In an effort to progress from disease-centered care to patient-centered care, new questions have to be asked. As summed up by Valerie Billingham in the Salzburg Seminar Session “Through the Patient’s Eyes” this means “Nothing about me without me.”

In 1988, the term “patient-centered care” was coined by the Picker Institute (then the Picker/Commonwealth Program for Patient-Centered Care). Further, in the Institute of Medicine report “Crossing the Quality Chasm”, patient-centered care was defined as “care that is respectful of and responsive to individual patient preferences, needs, and values” and that assures “patient values guide all clinical decisions.” This suggests moving from provider-centered care to patient-centered care where patients are actively engaged rather than passive participants, innovative care delivery strategies are developed beyond facility-based visits, and the questions go beyond “What’s the matter with you?” to include “What matters to you?”

Patient satisfaction surveys include the patient’s own evaluation of their level of satisfaction with services and systems. This is achieved through questions that may begin with, “How satisfied are you with X” – X being the appointment system, the caring and concern of the doctor, the ease of access to medical care, or others. The responses may range from strongly agree to strongly disagree or from very good to poor. Patient satisfaction responses may be used as an outcome measure.

It has been suggested that patient satisfaction is actually a component or subset of patient experience. While patient experience has been defined by the Beryl Institute as “the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.”(The Beryl Institute, available at: http://www.theberylinstitute.org/) there are a variety of definitions in use for this term. According to the Patient Experience Journal, which debuted in 2014, the definition may include occurrences and events, engagement of patients as partners with individualized care, realization of patient expectations, and the practice of patient/family-centered care. (Wolf JA, et al. Defining patient experience. Patient Experience Journal. 2014;1(1):7-19. Available at: http://pxjournal.org/cgi/viewcontent.cgi?article=1004&context=journal)  Definitions are as simply put as “how the patient feels/felt (good or bad) as/after he or she undergoes/underwent an episode of care”. More complex definitions may define the variety of components for expectations, from entrance to exit of the healthcare experience. Specific examples may include cleanliness, information about where to go, convenient/punctual appointments, choice of hospital and care providers, helpful staff, knowledge and understandability of health care providers, involvement in decision-making, reassurance and advice about health care, information about causes and management of health condition, and being given an opportunity to discuss issues.

Patient experience surveys may rephrase questions that are similar to patient satisfaction to determine their experience for items, such as wait times, addressing patient concerns, and other topics. These responses may quantify their experience ranging from always to never or a selection of specific options, such as 1 day to more than 7 days. Patient experience ratings generally have more to do with the interaction with clinicians and others in the care system than outcomes.

It can be confusing because a patient may have a negative outcome and still have a positive experience or may have a positive outcome with a negative experience. Patient experience responses provide an opportunity to learn how to address lower patient satisfaction scores by providing specific experience information. For instance, a low patient satisfaction rating for a doctor’s caring and concern may not identify a correction while an experience response on an item, such as being treated with courtesy and respect, may indicate where an improvement can be made.