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Patient Experience, Guide
Patient Experience, GuideHow to Improve Patient Experience?
Theoretical and practical framework for operationalising patient experience improvement.
Improving patient experience is a key strategic objective for healthcare organisations, as it directly impacts on care quality, efficiency and clinical outcomes. The evidence shows that factors such as communication, empathy, coordination and the reduction of treatment burden have a direct impact on adherence, safety and health outcomes, reinforcing the role of patient experience as the central axis of healthcare system transformation.
Riccardo Begelle, 2025 
17 min 
Improving patient experience is the ultimate goal of healthcare organisations that place the patient at the centre of their activity. This paradigm shift orientates organisations towards a more modern, efficient and humane system.
To discover HOW to improve patient experience, it is essential to review WHAT it is, WHY it matters and WHO needs to be involved in the improvement.
What is Patient Experience?
""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 et al., Patient Experience Journal, 2014
If safe care and clinical excellence are the 'what' of healthcare, then experience is the 'how' from the patient's point of view. It encompasses the perception of the treatment received, communication with the clinical team, access to care, the physical environment and emotional support throughout the entire care process.
The SECA Guide for the Implementation of Value-Based Healthcare (2025) confirms that patient experience is the least valued dimension within the VBHC framework, despite its impact on adherence, costs and perceived quality. The guide frames it as one of the five dimensions of value alongside clinical outcomes (CROMs), quality of life (PROMs), efficiency and satisfaction.
Why Improve Patient Experience?
Several studies demonstrate that patient experience is related both to the financial results of the organisation and to the patient's health outcomes. Improving experience is about reducing avoidable suffering: unnecessary waiting, anxiety due to lack of information, lack of coordination and lack of respect.
According to Press Ganey (2025, analysis of 6.5 million encounters), patients with a high perception of safety score the likelihood to recommend at 85.3/100; those with a low perception drop to 34.6. Unplanned admissions generate recommendation scores 16% lower than planned ones. Clear communication at discharge reduces readmissions.
"85.3 vs 34.6 likelihood-to-recommend score based on the patient's perception of safety. The difference is more than 50 points. Safety and experience are no longer separable dimensions. (Press Ganey, 2025)
Who Needs to Improve Patient Experience?
Improving patient experience is not a task that should be relegated solely to the quality department. It involves all staff with direct patient interaction — reception, telephone operators, physicians and nurses — as well as those without direct contact.
| Actor | Level | Key responsibility |
|---|---|---|
| Management | Strategic | Sponsoring a patient-centred culture, integrating experience KPIs into management reporting and investing in improvement programmes. |
| Central Services | Normative | Establishing guidelines, realistic objectives and best practices, and fostering the sharing of successful experiences between organisations. |
| Quality team | Operational | Ensuring that patient experience has the same status as clinical efficacy and safety, and leading improvement programmes. |
SECA (2025) reinforces the role of managerial leadership: it is impossible to implement a patient-centred quality management system if senior management is not committed to it. Visible leadership on quality issues sends an unequivocal message about its importance throughout the entire organisation.
What are the Most Important Factors for the Patient?
King's College London, in one of the broadest scientific reviews on patient expectations, concludes that patients value relational factors as much as functional ones, although the former are frequently underestimated.
| Relational factors (frequently underestimated) | Functional factors (frequently prioritised) |
|---|---|
| Feeling listened to and respected | Waiting times and access to the service |
| Empathy and emotional support from the clinical team | Cleanliness and comfort of the physical environment |
| Patient dignity and independence | Efficiency of administrative processes |
| Clear communication about diagnosis and treatment | Coordination between services and specialities |
| Involvement in care decisions | Availability of technology and resources |
| Support for family members and carers | Quality of food and rest |
Patients want to be treated as people, not as numbers
Relational factors carry equivalent weight in the perceived experience to functional ones. An improvement strategy that only addresses the latter will not deliver the expected results.
The 8 Picker Principles: The International Reference Framework
SECA (2025) explicitly integrates the 8 Picker Principles (Harvard Medical School / Picker Institute, 1993) as the dimensions that lead to a positive patient experience within the VBHC framework:
| # | Picker Principle — Dimension of patient experience |
|---|---|
| 1 | Respect for patient values, preferences and needs: dignity, privacy, independence, cultural aspects and shared decision-making. |
| 2 | Coordination and integration of care across the healthcare and social system. |
| 3 | Information, communication and education about clinical status, progress and processes to facilitate autonomy and self-care. |
| 4 | Physical comfort: pain management, support with daily activities, clean and comfortable environment. |
| 5 | Emotional support and relief of fear and anxiety related to clinical status, prognosis and the impact of illness. |
| 6 | Involvement of family members and carers in decision-making, with attention to their needs. |
| 7 | Transition and continuity: information for self-care, coordination and discharge planning. |
| 8 | Access to care: waiting times for admission, outpatient appointments and primary care. |
Treatment Burden: A Key Concept for Improving Experience
SECA (2025) introduces the concept of 'treatment burden': how much of their quality of life a patient must sacrifice in order to receive treatment. It refers to how much of their life a person is willing to invest to gain life time or to manage their illness.
