Healthcare Net Promoter Score (NPS) Survey Best Practices

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July 15, 2022
The Net Promoter Score (NPS) is a widely used market research metric that takes the form of a single survey question asking respondents to rate the likelihood that they would recommend a company, product, or a service to a friend or colleague.

In healthcare, it can be used to measure patient satisfaction, help redesign workflow and process, and also predict and shape organizational growth. This proven metric has transformed the general business world and is now starting to provide a core measurement that gauges patient loyalty to a provider group's brand, products or services.

For more background on what NPS is exactly and why it’s important, please see the Lobbie Institute article: Growing Your Healthcare Business Using Net Promoter Scores (NPS)

This article addresses tips, best practices, and benchmarks for getting the most out of NPS campaigns in a healthcare environment.

Tips to effectively implement NPS in healthcare

NPS offers valuable feedback to any type of organization, but in healthcare it can be leveraged in ways that provide added value. Interacting with patients by demonstrating that their feedback was heard and matters is a way to build loyalty and ultimately improve care and outcomes. By learning where there is room for improvement at any level, you can make organizational changes and then follow up with the patients who filled out your NPS surveys to notify them of improvements. With the extremely personal nature of healthcare, demonstrating to patients that you responded to their feedback can be a powerful tool in building positive relationships and an affinity for your brand, services, and products.

Use personalization

Your response rate will be higher if you communicate with patients by name and demonstrate any historical knowledge of their medical journey. Personalization is also critical in producing quality NPS responses in healthcare because patients want to be seen as individuals, not as an extension of their medical needs.

Consider visual elements

Customers can be turned off by how a NPS survey looks. To increase brand loyalty and recognition, it’s a good idea to make the survey as visually appealing as possible, and also customize your survey template to include brand assets like colors, logos, and fonts.

Test internally before sending

Best practices are to never send out a survey before you’ve first tested it internally, typically to your staff. This allows you to fix any errors and gather feedback about other potential issues and ideas for improvement.

To gather the highest volume of reliable data, you need to ensure:

  • Your email engine is working
  • Emails open with the correct format and layout
  • Links to the survey work
  • The survey opens and runs smoothly across different browsers
  • You are reliably receiving, collating and tracking your survey responses

When to send your NPS survey

Bad data is worse than no data. If you send a survey before consumers have had a meaningful interaction with your service, they won’t be able to answer questions about satisfaction or whether they’d recommend you. Wait too long, and the patient experience won’t be fresh in their memory. In both instances, your healthcare NPS benchmark will be inaccurate.

The best time to send your questionnaire depends on how you are using NPS surveys. There are two types of NPS Healthcare surveys:

Transactional NPS Survey - Following a particular event, like involvement in a new procedure, treatment, or a significant office visit. Send out transactional surveys as close to the interaction or service to achieve the best response rate and most accurate scores.

Relationship NPS survey - These NPS healthcare benchmarks are a long-term measure of customer satisfaction, so many businesses send surveys bi-annually or quarterly. Relationship surveys measure overall customer satisfaction, and it’s generally agreed they should be sent somewhere between one week and 3 months after a customer signed up or first started using your services. You can track changes in satisfaction over time by sending follow-up surveys. Bigger organizations with large customer databases may experiment with monthly feedback requests. However, for many companies, that would likely be overkill as most healthcare customers don’t appreciate being overly reminded of their medical needs.

Send reminders

Sending survey reminders is a proven way to increase your response rate, especially with transactional surveys where you want to gather feedback close to the date of the visit or service and it’s fresh in the patient’s memory.

Build a continuous feedback loop

Add an opt out or check-box indicating permission for further follow-up. You’ll get more in-depth feedback this way and it lets patients know they have a voice for their valuable feedback about your brand and services.

Trust but verify

Full automation is the holy grail of any ongoing process such as NPS and its continual collection of data at the right time, over time. The goal with automation is every patient is always surveyed when you want them to be, you can set it and forget it. That said, the more you automate, the more the components in the process need to run reliably and be regularly monitored. At the minimum, episodic reporting on who has been sent what and when are critical (for example, email every day), and even better is real-time data on the same with status metrics, dashboards, mobile alerts and push reports, etc.

Best practices to leverage NPS data in healthcare

Create organizational understanding of NPS

The potential internal impact of NPS should not be overlooked. Concepts of NPS are easy to understand and communicate. Make it clear to all relevant parties what NPS is, how it is administered, and the value of the results. NPS captures one simple, key metric. Keep it that way. Don’t keep adding questions and complexity that could reduce response rates and cloud your results.

Use NPS to build a common language and align goals with staff

The clarity of NPS makes it a powerful instrument of culture change, and can be used to rally your staff around the effort to continually improve patient satisfaction and build your brand. Sharing the concepts of Promoters, Detractors, and Passives drives home the value of NPS and gets your staff communicating in a common language about improving patient experience and loyalty. Tracking and communicating NPS data to your organization creates a shared vocabulary that can build unity around earning consumer loyalty, which ultimately translates into more effective—and more empathic—care.

