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Patient Experience, GuidePatient Experience Definition
What patient experience means according to the most recent scientific literature and how the concept has evolved.
Patient experience is defined, according to the Beryl Institute, as the sum of all interactions that, influenced by organisational culture, shape the patient's perceptions throughout their entire care process. This concept goes far beyond point-in-time satisfaction, integrating emotional, relational and care continuum dimensions, and has evolved towards the "human experience in health", which also includes family members and healthcare professionals. Its precise definition is key to measuring and improving it, as it directly impacts clinical outcomes, adherence and the efficiency of the healthcare system.
Riccardo Begelle, 2025 
15 min 
Today, patient experience is a central topic among healthcare professionals. However, there is no universally accepted standardised definition: many exist, with different nuances depending on the perspective — clinical, organisational, quality-based or experiential — from which the concept is approached.
This article summarises the most referenced definitions in the scientific literature, explores their components and traces the evolution of the concept from its original formulation to its most recent version: the human experience in health.
The Reference Definition: The Beryl Institute
Among all existing definitions, that of the Beryl Institute stands out most for its acceptance and references in the sector, both in the scientific literature and in professional practice. It has been cited in studies from more than 220 countries and territories:
""Patient experience is the sum of all interactions, shaped by an organisation's culture, that influence patient perceptions across the continuum of care."
— Beryl Institute — Wolf JA, Niederhauser V, Marshburn D, LaVela SL. Patient Experience Journal, 2014
— Beryl Institute — Wolf JA, Niederhauser V, Marshburn D, LaVela SL. Patient Experience Journal, 2014
To understand this definition it is necessary to examine its four essential components in depth:
| Component | Meaning |
|---|---|
| 1. Interactions | The previously established touchpoints that a patient has with the healthcare centre: calling to make an appointment, reception, consultation, admission, discharge, post-operative follow-up. |
| 2. Culture | The people, vision, community and values that define the organisation. Culture is the substrate that determines how all interactions occur. |
| 3. Perceptions | Everything that patients remember, understand and recognise during their time with the organisation. Perceptions are subjective and vary according to each patient's prior personal experiences. |
| 4. Care received | All actions carried out by professionals before, during and after the patient's time at the medical centre. The experience does not begin when entering the hospital nor end when leaving. |
Patient experience is not just what happens inside the hospital
It is the sum of the entire continuum of care, shaped by organisational culture and filtered through the patient's perceptions. Two hospitals can offer the same technical quality and generate completely different experiences.
Patient Experience Within the VBHC Framework
The SECA Guide for the Implementation of Value-Based Healthcare (2025) integrates the Beryl Institute definition within the VBHC paradigm and expands it with practical implications. According to the guide, the patient's perspective operates at three levels:
- Biological-symptomatic level: Identifies the symptoms present in the person's health condition. This is the fundamental level that helps identify when we feel ill or well.
- Intimate-emotional level: Directly related to the way in which the person experiences their health condition at a personal, family and social level.
- Level of interaction with the healthcare system: It is at this third level that patient experience is forged in the strict sense: treatment received, care environment, waiting times, available information, trust in the professional, perceived empathy and the possibility of shared decision-making about their health.
SECA also establishes that patient experience is the least valued dimension within the VBHC framework, despite having a highly relevant impact on adherence to tests and treatments and on economic costs. This reinforces the urgency of its systematic measurement and improvement.
| VBHC Dimension | Tool | What it measures |
|---|---|---|
| Clinical outcomes | CROM | Outcomes evaluated by the professional |
| Quality of life | PROM | Patient-reported outcomes |
| Patient experience | PREM | How the patient experienced the care process |
| Satisfaction | CSAT | Point-in-time assessment of the service received |
| Efficiency | Costs | Economic resources associated with the process |
The Evolution of the Definition: Towards Human Experience in Health
In 2014, Wolf et al. published the foundational article 'Defining Patient Experience' in the Patient Experience Journal, which analysed 18 definitions used in the literature and identified the core convergent components. In 2021, the same authors published a revision that expanded the analysis to more than 436 articles and proposed broadening the concept towards the 'human experience in health':
""The human experience in health integrates the sum of all interactions between patients, families, carers and healthcare staff. It is driven by the culture of organisations working to sustain a healthcare ecosystem that operates across the continuum of care." — Wolf JA et al. — Reexamining Defining Patient Experience, Patient Experience Journal, 2021
In 2024, the Beryl Institute published its largest global consumer study to date — 13 countries, the largest collection of healthcare consumer voices ever captured — which reaffirms the essential components of the 2014 definition and confirms that what matters most to people around the world are the human interactions that shape their healthcare experience.
13 countries · 220+ territories
Scope of the Beryl Institute report (2024). Global conclusion: safe care, clear communication and respectful treatment are universal priorities. Human connection outweighs processes and environments in importance for patients worldwide.
Reflections from the Scientific Literature on the Concept
Patient Experience Goes Beyond Satisfaction
Satisfaction is a point-in-time measurement, eminently rational, about whether certain expectations were met. Patient experience is a blend of an organisation's rational and emotional performance, assimilated through the patient's expectations. The Beryl Institute's 2024 global report confirms this emotional dimension: the three most cited factors globally are safe care, clear communication and respectful treatment. None of the three is purely technical.
Responsiveness as a Conceptual Framework
Authors such as Needham propose framing patient experience within the concept of 'responsiveness', which includes: autonomy, choice, communication, confidentiality, dignity, prompt attention and quality of basic amenities. Three actions are proposed to shape a positive experience: personalising medicine, partnering with patients and empowering employees.
