Seeing Beyond Trendlines: Patient Experience as a Strategic Asset

By Jason Messerli, Strategic Advisor, Customer Strategy, NRC Health 

In healthcare, it is widely agreed that no two patients are exactly the same. While treatment approaches may be similar, a range of factors necessitate variation and influence patient behavior.  

The same is true of the patient experience itself. In our most recent NRC Health nSight, we take a closer look at how organizations can use all their patient feedback to effectively drive change, even when different data points appear to compete rather than converge.

Key Takeaways

• Conflicting patient experience metrics are not a data problem. They’re a perspective problem. Short-term volatility and narrow timeframes often mask meaningful long-term improvement. Longitudinal views reveal trends that monthly or quarterly snapshots miss. 
• Measurement bias causes organizations to ignore valuable patient insight. When metrics don’t align as expected, especially between HCAHPS and real-time feedback, leaders may dismiss the data instead of interrogating what it’s revealing. 
• Relying on HCAHPS alone creates significant blind spots in patient experience. Older patients dominate response rates, leaving younger and underrepresented populations unheard, putting both future revenue and long-term loyalty at risk. 
• Patient experience improvement starts with behavior, not scores. High-performing organizations focus on the behaviors driving experience and use both quantitative and qualitative data to reinforce consistency across teams. 

Measurement bias often determines which insights organizations act on and which they ignore. When organizations measure patient experience, uniformity is often desired. When feedback doesn’t meet expectations or metrics don’t align, it is often dismissed. This bias was referenced in our our recent research, “Negotiating the Trust Cliff”. 

Patients experience this, but for healthcare organizations, it can lead to inaction or inhibit their ability to see priorities clearly in the present. This is especially common when trends differ between traditional HCAHPS outreach and feedback via NRC Health’s Experience Platform. When both data sets are collected from inpatient populations, the assumption is that they should be the same and tell the same story. 

In practice, these two data sets often appear at odds because they “don’t move together,” or show “opposite trends.” Our research shows that this is highly dependent on several factors, especially the timeframe being viewed. Over time, the two seemingly disparate data sets do move together and exhibit similar trends. Emphasis on short-term views can distract from broader performance trends and lead to the misinterpretation of overall performance.  

I saw this firsthand when I recently presented a year-over-year trendline to a health system leader, who stated unequivocally, “I had no idea we were improving like that.” They had only been shown monthly/quarterly trends by their internal team—and smaller date ranges and n-sizes mean greater volatility. At times, the longitudinal view of performance can provide necessary perspective. Short-term variations distract you from the true purpose of collecting feedback: to learn from your patients and take appropriate action.

If this sounds familiar, consider the following: if one method of feedback provides you with insight, why can’t two? Since the inception of HCAHPS, respondents have been largely homogeneous, with research showing around 63% of feedback coming from those aged 65 and up. In recent reviews, I have seen this number climb to 70%, 75%, and even 80% for individual partners.  

Utilization certainly rises with age, and 65+ patients do represent the largest volume of inpatient stays for most organizations. However, those populations rarely represent 80% of inpatient volume. What does your respondent distribution look like by age? Who aren’t you hearing from?  

If you base your improvement strategy on HCAHPS alone, are you creating a massive blind spot among younger generations? There are both financial reasons and clinical reasons why retaining patients matters—and if you don’t know anything about their experience today, you may not get the chance to treat them in the future.  

When organizations struggle to capture feedback from certain populations, more flexible and non-traditional approaches are often required. By expanding beyond traditional survey methods with NRC Health’s Community Insights and nGage solutions, organizations can reach underserved and underrepresented voices, uncover meaningful disparities in experience, and gain a more complete understanding of performance.  

In-the-moment, unstructured feedback options create additional pathways for participation, particularly in areas with historically lower response rates, such as maternity and NICU. Together, these approaches help ensure that insight reflects the full patient population—not just those most likely to respond. 

I always advocate for focusing less on the trendline itself, and more on what it reveals. Even when highly correlated questions don’t align verbatim, the underlying behaviors may still be consistent.  

Our top-performing partners utilize our tools to optimally leverage both qualitative and quantitative feedback. First, they determine quantitative priorities. Through easy-to-use views like Priority Matrix, Question Correlation, and Key Drivers, organizations can identify what truly drives experience. The most effective organizations look beyond the verbiage of the question and ask what behaviors need to be emphasized to drive consistency.  

They can then leverage our AI-enabled qualitative tools to make queries of the data surrounding those key behaviors. This provides context and clarity into what may be lacking. If immediate needs arise, our service-recovery process enables our partners to address urgent items immediately. Our research shows that this leads not only to greater loyalty among those who receive effective service recovery, but also to higher HCAHPS scores.  

Our AI-enabled smart responses also allow for the expansion of service recovery scope in the face of strained budgets and dwindling FTE hours. Within a matter of days/weeks, we can track and trend progress on priority behaviors and provide insight, thus shortening the improvement cycle. We enable our partners to audit these behaviors in the moment with our best-in-class NRC Health Rounding solution.  

As someone who has worked with over two hundred healthcare organizations in the past fifteen years, I can tell you: if you aren’t conducting consistent leadership rounds that are positioned as a supportive function to your staff, I strongly encourage you to start there today.  

Remember, changing behaviors is not, to borrow the infomercial slogan, a “set it and forget it” type of exercise. It needs to be revisited frequently, and when the right behavior is exhibited, it should be reinforced and recognized.  

This holistic approach we take to enabling our customers with the right tools, insights, and resources to be successful is a key reason why our partners outperformed their peers on all HCAHPS metrics in post-pandemic recovery. 

Patient Experience is not simply a metric to track and manage, it’s a strategic asset. Organizations that listen to and act on patient feedback move beyond scores to deliver meaningful, sustained improvement.