Review and report insights regularly and track trends

NPS scores can be revealing on their own. But examining them in isolation means missing out on powerful insights. NPS results should be reviewed on a consistent basis and better, also tracked over time. When establishing NPS you should consider the most relevant people in your organization who would benefit from consistent review of your NPS scores and then provide easy access to the data and insights in organized reports. Consider also developing a consistent cadence and approach for reporting the insights on a regular basis so everyone in your organization has clear visibility into which direction the score is tracking and what issues need to be addressed. Healthcare organizations must always be looking for ways to improve operations and care while increasing efficiency and value. Correlations and patterns will show you where to direct your efforts. Comparing NPS scores to day-of-discharge data at the University of Missouri system, for example, showed them that patients who were discharged over the weekend at one facility were some of the least satisfied patients. That insight helped them to better communicate with weekend patients about why they had to stay past Friday, and assure them they were being looked after. They saw very meaningful improvements in patient satisfaction after that.

Grow sample sizes

While the NPS model is statistically robust, to increase its validity, organizations will need to gather responses from lots of patients. One of the great benefits of NPS is that once you have established the practice of sharing the questionnaires with patients, you can gather feedback on an ongoing basis and grow the pool of response data quickly. To maximize response rates keep the surveys short and get them to patients right after their care episodes, that will ensure an adequate sample size so you know your NPS reflects what’s actually going on in your organization.

Integrate patient data to improve results

You can always collect some basic data about the respondent, such as age bracket or income level if you can’t easily tie that to your NPS survey data through integration. This, and other patient data can be tied to NPS results to group respondents into determine if your company and services are perceived in different ways among different segments. This can show trends that allow you to directly address issues that might be affecting a certain group more significantly than others. You can also amplify the value of NPS survey data by connecting it to EHR and revenue cycle data. This allows you to take targeted action and improve the patient experience with the hope of boosting their perception of your organization.

Monetize your NPS data

Many companies measure NPS extensively but fail to act on it. A monetized Net Promoter Score is taking it to the next step:  improving your operations and financial results. Here are some ways to operationalize and monetize NPS:

  • Reach out to happy patients (Promoters) directly to ask for friend and family referrals, online reviews, and shoutouts on social media.
  • Use NPS to identify which of your accounts are about to churn. Intervene quickly to turn negative patients (Detractors) experiences around and convert them to Passives or Promoters in future NPS surveys. This is an important process because research has shown that increasing customer retention rates by just 5% can lead to profit increases of between 25% and 95%.
  • Identify which of your accounts are happy Promoters and likely upsell opportunities for new treatments, products or services
  • To work towards a better Net Promoter Score, healthcare providers should reach out to Passive respondents to prevent them from becoming tempted by competitor offers. Impress them with a superior patient experience, earn their loyalty, and work towards your next NPS benchmark goal by turning them into a Promoter.

If you start to see that all NPS respondents are improving their scores, every review meeting is a good chance to focus on what’s next that can be tracked and improved to create more Promoters. A study by the University of Missouri found that:

  • The average promoter re-admission rate is 4.7% lower than for detractors
  • The average promoter emergency room return rate is 7.7% lower than that of detractors
  • The average care compliance is 14.2% higher in promoters than detractors

Promoters don’t just say the good things about your brand for other potential patients to hear. They can actively reduce your overhead costs and increase your profits.

Benchmarking NPS

Benchmark your results

Once you’ve got your NPS data, you can set initial internal benchmarks, then repeat the survey regularly to see whether your score is moving in the right direction—and make changes accordingly. One of the most valuable benefits of NPS is the ability to see beyond your internal benchmarks to see how your healthcare organization stacks up against the external NPS benchmarks of your competitors or industry.

While you’re continuously monitoring your customer loyalty ratings with NPS to make internal changes to your organization, you can also gather external NPS benchmarks to understand if your Net Promoter Score is good or bad. For example: If your Net Promoter Score is 50, what does that really mean? A score of 50 may not seem great to you. But an NPS of 50 could actually be a strong score when compared with the average NPS for organizations in your industry or specialty.

What's a good NPS score for healthcare companies?

Various studies indicate the average NPS score for the healthcare industry is benchmarked at between +38 and +58, and can vary by specialty, facility type, market, etc. Bain & Company (the creators of NPS) note that a good NPS score is 0 and above. Above 50 is excellent and above 80 is world class. A score that's zero and above suggests that you have more Promoters than Detractors, which is a good sign.

We suggest starting with a benchmark goal of 50 and adjust it over time as you gather internal and competitive data. It should be your ultimate goal to match leading players in your specialty.

In summary

The digitalization of healthcare in a post-pandemic world has changed the way many consumers take ownership of their health. Looking to the future, healthcare providers should expect to adopt valuable new technologies, tools and methodologies to continue finding ways to meet and exceed patient expectations. Patients are also more selective and research-savvy than ever. According to Google, patients are 3X more likely to use search than non-search methods to find a hospital. To set themselves apart from the competition, providers can create more personalized patient experiences through collecting and acting on feedback such as with the Net Promoter Score.

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