the delightful news that the patient has fully recovered and can go home now! The PRE requests the attendant to clear the bills and meet the doctor for post-recovery care. Subsequently, the PRE moves on to attend the next patient.

On the other hand, in the second hospital, the PRE hands over the tab-based feedback form and sincerely requests the patient / attendant to fill in the feedback form. The PRE says “We would be very thankful if you could let us know how well we took care of you. Please be completely transparent in your feedback. Do not hesitate to mention anything you might not have liked in our service. This will ensure that we take care of it with other patients too. Your feedback is extremely valuable to us. Please do take three mins to complete the same. We read through every feedback and constantly work towards delivering a great patient experience.” After this, the PRE also shares the delightful news about the patient’s discharge and clearly explains the next steps of billing and clearance. Subsequently, the PRE moves on to attend the next patient.

Which of the hospitals in the above example is receiving a higher response rate? I am sure you’d agree it is the second one! If the importance and value of their feedback are communicated, patients will be motivated to give their honest feedback. Therefore, coaching employees on what and how to communicate to patients massively improves the response rates.

5. Close the loop with your respondents

Collecting feedback without taking any corrective or remedial action on it is futile. Once feedback is collected, it must be worked upon and organization must close the loop on patient feedback. This means taking corrective action and, further, apprising the patient of the same.

In a healthcare business, it becomes more important to close the loop on feedback because this is one of those industries where word-of-mouth plays a substantial role. Even if a patient has not had a good experience at the hospital, if the hospital reaches out proactively, apologizes for the bad experience, and assures that a set of corrective actions have been taken to correct the wrong, the patient would be less upset than before. To be honest, this gesture would convert a detractor into a passive, if not a promoter.

6. Setup a process to act on patient feedback

Horst Schulze, the President of the Ritz-Carlton Group of Hotels has remarked,

If a mistake happens once, it may be the fault of the employee. If it happens twice, it is most likely the fault of the system.

Many a times hospitals collect feedback and analyze it. However, unfortunately, there is no well-defined action plan or a system to act on the feedback. An oft-repeated feedback from customers points to the fact that the process used by the hospital itself might be flawed. Hospitals are extremely process driven and it is equally important to set up a process to take prompt action on patient feedback.

In Omoto, an omnichannel feedback management system being used by leading healthcare brands, we have seven levels of hierarchy, whereby a negative patient feedback can be addressed through an inbuilt workflow management system. Once a negative feedback is received, Omoto automatically sends a real-time trigger to the most relevant department to take corrective action. If nothing gets done, the feedback is automatically escalated to higher levels in the hierarchy. Employees can also report the remedial action taken on feedback.

Setting up such a system establishes transparency and accountability of employees towards the feedback received and brings promptness in feedback redressal process.

7. Don’t chase the score

How the leadership views the feedback defines how employees work towards it. Unfortunately, the top management does not have the time get into details about the reasons behind the NPS and it focusses only on the score. This seeps into the employees too, who might look for unethical means to only increase the score. This defeats the entire purpose of collecting feedback.

Rather, the leadership in a healthcare brand must align the employees towards delighting patients rather than merely increasing the score. As discussed earlier, the score will inevitably increase if the patient experience is top-notch.

8. Share feedback summary every day

There are multiple benefits of sharing the feedback summary regularly with the employees. Firstly, employees are aware of the impact that their efforts have on the patient experience. It makes the employees more empathetic towards the patients’ needs.

Secondly, repetition improves retention. Whenever ideas are repeated, they are retained effectively. Similarly, repeating the importance of improving patient experience day in and day out drives the employees to understand it better. For instance, if you are conducting only annual feedback analysis sessions, its importance would not be understood by employees. However, sharing feedback, along with the verbatim comments of the patients every day, makes employees enthusiastic and motivated towards this cause.

Finally, by sharing feedback every day, employees also realize what good they must repeat and what bad they must reduce. This ensures that corrective action happens every day rather than at intermittent intervals.

9. Review and report insights with management regularly

A monthly, deep analysis of feedback must be done so that actionable insights from the feedback can be drawn. A detailed analysis and review of NPS data might uncover certain operational or structural changes that the organization needs to undertake in order to improve the patient experience beyond the current level.

Performing regular analysis of NPS data will also uncover insights that will help hospitals understand their patients better. It is quite possible that a certain group of patients are having a poor experience due to their inherent nature. For instance, young patients might want services such as wi-fi or a TV in their rooms. However, the older patients might prefer services such as timely availability of food. Based on feedback given by such customers, the management can look to customize their services based on the patient group. Such simple insights could bring about a massive improvement in the patient experience.

10. Identify and resolve structural problems to improve NPS

The Net Promoter Score is a simple yet super effective manner of understanding the recurring problems with the organization. This kind of an exercise must be done every quarter. By looking at longer-term data trends, a hospital can identify such recurring problems that might be occurring because of certain traditional operational practices. Acting on such insights would require bigger changes but will lead to massive improvements in patient experience and hence NPS too. This might also call for breaking traditional ways of doing things.

For instance, Rohit MA, the co-founder of Cloudnine Group of Hospitals, in his interview with Customer Guru shared that none of the Cloudnine Hospitals have a regular pharmacy at the entrance of their hospital. Rather, patients see a vibrant coffee shop and a photo-booth for new mothers as soon as they enter the hospital. This departure from the traditional hospital design was undertaken after the analysis of patient feedback that said the view of a pharmacy at the entrance of a hospital was depressing and gloomy! Isn’t that a wonderful corrective action on patient feedback!

How else is the patient experience different from customer experience in other industries? How can healthcare businesses effectively use the NPS to improve the experience delivered to patients? Do let us know!

Vivek Jaiswal
I am the founder and CEO of Customer Guru, a boutique customer experience consultancy based in India. We are committed to building a happier customer base for our clients in all industry segments. I bring extensive industry experience in implementing NPS® in major global brands. I believe that the path to sustainable organic growth for any business is only by delivering exceptional customer experience.


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