Evolving the Friends and Family Test (Part 2)

In my last Friends and Family Test (FFT) blog, I outlined the significant benefits of a digital first approach:

  • Reaching more people
  • Building bigger datasets
  • Reducing the burden on staff, and
  • Ensuring feedback reaches staff in a timely way.

In this blog I want to talk about the FFT question itself, and why it isn’t enough.

The FFT question – that is, a patient’s likelihood to recommend a service – is widely used across many industries. It’s regarded as a reliable proxy for customer or patient experience. Cemplicity field many surveys that include the FFT or its close cousin, the Net Promotor Score (NPS).

However, even when supported with a patient’s comment, FFT is not enough to drive service transformation.

With the continued high use of slow, work-intensive, paper-based feedback modes and interactive voice response, it’s understandable that staff like to stick to one question, one comment and perhaps some demographics. However, digitally led programmes create the opportunity for a more advanced survey.

Key drivers of good patient experience

Health research and work by improvement specialists like Picker Institute Europe and Oxford University have helped define the key drivers of a good patient experience. If improved, these drivers will most strongly impact on the patients’ overall experience (as measured by the FFT).

These drivers include: ‘Good clear communication I can understand’, ‘a coordinated service’, ‘being treated with dignity and respect’ and ‘being treated with kindness and compassion’, all of which matter very much to patients.

The shorter a survey, the less actionable it is. You have received a low rating – what exactly needs to change to make it better for the next patient? On the other hand, a survey structured around the above key drivers is rich fodder for continuous improvement.

Cemplicity works with over 2,500 facilities and our experience is that response rates in a healthcare setting remain the same for longer, warmly worded, well designed survey as for shorter surveys. People are willing to participate generously when they know their feedback may help others who follow.

Asking about the proven key drivers for your health care setting offers more insight into what matters most to patients, as well as your priorities for action. Of course, FFT will be one of the questions. A digital first approach also creates more opportunities for patient stories. If a patient gives you a low or high rating for coordination of care, let’s ask what happened. You don’t want to second guess. Modern reporting tools derive much value from the patient stories and we already know these are as important as the statistics – even in their verbatim form.

Concluding these three opinion pieces on the FFT:

The widespread use of FFT is a credit to the NHS and the staff who work so hard to enable patients to have our say. I’m sure it contributes significantly to the level of engagement and pride people have in the NHS.

The FFT’s approach reflects the technology and mindset of 2013, when it was designed and put in place. With a fresh look, FFT can remain the global standard for using systematic patient feedback for quality improvement. Increasing the FFT’s reach, and reducing the cost and effort to implement it, are opportunities to be addressed. Using digital methodologies and widening the scope of the survey itself to cover the key drivers of a good patient experience are key to ensuring both the statistics and the stories drive real improvement.

FFT Blog 1

FFT Blog 2

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