Feedback for impact: Using employee and patient insights to drive operational improvements

Enhancing patient experience remains a top priority for healthcare organizations, as it directly influences how care is perceived and delivered. Patient experience encompasses all interactions within the healthcare system — from scheduling and parking to billing conversations and bedside manner.¹ Each of these touchpoints shapes the patient’s perception of quality, compassion, and coordination.

When organizations focus on the complete experience, studies indicate improved patient experience is linked to greater adherence to recommended treatments and preventive care, better clinical outcomes, increased hospital safety, and reduced utilization.² To continuously enhance this experience, a data-driven, holistic approach is essential for evaluating all areas impacting patient perceptions and satisfaction.

Patient perception directly influences patient satisfaction. Patients rate their satisfaction based on their expectations and whether those expectations were met. Typically, this Voice of the Patient (VoP) data is collected through surveys and formal and informal word-of-mouth recommendations. Leaders can use VoP insights to develop responsive, targeted strategies for continuous improvement.

While regularly monitoring patient feedback is crucial, organizations less frequently apply a parallel process with frontline level. Employees often participate in cyclical organizational surveys (satisfaction, engagement, culture, pulse, etc.), which support broader organizational improvements, recruitment efforts, and cultural shifts. Although valuable for system-wide goals, these surveys may not address specific issues at individual locations. Therefore, frontline managers should use internal team feedback to uncover hidden insights and drive targeted improvements that directly enhance patient experience. Integrating Voice of the Employee (VoE) with VoP is crucial when planning patient experience improvements.

The disconnect: Why one feedback loop isn’t enough

For most clinics, patient survey data is central to change initiatives. Patient perception is fundamental to healthcare organizations’ success because it reveals how patients interpret their experiences and highlights the organization’s strengths and weaknesses. However, incorporating employee feedback into the decision-making process is equally vital for understanding necessary changes comprehensively.

Consider a clinic manager reviewing Press Ganey surveys who reads, “I had to wait almost 45 minutes past my appointment time. No one explained the delay, and I felt like my time wasn’t respected.” At first glance, this feedback suggests issues with wait times and staff communication, possibly attributing delays to front-office staff communication and provider inefficiency.

In the same scenario, imagine if the clinic manager engaged employees and received the following feedback:

• “We’re consistently short a medical assistant in the afternoons, and it backs up the whole schedule. We’re doing our best, but we can’t keep up with rooming patients on time.”
• “Patients aren’t notified when a provider runs behind because we don’t have a consistent communication process or designated staff to relay updates.”

Instead of assuming provider inefficiency, leadership would recognize operational root causes, such as staffing, workflow issues, or communication gaps. Armed with these insights, leadership could implement targeted fixes, such as:

• Adjusting MA staffing levels at high-volume periods
• Establishing standard scripts and processes for communicating delays
• Building real-time dashboards or updates for front desk staff.

Incorporating VoE in this assessment provides a 360-degree view, simplifying decision-making. Frontline leaders often hesitate to engage employees due to time constraints; However, failing to include this feedback can result in inconsistent implementation of performance initiatives, missed improvement opportunities, and employee burnout.

A study has shown that disengaged healthcare workers provide quality care only 23% of the time,³ while engaged employees contribute to better patient outcomes and reduced readmission rates. When staff feel supported and satisfied, it fosters a positive and attentive environment, ultimately leading to more satisfied patients. Staff engagement significantly shapes patient experience, leading to stronger patient loyalty, higher satisfaction scores, and improved quality of care.

Building a parallel feedback infrastructure

Successful integration of VoP and VoE feedback requires appropriate infrastructure. Traditional patient feedback mechanisms include Press Ganey surveys, Google reviews, CAHPS, and Healthgrades. Patients also often communicate directly with frontline staff and providers, especially during negative events. Acting on patient feedback without considering VoE often results in decisions based on incomplete information, delayed data, or biases.

Incorporating VoE effectively requires a tailored approach to each situation. Common methods include pulse surveys, suggestion boxes, huddles, and rounding. Leaders should select appropriate methods based on specific circumstances. For recurring issues such as wait times and communication delays, forming a dedicated patient experience team can provide valuable insight and missing context. In adverse events, involving relevant team members and employing structured root cause analysis ensures accurate assessments. This tailored approach evaluates each situation individually, rather than using a one-size-fits-all method.

Integrating external and internal feedback provides leaders with a holistic perspective, enabling clear, informed decisions. Internal feedback often identifies specific trends and root causes of recurring issues. Synchronizing VoP and VoE ensures comprehensive stakeholder input and balanced decision-making. 

Turning insight into action

Effectively turning feedback into action requires structured processes to ensure consistency and stakeholder buy-in. Three effective different strategies include:

5-Step Feedback Loop

• Collect: Regularly gather feedback from patients (surveys, reviews) and employees (pulse surveys, suggestion boxes, one-on-ones).
• Analyze: Group feedback into themes (e.g., wait times, communication) to identify trends.
• Communicate: Transparently share insights with relevant teams.
• Act: Assign ownership, develop targeted improvement plans, and implement them.
• Close the loop: Communicate changes back to patients and staff, reinforcing trust and continuous improvement.

Feedback Huddle Cycle

• Collect recent feedback from patients and employees.
• Summarize feedback in a shared document or dashboard.
• Hold short team huddles (front desk, MAs, providers) to discuss insights.
• Identify one quick win and one long-term improvement to address.
• Track progress and revisit updates in subsequent huddles, promoting accountability and team engagement.

Tiered Response Framework

• Categorize feedback responses based on issue complexity:
  • Quick fixes handled immediately by frontline staff.
  • Team-based improvements coordinated within departments.
  • Systemic challenges escalated to leadership for cross-function resolution.
• This framework ensures timely, appropriate responses, enhancing organizational agility, staff empowerment, and responsiveness to concerns.

While the 5-Step Feedback Loop provides structured, end-to-end feedback management, the Feedback Huddle Cycle encourages real-time, collaborative team actions. For complex issues beyond a single team’s scope, the Tiered Response Framework escalates concerns appropriately, involving all organizational levels in continuous improvement.

Lessons learned and best practices

Feedback is an ongoing, dynamic process. Regularly reviewing internal and external inputs is crucial for achieving desirable outcomes for patients and staff. Employees, as patient care experts, provide valuable insights beyond leadership’s scope. Consistently employing structured feedback methods ensures actionable steps to address core issues, maintaining transparency, celebrating achievements, and reinforcing trust.

For frontline leaders, intentionally incorporating employee feedback fosters sound decision-making and enhances team cohesion and engagement. Viewing patient and employee experiences as interconnected drives deliberate actions, improving outcomes for both groups.

Notes:

1. AHRQ. “What Is Patient Experience?” Agency for Healthcare Research and Quality, Rockville, MD. Available from: https://bit.ly/4jIzrfz .     
2. Anhang Price R, Elliott MN, Zaslavsky AM, Hays RD, Lehrman WG, Rybowski L, Edgman-Levitan S, Cleary PD. “Examining the role of patient experience surveys in measuring health care quality.” Med Care Res Rev. 2014 Oct;71(5):522-54. doi: 10.1177/1077558714541480. Epub 2014 Jul 15. PMID: 25027409; PMCID: PMC4349195.
3. Hirpa M, Woreta T, Addis H, Kebede S. (2020) “What matters to patients? A timely question for value-based care.” PLoS ONE 15(7): e0227845. https://doi.org/10.1371/journal.pone.0227845 .