Patient Experience Improves Year to Year

By: Marc Shapiro

To measure patient satisfaction, Johns Hopkins Community Physicians (JHCP) director of patient experience Ron Cox relies on CG-CAHPS (Clinician and Group Consumer Assessment of Healthcare Providers and Systems) scores. Derived from patient survey results, CG-CAHPS measures each practice’s quality of care, communication within staff and with patients, wait times and more.

Thanks to the work of the patient experience team and locations across JHCP, every CG-CAHPS measure improved from FY24 to FY25.

“This demonstrates that the investments our teams have made in communication training, empathy-centered care and frontline engagement are truly resonating with patients,” Cox says. “More importantly, it reflects the hard work of our physicians and staff to build trust, strengthen relationships, and create a culture of compassion and accountability.”

There was a big improvement in patients’ likelihood to recommend their JHCP office, an important metric that the patient experience team tracks closely, with scores consistently exceeding the national average and improving throughout the year. Cox noted that the scores not only increased but were more consistent throughout JHCP than in previous years.

“This progress is one of the areas we’re most proud of because it demonstrates that we’ve improved patient care across the board enough that patients want to recommend JHCP to their friends and family,” says JHCP President Steven Kravet.

Other notable improvements were in telemedicine technology, staff working well together, overall provider rating and visit wait time. Other measures that improved include staff quality, physician communication quality, overall visit rating, appointment access, hand hygiene and patient identification.

The CG-CAHPS, developed by the Agency for Healthcare Research and Quality, measures patients’ perceptions of care, allowing health care organizations to compare performance with thousands of medical groups across the country, Cox says. Ranked by how much they improved, JHCP was among the top 30% of organizations that saw scores increase in FY25, according to survey administrator Press Ganey.

“Because these surveys directly reflect the patient voice and are tied to national quality and value-based care programs, they are a key indicator of how effectively we communicate, coordinate care and deliver an overall positive experience,” Cox says.

The survey that determines CG-CAHPS scores is sent to patients within two days of their JHCP visit, as long as they haven’t been seen within the last 30 days. The response rate is about 18%, which is around the national average. Some practices try to increase the response rate by giving patients a slip of paper with information about the forthcoming survey and a QR code that leads to a website with information about how JHCP utilizes the feedback.

Throughout the year, Cox and his teams track the performance of each JHCP practice, meeting with leaders at each site and helping develop individualized action plans for lower-performing sites. They review patient comments and focus on their two key drivers — the scores related to provider communication and to staff working well together.

Cox and his team then coach JHCP staff using nationally standardized best practices. For example, they ask staff members to pick three words they want patients to use to describe the practice — friendly or efficient, for example — then talk about how to remove barriers toward meeting those expectations.  

The patient experience team also created individualized action plans for providers who needed to improve their own CG-CAHPS scores.

In addition, clinical operations meetings and patient experience webinars give JHCP staff and leaders a chance to hear from subject matter experts.

In FY25, the patient experience team also developed a patient experience all-star program that recognized high performers who were nominated by a staff member, leader or patient. The “all-star” receives a certificate signed by the executive team and a star pin to wear.

“We noticed really dramatic improvement with sites that work with their frontline staff and put processes in place, whether it was utilizing Epic chat or other tools to keep patients informed,” Cox says.

“If there’s a delay and the provider is running behind, how is the care team in the back office letting the front office team know? Then how is that team informing patients?” 

Seizing the Opportunity

JHCP’s Montgomery Grove location was one of the practices Cox describes as an “opportunity site.” He worked to help them raise their scores in the categories of staff working well together and visit start times.

Patricia Young, a nurse practitioner who became practice administrator three years ago, has since taken steps that have improved communication with patients, as well as between the front office and medical staff. This has helped ensure consistent messaging with patients, including what to expect at their appointments, as well as more efficient coordination with diagnostic tests and follow-up needs.

“These are things we already do, but I think the improvements are just everybody being more intentional and understanding the importance of these metrics,” Young says. “And we’re working better together front to back. We discussed that when talking about the team working well together — coordinating administrative and clinical personnel.”

Spencer Schron, a member of the Montgomery Grove Patient and Family Advisory Council (PFAC) says things have continued to improve under Young’s leadership. Each JHCP practice has its own PFAC, which meets at least twice a year.

“We’re all impressed with the communication and coordination of the office,” Schron says. “The team seems happier, and I don’t see turnover like I did before, which says quite a bit.”

Practice leaders are encouraged to engage the PFACs around areas of opportunity, which are often identified through CG-CAHPS feedback, Cox says.

“PFAC discussions have led to changes in check-in processes, communication workflows and signage to make the care experience clearer and more welcoming,” he says. “It’s a practical way to keep the patient voice front and center in our improvement work and ensure that our changes reflect what matters most to those we serve.”

For Young, this is exactly why she took on the role of practice administrator.

“You don’t go into health care if you don’t care about people,” she says. “And if you care about people, you’re going to do the best that you can for them every day.”