Expectations as a Central Component
Bowling et al. (2012) carried out a comprehensive review of patient expectations before and after the visit. The main expectations identified are:
| Relational expectations | Functional expectations |
|---|---|
| Respectful physician, dignified treatment | Cleanliness of the environment |
| Clarity and ease of explanations | Information on where to go and punctuality |
| Participation in treatment decisions | Convenience of access and opening hours |
| Conveying support and reassurance | Being seen on time |
| Information on the cause and management of the condition | Choice of hospital and physician |
| Information on treatment effects | Reduction of symptoms and problems |
The definition is not an academic exercise: it is the working map
The more precise the definition of patient experience used by an organisation, the easier it will be to understand its components, select the appropriate measurement tools and find effective ways to improve it.
Patient Satisfaction vs. Patient Experience
One of the most frequent mistakes in practice is using 'patient satisfaction' and 'patient experience' as synonyms. The difference is conceptually important and has direct implications for how measurement systems are designed:
| Dimension | Patient satisfaction | Patient experience |
|---|---|---|
| Nature | Eminently rational | Rational and emotional |
| Type (Donabedian) | Outcome indicator | Process indicator |
| Time horizon | Point-in-time (post-visit) | Continuous (before, during and after) |
| What does it measure? | Whether expectations were met at a given moment | The accumulated perception of the care continuum |
| Typical tool | CSAT | PREM (PPE, IEXPAC, EUROPEP) |
| Primary use | Measuring the outcome of an interaction | Improving culture, processes and overall outcomes |
The Historical Evolution of the Concept (1980–2025)
| Period | Dominant focus | Conceptual milestone |
|---|---|---|
| 1980–2000 | Technical quality and clinical outcomes | The patient as a passive recipient. The quality standard is clinical efficacy. |
| 2000–2010 | Patient satisfaction | CAHPS and HCAHPS (USA, 2006). The patient begins to have a formal voice. |
| 2010–2020 | Patient experience | Beryl Institute definition (2014). Goes beyond satisfaction: emotional, cultural and continuum dimension. |
| 2020–2025 | PREMs + VBHC | Patient experience is integrated into the value paradigm (SECA 2025). PREMs as process indicators within the CROM/PROM/PREM/costs framework. |
| 2025→ | Human experience + equity | HX2030 (Beryl Institute, 2025): incorporates healthcare staff, carers, families and equity as a central dimension. |
The vast majority of scientific publications agree that the more precise the definition of patient experience used by an organisation, the easier it will be to understand its components, select the appropriate measurement tools and find effective ways to improve it.
The Beryl Institute definition, validated and expanded through successive revisions, offers a solid and flexible framework for healthcare organisations of any size. The SECA Guide (2025) integrates it within the VBHC paradigm, giving it a practical and operational dimension: patient experience is not just a philosophical concept, but a measurable, actionable process indicator with demonstrated impact on health outcomes and the sustainability of the system.
RateNow is the benchmark in patient experience measurement, with hundreds of implementations in European healthcare organisations. RateNow is explicitly mentioned in the SECA Guide (2025) as one of the initiatives working on the validation of PREMs for the main hospital processes in Spain.
Would you like to implement a PREM system in your organisation?
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Bibliography
1. Wolf JA, Niederhauser V, Marshburn D, LaVela SL.: Defining Patient Experience. Patient Experience Journal. 2014;1(1):7-19. doi:10.35680/2372-0247.1004.
2. Wolf JA, Niederhauser V, Marshburn D, LaVela SL.: Reexamining 'Defining Patient Experience': The Human Experience in Healthcare. Patient Experience Journal. 2021;8(1):16-29.
3. Beryl Institute: Consumer Perspectives on Patient Experience 2024 — global study, 13 countries, October 2024.
4. Beryl Institute: Human Experience 2030 (HX2030): A Vision for the Future of Healthcare — 2025.
5. Adams C, Harrison R, Wolf J.: The Evolution of Patient Experience: From Holistic Care to Human Experience. Beryl Institute / PXJ, June 2025.
6. Bowling A et al.: Patient expectations of treatment: survey of outpatients. BMJ Qual Saf. 2012.
7. SECA / Varela Rodríguez C. (ed.): Guía para la Implementación de Asistencia Sanitaria Basada en Valor. SECA 2025. Ch. 1.5, 1.6, 2.9.
8. de Oliveira Lima H et al.: Perspectives on Patient Experience: Healthcare Providers in Brazil. Journals Sagepub, 2025. doi:10.1177/23743735251325138.
What is patient experience?
According to the Beryl Institute (2014), the most referenced definition in the scientific literature: 'the sum of all interactions, shaped by an organisation's culture, that influence patient perceptions across the continuum of care.' Its four components are: interactions, organisational culture, patient perceptions and the continuum of care.
What is the difference between patient satisfaction and patient experience?
Satisfaction (CSAT) is an outcome indicator: it measures whether the patient was happy with a specific interaction. Patient experience (PREM) is a process indicator (Donabedian's taxonomy): it measures how care was delivered throughout the entire care pathway, including emotional and relational dimensions that satisfaction does not capture.
Has the definition of patient experience evolved?
Yes. In 2021, Wolf et al. (Beryl Institute) expanded the concept towards the 'human experience in health', integrating healthcare staff, families and carers. SECA (2025) integrates it within the VBHC paradigm, as one of the five pillars of value alongside CROMs, PROMs, satisfaction and costs. The Beryl Institute's 2024 global report (13 countries) confirms that human connection outweighs processes and environments in importance for patients.
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