← Becker’s Healthcare Podcast
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- [00:00]
A
Hi everyone, this is Lucas Voss with Becker's Healthcare. Thanks so much for tuning in to the Becker's Healthcare podcast series. It's great to have you. Very excited to talk today about the insights from NRC's health through report Negotiating the Trust, the high cost of low reliability in healthcare experiences. And the report really highlights compelling data on how brand image shapes trust and the critical connection between patient expectations and actual experiences, which is certainly very important. And joining me for today's discussion, very excited to have a on Dr. William England, strategic advisor for research at NRC Health. Dr. England, thanks so much for being here today. It's great to have you.
- [00:40]
B
Thanks Lucas. It's a pleasure to be here. First time on the podcast. I'm very excited.
- [00:45]
A
It's great to have you, especially since it's your first time. If you want to kick us off just introducing yourself and tell us a little bit about your work in healthcare.
- [00:53]
B
Yeah, sure. So I've been with NRC Health for the last 10 years. I've served in a variety of roles from custom analytics to data science. My current role is serving as a strategic advisor for research as part of our thought leadership team, which is a relatively new endeavor for our organization. Really excited. The primary task in that role is basically conducting database wide research and surfacing insights for publication like the one that we're talking about today. Just really excited to be working at NRC because we bring, I think we bring a lot of like really unique healthcare related data sets together like our nationally syndicated Market Insight survey and our patient experience feedback, which is sort of the work for this trust clip article sits at the intersection of those two data sets. So it's not just about reporting data, it's about leaning into surfacing patterns that can really help leaders, I think, connect dots across, you know, brand patient experiences and more than that. So really excited.
- [01:46]
A
Yeah. And I think the report that we're talking about today really does that extremely well, which is connecting those dots and connecting the dots, you know, framing reliability as sort of the inflection point between expectation and experience. Again, connecting the dots there. And I'd love to know why is consistency and delivering on promises so foundational to trust in healthcare in general? And why is breaking that trust, on the other hand particularly damaging compared to other industries when we look at healthcare?
- [02:19]
B
Yeah, it's a great question. And just to like go take you down a different path for just a moment if you've ever had that experience where like your friend, you know, really strongly recommends a movie to you and they talk it up and you go down, you go to watch the movie, you know, that's the best movie you'll ever, you'll ever see. And you end up turning it off halfway through and you go, well, that's the last time I'm going to watch a movie that guy recommended. You know, in most industries, if expectations fall short, it's frustrating, but you can switch brands, you can write a bad review and move on with life. The stakes are a little higher, you know, maybe profoundly higher in health care, where people are at their most vulnerable and, you know, and they're putting their money, and not just their money, but their faith, you know, their health, their lives, their family's well being on the line. And our research has just shown that trust is crucial for not only healthcare brands, but for building patient loyalty. In the connection to that research, we've also found that reliability is a key driver of trust for both consumers and patients. Which is why we argue that the ability to deliver great experiences, not just occasionally, but across visits and across care settings within the organization, across the patient's journey is so critical. We cite a couple of different phenomenon in the academic literature, expectation violation theory and expectation disconfirmation theory, which are just, just, you know, avenues of research that show that trust is most damaged when expectations and experiences are not aligned. And so that's where really the bedrock of this analysis began.
- [03:43]
A
And again, I love the movie analogy because that's something that everybody can understand, right? It's a recommendation that you get, you have an expectation, you go into it, it's not what you expected, and you immediately lose that trust in that recommendation, which is a great illustration of this and, and what you've done with this data, which is really interesting, you've identified four distinct pattern trust, which was really great to see. And I hope everybody checks out the report because it illustrates it very nicely. So these four district distinct patterns, the gold standard, the pleasant surprise, low expectations met, and the trust cliff. I was wondering if you could walk us through these categories, what each reveal about the relationship between brand perception, patient experience and trust and what they mean.
- [04:25]
B
Yeah, sure. So just a brief word sort of methodologically here with this analysis, it's a fairly simple and you know, sometimes the simplest analyses are the ones that yield the most insights. And so I hope that describes, describes this one. But basically what we did was we took some image and reputation data from our market insights survey and the patient experience data that, you know, would you recommend this hospital or facility to friends and family? We took, we combined those Two data sets basically in a scatter plot. And when, when you do that, you know, you kind of get a quadrant of analysis or the ability to perform a quadrant analysis which shows, you know, like in the upper right hand quadrant where experiences are really good and brand perceptions or image and reputation perceptions are really high. We get this gold stand where patients are arriving expecting great care and the delivery matches. And so trust in that instance, we're saying, is reinforced. The pleasant surprise quadrant where maybe the brand is low, image and reputation is a little bit lower relatively, but experiences are really good. People come in, maybe skeptical, but a strong experience sort of yields opportunities to build loyalty and think about branding. Low expectations met. These are unfortunately organizations or hospitals where the image is low. And that's confirmed by not, that's not such a strong experience. We were saying there's a pretty steep climb. So improvements have to start with the basics in that case. But where it gets really interesting and we're sort of re cover some of the academic research and literature that we were, that we were looking at is where the image and reputation is high, but experiences are low. And this is where, when you go and ask, you know, we go and measured in sort of a post hoc analysis where, where is trust the highest and lowest in these quadrants? Well, it turns out that when brands are set high expectations, but front experiences fall short, that's where trust is the lowest, just 66% in our sample of data. And that was the lowest among all hospitals in this scatter plot in this quadrant. So that led us to start thinking about, okay, tactically, what does that mean? Where do you show up in this quadrant if you're a hospital and what does that mean tactically to start changing the narrative or changing the trajectory?