This concept is particularly relevant in chronic diseases and comorbidities. It encompasses everything from economic dimensions to deeper qualitative aspects. Reducing treatment burden — by simplifying processes, digitalising interactions, improving communication and adapting the care plan to the patient's actual preferences — is a direct lever for improving patient experience.
How to Improve Patient Experience? The 5 Levers
According to the study What Matters to Patients? (NHS/DH), there is no exact formula for improving patient experience. However, these five levers are shared by all organisations that have successfully improved:
| # | Lever | What it involves |
|---|---|---|
| 1 | Measurement | Continuous, segmented, real-time data capture systems with PREMs as the standard tool. |
| 2 | Leadership | Management commitment, central services guidelines and active quality teams. |
| 3 | Culture | Organisational transformation to place the patient at the centre of all decisions. |
| 4 | Patient engagement | Communication, coverage of basics and co-design of improvement programmes. |
| 5 | Staff involvement | Staff with clear objectives, empowered and recognised for delivering good experiences. |
1. Measurement: PREMs as a Driver of Continuous Improvement
The five requirements of a modern measurement system are: continuous measurement, service-segmented information, real-time feedback, patient-friendly channels and qualitative feedback. In 2025, the analysis of open-ended responses is carried out with NLP (Natural Language Processing) AI, which automatically classifies topics, sentiments and urgencies across thousands of responses simultaneously.
SECA (2025) describes how PREMs act as a driver of continuous improvement at three levels: at the level of the health system (identifying key areas, informing health policies), at the meso-management level (optimising processes, promoting institutional learning) and at the level of care processes (enabling real-time adjustments and promoting personalisation of care).
The guide warns of a frequent mistake: measuring experience does not by itself guarantee its improvement. Measurement is a tool for detecting aspects that need to improve, but data must be translated into concrete actions at all levels of the organisation.
When PREMs and PROMs cross-reference
When PREM data is cross-referenced with PROM data (patient outcomes), valuable correlations emerge. In the home respiratory therapy study cited in SECA (2025), when family involvement was greater (PREM), exacerbations and symptoms (PROMs) decreased. Improving experience has a direct impact on clinical outcomes.
2. Leadership
The most successful improvement programmes have the active support of management, the guidance of central services and frontline work from quality managers. Press Ganey (2025) identifies teamwork as the most relevant emerging factor in patient experience and trust: when patients perceive the team working in a coordinated manner, their recommendation score rises significantly.
SECA (2025) defines four pillars for leadership in healthcare quality: (1) quality training and culture, (2) visible managerial leadership and commitment, (3) strategic and operational management with clear objectives, and (4) deep change towards a culture of continuous improvement, from senior management to operational staff.
3. Culture
The organisation's culture defines how its staff behave. A true culture change means moving from an organisation focused on its own operational needs to one centred on patient experience:
- From an organisational focus to a patient focus: seeing the service through the eyes of those who use it.
- From one-way to two-way information exchange between patients and the hospital.
- From ad hoc changes to continuous improvement processes at all points of the patient journey.
- From exclusive focus on the functional to active recognition of the emotional and relational side of care.
- From disconnected incentive systems to systems aligned with patient experience outcomes.
- From siloed working to a culture based on the patient journey and integrated care.
4. Patient Engagement
Time in hospital or with the physician is just a fraction of the patient's journey. Press Ganey (2024, 6.5 million encounters) identifies a critical generational gap: patients aged 18–34 score 77.7/100 vs 85.1 for those aged 65–78. Millennials and Generation Z expect digital access, online booking and asynchronous communication.
SECA (2025) reinforces co-design as one of the most effective ways to improve experience: patients must participate in advisory councils and quality committees. The guide insists that 'patients are allies of their carers', not passive recipients. Reducing treatment burden — by simplifying processes, improving communication and digitalising interactions — is co-design in action.
5. Staff Involvement
Press Ganey (2025), in the analysis of 2.3 million healthcare workers, demonstrates that environments with a strong safety culture are simultaneously better for staff and patients. Hospitals with lower disparity in experience between ethnic groups are almost 3 times more likely to be top performers in likelihood to recommend.
