As all clients of Cemplicity know, we spend a lot of time talking about good communication. Every project we do throws up good communication with patients as one of the strongest drivers of an overall good experience.
We recently came across this rare study, which linked up PROMs and PREMs feedback from over 10,000 patients, a large, reliable dataset. Researchers were able to explore how a patient’s experience of care related to their reported health outcomes.
This study is different not only because of the size of the dataset, but also because it linked PREMs and PROMs responses at the patient level – rather than in the aggregate.
Communication and Trust: The Strongest Link
The researchers found a weak but consistent positive correlation between patient experience and outcomes. Patients who reported better experiences also tended to report:
- Greater health gains (improvements in PROM scores).
- Fewer complications.
Interestingly, when experience was broken into eight dimensions — such as pain control, respect, cleanliness, and discharge information — one stood out: Communication with and trust in doctors showed the strongest relationship with better outcomes, followed by communication with nurses and involvement in decisions.
This finding reinforces what many frontline providers already know intuitively: clear, compassionate communication isn’t just “nice to have” — it shapes recovery and how patients perceive their health improvements.
Why Experience Cannot Replace Outcomes
One of the most striking insights was that while the two domains are linked, experience and outcomes are not interchangeable.
- Patients clearly distinguish between their health improvements and how they were treated.
- Some patients reported poor outcomes but still high satisfaction with their experience — and vice versa.
- This means that experience metrics cannot serve as proxies for outcome measures.
For healthcare providers, this is a crucial reminder: excelling in patient experience does not guarantee good clinical outcomes, and good outcomes don’t automatically translate into positive patient experience. Both must be measured and improved independently.
Practical Implications for Healthcare Providers
So, what does this mean for hospitals and clinicians?
- Invest in communication skills: The strongest patient experience predictor of better outcomes was how well doctors and nurses communicated and earned trust. Training and supporting staff in communication may have ripple effects on outcomes.
- Don’t rely on one metric: Regulators, managers, and providers should resist the temptation to lean on PREMs as a shortcut for measuring effectiveness or safety. True quality measurement requires multiple domains.
- Look at both the mismatches and the patterns: Patients who report good experiences but poor outcomes (or vice versa) may highlight areas for targeted quality improvement.
- Experience and outcomes are complementary: Together, they offer a richer, more balanced assessment of care quality than either can provide alone.
The Bigger Picture
This study adds to growing evidence that quality in healthcare is multidimensional. Safety, effectiveness, and patient experience are interrelated but distinct. For providers, that means improvement strategies must address all three domains.
Most importantly, the findings give empirical weight to a principle that patients themselves have always emphasised: how we communicate, explain, and involve them in care is not separate from outcomes — it is part of what drives them.
For healthcare providers, the message is clear — measure both outcomes and experiences, don’t conflate the two, and never underestimate the power of trust and communication in shaping patient recovery.
Read more: Black N, Varaganum M, Hutchings A Relationship between patient reported experience (PREMs) and patient reported outcomes (PROMs) in elective surgery. BMJ Quality & Safety 2014;23:534-542