- [06:35]
A
As you've mentioned, there's different parameters for these. Different organizations find themselves on different spectrums around these. I was wondering if there's one that's more important than the other in all of these categories or are they equally, equally important? Are they equally looked at when you're looking at your research?
- [06:53]
B
We argue that the trust cliff is the quadrant that leaders need to be focused on most urgently because it's where the gap between promise and reality is most damaging to trust. I think long term the gold standard is where every system wants to be delivering reliable, consistent experiences with high expectations, experiences reinforcing each other. But the thing is, each quadrant to your point comes across, comes with its own potential actions and reactions, whether it be better communicating the good work being done within the four walls, the care setting or rolling your sleeves and figuring out how to deliver on the brand promises you made to consumers. Each quadrant sort of comes with its own set of actions and reactions. And so they're all important, I think. But like I said, long term, I think the gold standard is where organizations want to be and where patients and people who are consuming health care want their organizations to be.
- [07:44]
A
Yeah, now we have to get there.
- [07:46]
B
Right?
- [07:46]
A
We have to get to the gold standard. It's a process. There are certain things that can be done to be able to reach those processes and to be able to go through that and get to that gold standard that we want to get to. And you have five strategic imperatives in the report, from auditing brand experience to training for consistency. That's a big part of it too. From your perspective, which of the five actions and these strategic imperatives are most critical for health system leaders to prioritize and how can they operationalize them to then get to that gold standard?
- [08:18]
B
Yeah, it's a good question. If I had to pick one, which, you know, they're all important. I think, I think the one that's most interesting at least, is the auditing, the brand experience alignment. I think too often marketing strategies and listening to some of my, some of the folks that I work with that are, that are, you know, on the marketing side or helping, you know, market strategies. I think too often marketing and patient experience teams work alone and in siloads. And when we put market insights alongside the patient experience data as we have, I think we can pinpoint exactly where expectations are outpacing delivery. And the pleasant surprise reveals an interesting opportunity, I think, to better evangelize the good work being done. I think a lot of times there is really good work being done, and it's just like all it would take is to bridge the gap between, hey, this is what we're telling our community, this is how we're communicating to the community, and this is what we're actually doing within the four walls of the care setting. And I think that presents a really intriguing opportunity to me. It kind of tells leaders where to focus improvement efforts and recalibrate messaging, and it also celebrates where they're getting things right. I also think that, like, but, you know, not to ignore the, the, the other aspects. I think training for consistency is really critical because, you know, excellence without reliability feels more like luck, you know, maybe than, than consistency. And so systems that bake reliability into their culture through hiring and training and recognition and accountability, those kinds of things, I think those are the organizations that sustain trust over time.
- [09:43]
A
And I think one of the key pieces too from the report as well is having those solutions. Right. There is a path. It's not something that you're loc. It's you can improve, you can build and you can improve ultimately and get to that. Which is a key piece to this. I want to close our conversation looking ahead a little bit. Right. We, we mentioned the movie experience in the beginning of our conversation. Right. And I think it relates to this as well because consumer expectations are changing, patient expectations are changing. They relate things more to what they're seeing in their day to day life. Consumer. Right. Consumer experiences, et cetera. It's evolving. Where do you see the biggest opportunities for healthcare organizations to differentiate through trust right now?
- [10:23]
B
Yeah, I mean, you said it. Patients, you know, especially younger patients. But we, you know, in our data, we see older, older patients too, are comparing their healthcare encounters to other service experiences in their lives, be it banking or hospitality or retail. I think that means that, you know, speed, clarity, personalization, transparency, the things that we sort of get accustomed to in our daily lives, they're no longer nice to haves in healthcare. They're sort of table stakes. And so the opportunity to me is for healthcare organizations to differentiate on this idea of reliability and the confidence that patients feel that what they're promised is what they're going to get. But not just once every time. Right. I know that's easy to say sitting in my armchair here, but our data does show that younger, more digitally savvy patients are, are attuned to this. And organizations, I think, that are able to sort of look at not just their patient feedback, but their brand and then think about storytelling and how those align with authentic experiences. I think those are the organizations that are well positioned to build lasting trust. And, you know, I think how you make that part of the DNA within the organization and how you communicate that is how you operationalize reliability and gain.
- [11:35]
A
Patient loyalty and then being able to transition into that gold standard category, which is the ultimate goal. Well, Dr. England, thanks so much for being here today. We will not be making movie recommendations to not erode trust for this episode. I want to thank you again, Dr. Englund, for being here and for all of your insights today. It's great to have you.
- [11:53]
B
Thanks. It was a pleasure.
- [11:54]
A
And we also want to thank our podcast sponsor, NRC Health. You can tune in to more podcasts from Becker's Healthcare by visiting our podcast page@beckershospitalreview.com.