What Does Patient Loyalty Look Like?

Leaving patients with a positive feeling about the care they received is obviously a primary goal for any healthcare organization. But the organization's viability may rest on whether those feelings are translated into a tendency to use the facility for future healthcare needs -- in other words, whether the facility is building loyalty.

Reflecting a broader trend in business metrics, healthcare organizations are increasingly building customer loyalty (in their case, patient loyalty measures) into their existing satisfaction surveys. As the graph above suggests, loyalty, more so than satisfaction, is crucial in explaining a healthcare facility's bottom-line financial measures. In fact, hospitals not attentive to loyalty may be jeopardizing their long-term sustainability.

Gallup recently completed an in-depth analysis that offers some useful guidelines for measuring patient loyalty. A few key findings are listed below.

Focus Groups*

The first phase of the study involved conducting nine focus groups with key patient segments from diverse regions in the U.S. The results suggested that:

• Loyalty to physicians is a much easier concept for patients to grasp than is loyalty to hospitals.
   
• People tend to equate the concept of physician or hospital loyalty with repeat use and trust or confidence in the provider.
   
• The primary loyalty driver is "quality of care," which translates operationally into technical competence and "high touch" skills of providers, especially physicians and nurses. Technical competence includes not only technical skills, but also the ability to inform and to provide clear explanations of a patient's medical condition and treatment. The core high-touch themes are compassion/empathy and a caring attitude, which are tied to being "knowledgeable about the patient."

Survey Results*

The full-scale survey included 2,826 patients from 52 facilities covering 12 metropolitan statistical areas. Key findings included the following:

• There are five key predictors of patient loyalty: overall satisfaction, hospital image or reputation, satisfaction with problem resolution, staff following through with what they say they will do, and staff treating patients with dignity and respect.
   
• Satisfaction is clearly a link in the chain of events culminating in loyalty. However, the hospital's image or reputation also makes a difference. A hospital that brands itself a leader in given specializations will gain an advantage in winning patients' loyalty, as well as their trust.
   
• Patients expect hospitals to deliver on their promises by resolving problems to their satisfaction, doing what they say they would do, and treating patients with respect and dignity. Patients want a fair return on both their emotional and financial investment.
   
• While satisfaction is a key predictor of hospital loyalty, trust has an independent effect. The item judged to be the key trust measure "you can trust this hospital to do what is right for you as a patient" figures prominently, but another trust measure "you can trust this hospital to handle all your future healthcare needs" also exerts significant influence.
   
• Satisfaction and loyalty, while strongly related, are distinct. The key satisfaction predictor "treats you as a person, not a medical condition" fails to predict loyalty, as do the next most important predictors, cleanliness of the hospital and problem resolution.

* Patients were surveyed by telephone between November 1999 and January 2000. Only in-patients discharged six to eight weeks prior to the actual interviews were surveyed.