Building a Culture of Trust: Engaging Teams with Targeted Tactics for Meaningful Improvement in Patient Experience

Rising financial pressures and the need to revitalize culture prompted a renewed emphasis on patient experience at Billings Clinic. This case study describes the impact of redefining patient experience as a measure of trust and a set of care processes. It presents an alternative to the more traditional view of patient experience as an outcome metric based on meeting patient expectations. Billings Clinic chose the patient survey question likelihood of recommending as an organizational goal or key performance indicator (KPI). Under the direction of executive leadership, the patient experience team developed a new strategic framework aimed at driving improvement for this metric. Key features of this framework include reframing likelihood to recommend as a measure of trust, creating strong executive and departmental leadership connections, engaging directly with care teams, developing a patient experience tactic library, sharing patient survey data transparently and utilizing industry developed patient survey goal setting and improvement tools. In all service lines where goals were set, there was an increase in the likelihood of recommending scores. The increase also outpaced the national average increase in several service lines. Patient experience metrics were viewed as a reflection of process consistency rather than individual performance. Overall, this approach created a more focused, collaborative, and actionable way to improve patient experience. By simplifying data, refining communication, and connecting insights to daily workflows, teams were better able to understand their impact and take meaningful action.