"3x more likely to be top performers in patient experience in hospitals with a smaller equity gap between groups. Equity and excellence in experience are correlated. (Press Ganey, 2025)
AI and Digitalisation in Improving Patient Experience
In 2026, artificial intelligence is applied in a practical way across the complete cycle of patient experience improvement:
| AI application | Impact on patient experience |
|---|---|
| NLP analysis of open feedback | Automatically classifies thousands of qualitative responses by topic and sentiment, enabling real-time action. |
| Readmission prediction | Digital monitoring platforms reduce readmission rates by up to 30%. (WEF / Huma, 2024) |
| Predictive rounding | Identifies which patients need immediate attention, optimising clinical team time by up to 40%. |
| Assisted documentation | Reduces the physician's administrative burden, giving them more time for the patient relationship. |
| Care personalisation | Analyses patient history and profile to tailor communication and the care plan. |
SECA (2025) recommends automating the statistical analysis of quantitative data and using artificial intelligence for the interpretation of qualitative results, leaving the final interpretation and decision-making in the hands of experts. The European AI Act (in force since August 2024) classifies medical AI systems as high-risk, subject to strict requirements on transparency, data quality and human supervision.
Practical Steps to Improve Patient Experience
| # | Practical step |
|---|---|
| 1 | Develop a business case with numerical data and patient stories to invest in measurement and improvement. |
| 2 | Understand the current situation by working directly with patients and families to capture what the care process is really like for them. |
| 3 | Dedicate regular time to discussing patient experience at the same level as finances, safety and clinical efficacy. |
| 4 | Motivate staff: an empowered employee with clear objectives has a direct impact on the experience perceived by the patient. |
| 5 | Harness the power of stories: when the clinician hears the patient's story directly, they empathise and become motivated to improve. |
| 6 | Give patient experience formal status: create specific meetings, appoint responsible leads and treat improvement as a priority programme. |
| 7 | Incentivise improvement: align incentive systems with experience outcomes, rewarding innovation and good practices. |
As we have seen, improving patient experience starts with measuring it. RateNow is the Patient Voice programme tested in more than 150 healthcare organisations, designed specifically for the health sector.
Ready to place the patient at the centre of your organisation?
Contact us and we will explain how to improve patient experience: sales@ratenow.cx
Bibliography
1. Wolf JA et al.: Defining Patient Experience. Patient Experience Journal. 2014;1(1):7-19.
2. NHS / DH: What Matters to Patients? The Patient Experience Book. 2017.
3. King's College London: What Matters to Patients? DH & NHS Institute, 2011.
4. SECA / Varela Rodríguez C. (ed.): Guía para la Implementación de Asistencia Sanitaria Basada en Valor. SECA 2025. Ch. 1.5, 1.6, 1.7, 2.9.
5. Press Ganey: Patient Experience in 2024: Bridging the Gap — analysis of 6.5M encounters, August 2024.
6. Press Ganey: State of Patient Experience 2025 — July 2025.
7. Press Ganey / AHA: Improvement in Safety Culture Linked to Better Patient and Staff Outcomes — March 2025.
8. WEF / Huma: Digital Health Transformation Initiative: reduction of readmissions with digital platforms, 2024.
9. European Commission: Artificial Intelligence Act. In force August 2024. High-risk AI systems in health.
10. Nundy S, Cooper LA, Mate KS.: The Quintuple Aim for Health Care Improvement. JAMA. 2022;327(6):521-522.
What are the 8 Picker Principles for a positive experience?
Validated by SECA (2025): (1) respect for values and dignity, (2) coordination of care, (3) information and communication, (4) physical comfort, (5) emotional support, (6) involvement of family members, (7) transition and continuity at discharge, and (8) access to care.
What is 'treatment burden' and why does it matter for patient experience?
A concept introduced by SECA (2025): how much of their quality of life a patient must sacrifice in order to receive treatment. It is particularly relevant in chronic diseases. Reducing treatment burden — by simplifying processes, improving communication and digitalising interactions — is a direct lever for improving patient experience.
What role does AI play in improving patient experience?
In 2025, AI is applied in NLP analysis of qualitative feedback in real time, readmission prediction (up to 30% reduction), predictive rounding, assisted documentation and personalisation. SECA (2025) recommends automating quantitative analysis and using AI for qualitative analysis, leaving the final decision to experts. Subject to the European AI Act (in force since August 2024).
How to improve patient experience in my organisation?
The 5 key levers according to the scientific evidence: (1) continuous measurement with PREMs, (2) committed leadership from senior management, (3) patient-centred culture focused on continuous improvement, (4) active engagement and co-design with the patient, and (5) involved and empowered staff. The starting point is always systematic measurement.
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