Systemic Integrated Care Journey Experience: A Novel Patient Experience Measurement Approach for Driving Integrated Care Outcomes at Scale

Background: Traditional patient experience surveys achieve response rates below 30% whilst generating fragmented insights inadequate for system-level integrated care improvement. Current methodologies burden patients with lengthy questionnaires whilst producing isolated snapshots that fail to capture interconnected care experiences. As a large regional hospital system seeking to improve integrated care outcomes, we require comprehensive patient journey experience insights without overwhelming patients or compromising data quality.

 

Objective: To develop and validate an intelligent, population-based, patient experience measurement approach that generates systemic integrated care whole-of-journey insights through novel survey module/question distribution across disparate patient care settings, eliminating individual survey burden whilst maintaining statistical validity.

 

Methods: Using systemic design principles and stakeholder consultations, we analyzed patient flow data and care utilization patterns across our hospital system and mapped standardized patient journeys and pathway. Patient experience survey questions were developed and refined using stakeholder and patient engagement and were based on the Patient Value Compass framework across four domains:

Quality of Healthcare Delivery

, Perceived Well-being,

Health Benefits Perception, and

Patient Satisfaction.

To minimize patient survey fatigue whilst enabling complete integrated care journey intelligence, a sampling matrix was developed and deployed using a commercially available survey software platform which we programmed to methodically distribute survey modules and survey question elements across different patient care settings, collecting adequate patient responses from multiple patients that triangulate and reconstruct complete journey intelligence for all integrated patient journeys. Finally, the resulting patient experience data was aggregated to generate a systemically representative patient experience outcome at scale for the whole hospital as an integrated care system.

Results: Our redesigned systemic patient experience measurement approach measured patient experience across eight distinct integrated patient journeys mapped across six care settings for integrated care delivered by more than 40 departments across four job families, i.e. medical, nursing, allied health, operations. The modular survey architecture comprised journey-specific modules containing 15-18 items each. The sampling matrix generated usable patient experience data for each of the 6 different care settings while producing usable patient experience scores for each of the eight integrated patient journeys.

 

Profession-specific patient experience data was also generated and returned to different clinical teams/job-families. Finally, whole-hospital system patient experience scores were returned to clinical, operational and hospital leadership. A comparative pilot study design (n=800) was also developed to validate the journey-informed modular approach against traditional quota sampling, comparing response efficiency, insight comprehensiveness, and actionable intelligence quality between SMS-deployed modules and telephone-administered comprehensive surveys.

 

Conclusion: s: While still requiring more work to refine our sampling matrix and validate our patient experience scores, the concept of Systemic Integrated Care Journey experience measurement is evidently possible and represents a novel and paradigm shift from individual-centric to system-intelligent patient experience feedback collection. This framework addresses fundamental limitations of traditional surveys whilst potentially generating superior actionable insights for healthcare quality improvement that is journey-focused and scalable for whole integrated care systems.

 

Keywords: Patient experience, healthcare quality, population health, survey methodology, patient journey, systems thinking, quality improvement