What is Experience? The Moments That Patients Remember Most

October, 2013

What is experience? Healthcare has a revived focus on improving something that we try to capture in surveys.  But how do we define something that can be as intangible as the feeling that staff offered emotional support?

According to a group of MIT researchers, when people are asked to evaluate any type of experience they tend to concentrate on a few aspects instead of the cumulative effects of how events took place.  People focus on variability, particularly high or low points, pace, and the final outcome.

Let’s break this down through an example. Taking a difficult exam consists of many different parts. If students were asked to discuss the experience afterwards, they would probably not describe the combined intensity of all parts – studying, getting to the classroom, each part of the test, and then leaving afterwards.  They would be more likely to focus on a few key components of their experience. Perhaps they’d say, “The essay questions really threw me, but the multiple choice was way easier. I was so relieved when I left the classroom; I treated myself to ice cream right away!”

The MIT team took a close look at the experience of patients at a bone-marrow transplant unit in a hospital.  A nurse asked the patients to rate their pain every hour.  At the end of the day, the patients were asked to rate the overall pain they experienced that day.  The researchers looked for consistency in the two measurements and found a highly significant correlation between patients’ overall pain rating and two variables – the intensity of the final state and the rate at which their pain changed throughout the day.  From the data, the researchers could also conclude that the patients’ evaluation of their overall experience was not influenced by the total amount of pain experienced by the patients throughout the day.

What does this mean? Patient experience, like any experience, is broken into parts.  If a patient is asked to evaluate their care, each part will be evaluated in terms of intensity and change over time.  Patients will assign a lot of weight to key moments of joy or of pain.  They will also focus on trends such as improvements or deterioration over time. Obviously, we can’t intentionally set a low starting point for patient experience. But we can take a closer look at the distinct states that make up experience from check-in to follow-up and make each moment as productive and positive as possible.

One last point on the MIT research – prior events will influence experience ratings.  The bone marrow transplant patients had all been in pain prior to the MIT study, and their comparison to this earlier pain was likely to bias their answers in the study.  So, a previously terrible healthcare experience will bias patient evaluation of a newer experience and not give assessors an accurate answer.  This means that, as your organization embarks on a patient experience improvement journey, reducing variability to create a consistently high quality experience will lead to the ideal outcome.

Source: Ariely, D. and Carmon, Z. Gestalt Characteristics of Experiences: The Defining Features of Summarized Events. Journal of Behavioral Decision Making. 13:191-201 (2000).