Ingrid Nembhard, Health Care Management, The Wharton School; Sasmira Matta, Florida State University; Dale Shaller; Rachel Grob, UW Madison; Mark Schlesinger, Yale University
Abstract: Many healthcare organizations struggle to improve their patient experience scores despite significant effort. Enthusiasm has grown about the potential for patient narratives stories about care experiences in patients’ own words to provide insights that advance organizational learning about care and thus how to improve it. However, there is no evidence establishing an association between narrative use and organizational performance. In a one-year study utilizing survey data from patients and personnel affiliated with primary care clinics, we tested whether organizations that share narratives with their personnel frequently have higher patient experience survey scores. We found that they do, conditional on domain of experience and personnel’s confidence in own knowledge of patients and practice. For operational measures of experience (e.g., timeliness of care), increased narrative use correlated with higher scores for more confident personnel and higher or lower scores for less confident, depending on measure. For relational measures (e.g., patient-provider communication), increased narrative use correlated with higher scores for the less confident and lower scores for the more confident. These results indicate that narratives use should be encouraged as an improvement strategy and that organizations need to address how narrative feedback interacts with confidence to yield higher scores across domains.