Patient experience (PX) is an independent measurement of quality of care, clinical effectiveness, and patient safety, making it a top priority for healthcare organizations in the short and long term. At the same time, a multidisciplinary analysis published by Press Ganey in the 2017 Strategic Report demonstrated the interdependent relationship between PX, safety, service quality, workforce engagement, and financial resources. Thus, an improvement in any one of these areas can positively impact the others and support progress in an improvement project, while a defect or deficiency in any one of these areas can jeopardize other areas. In this regard, patient involvement and their voice should be seen as powerful tools for improving and developing the culture of care in the hospital.

Over the past decades, the Kingdom of Saudi Arabia (KSA) healthcare system has dedicated itself to improving the quality of healthcare services by improving PX. However, there is a lack of empirical studies that examine how to improve mean PX scores in inpatient, outpatient, and emergency department settings. In this study, my colleagues and I sought to examine how to improve mean PX scores in inpatient, outpatient, and emergency department settings in a healthcare facility in the Eastern Province of Saudi Arabia. To achieve the research aim, a set of interventions were implemented that included a patient and family advisory council, empathy training, recognition of the PX, leadership–patient interviews, PX champions and quality improvement. These interventions were further measured using the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) in the inpatient, outpatient and emergency departments. The findings of HCAHPS served as a basis for the PX culture model for the three departments of the hospital, namely inpatient, outpatient and emergency departments.

In improving PX, one of the first steps was to establish a Patient and Family Advisory Council (PFAC) to promote best practice in the hospital, learn and educate from the patient and family perspective, and promote patient-centered care. Discussions at the meetings provided significant insights into patients' understandings and concerns regarding primary care delivery. The second step in improving the PX model was to improve empathy towards patients through training and a series of educational programs for all staff. We observed a direct positive relationship between increased patient support and decreased patient anxiety and distress, leading to significantly better clinical outcomes. The third step was to recognize the efforts of the staff in providing healthcare services and PX as such. In our case, the staff named in the positive comments by patients were awarded a certificate of appreciation by the hospital director. This step allowed us to confirm the evidence of the importance of motivating the staff and rewarding, not necessarily financial, motivational support (e.g. certificates) for the efforts of healthcare providers. At the same time, it is very important to consider the needs and demands of the staff that could improve their working conditions, which would lead to increased patient satisfaction and PX culture.

The next step of this study showed that management interviews with patients as part of the planned weekly management safety walkthroughs had a positive impact on patients and on improving the quality of care. It is therefore safe to say that hospital management can improve management effectiveness by focusing on key aspects of communication and leadership with patients and staff. The last step in PX improvement model of the current research was the quality improvement. This included a systematic and coordinated approach using specific methods and tools with the aim of bringing about a measurable improvement. This systematic approach and steps undertaken resulted not only into the quality improvement but also in exceeding the initial target of 4% by at least 1.5% in each department.

The improvement project was conducted in 2020, focusing mainly on transforming the culture and launching activities targeting specific touchpoints identified as priority areas. Although the team faced challenges in implementing action plans due to resource and budget constraints, the hospital was able to achieve PX goals across all three departments, including inpatient, outpatient, and emergency departments. Critical elements of improving PX and culture include recognizing staff, building networks across the system through effective leadership, engaging staff, and engaging patients and their families.