How to Improve Press Ganey Scores: An Evidence-Based Guide for Physicians and Healthcare Organizations

Patient experience has become an increasingly important measure of healthcare quality. Hospitals and clinicians are evaluated not only on clinical outcomes, but also on how effectively patients feel they were heard, informed, respected, and involved in their care.

For physicians—particularly hospitalists—improving Press Ganey and related patient-experience scores should not mean trying to “make patients happy” at the expense of appropriate medical care. The more sustainable approach is to improve the reliability, clarity, empathy, and coordination of the care experience.

Research supports this distinction. Patient experience encompasses communication, access to information, coordination, courtesy and respect, shared decision-making, and responsiveness to patient needs. Better patient experience has also been associated with improved adherence to medical recommendations and other favorable healthcare processes and outcomes.

1. Start With Communication, Not the Score

One of the most important drivers of patient experience is clinician-patient communication.

Patients typically evaluate their experience based on questions such as:

• Did the physician listen carefully?
• Were explanations understandable?
• Was I treated with courtesy and respect?
• Did I understand what was happening?
• Did clinicians communicate consistently?
• Did I know what would happen next?

A 2025 systematic review examining interventions to improve patient experience through provider communication found that structured communication training and shadow coaching can improve selected patient-experience outcomes. Importantly, substantial training—roughly 5.5 to 8 hours in several successful studies—performed better than very brief communication interventions, while coaching benefits could fade without reinforcement or booster sessions.

The implication is important: communication should be treated as a clinical skill that can be taught, observed, measured, coached, and improved.

2. Begin Every Encounter by Establishing a Human Connection

A hospitalized patient may see multiple physicians, nurses, consultants, therapists, and other staff members in a single day. Patients may not know who is responsible for which part of their care.

Hospitalists can reduce this confusion by beginning encounters with a consistent introduction:

“Good morning, Ms. Smith. I’m Dr. Jones, one of the hospitalists taking care of you today.”

Then briefly establish the purpose of the encounter:

“I reviewed your blood work and CT results, and I’d like to explain what we know, what we’re still evaluating, and what needs to happen before you can safely go home.”

This takes only seconds but provides the patient with three important pieces of information:

Who you are, why you are there, and what will happen next.

Communication interventions work best when they are reliable behaviors rather than optional gestures.

3. Sit Down When Practical

Patients frequently judge time differently from clinicians.

A physician may spend several minutes delivering excellent medical care but still appear hurried if standing near the doorway, looking repeatedly at a computer, or appearing ready to leave.

When feasible, sitting near the patient, maintaining appropriate eye contact, and reducing visible distractions can make the interaction feel more deliberate.

The goal is not to make rounds longer unnecessarily. The goal is to make the time already being spent with the patient feel attentive and purposeful.

4. Ask for the Patient’s Priorities Early

Physicians naturally structure encounters around medical priorities. Patients may be thinking about something entirely different:

“Why can’t I eat?”

“When can I go home?”

“Does this mean I have cancer?”

“Who’s taking care of my mother while I’m here?”

“Why did another doctor tell me something different?”

A simple question can uncover these concerns:

“What is the most important question you want me to answer today?”

AHRQ specifically emphasizes two-way communication and notes that tools such as patient question lists can help patients express their concerns and participate more effectively in their care.

Addressing the patient’s agenda does not mean agreeing to inappropriate requests. It means identifying the issue that may otherwise dominate the patient’s perception of the entire encounter.

5. Explain the Plan in Plain Language

Patients rarely experience their hospitalization as a collection of diagnoses, laboratory values, and consultant recommendations. They experience uncertainty.

Instead of saying:

“Your creatinine is improving and we’re monitoring your volume status before transitioning to PO diuresis.”

consider:

“Your kidney function is improving. We’re continuing to remove extra fluid today, and if your breathing and kidney tests remain stable, we may be able to switch you from IV medication to pills tomorrow.”

The second explanation answers the questions patients usually care about:

What is happening? Is it getting better? What are you doing about it? What happens next?

AHRQ identifies getting information and communication with clinicians as fundamental components of patient experience.

6. Use Teach-Back Rather Than “Do You Understand?”

Asking:

“Do you understand?”

is often ineffective.

Patients may answer yes because they are embarrassed, overwhelmed, fatigued, or simply want to be agreeable.

Instead, use teach-back:

“I know we’ve discussed a lot. Just so I know I explained it clearly, can you tell me what you understand the plan to be?”

Notice the framing. The clinician assumes responsibility for explaining clearly rather than testing the patient.

This is particularly valuable when discussing medications, follow-up plans, warning signs, and discharge instructions.

7. Set Expectations About What Happens Next

Many negative patient experiences are caused not by poor medical care but by unmanaged expectations.

Consider a patient waiting for an MRI.

Compare:

“We’re waiting for MRI.”

with:

“I’ve ordered the MRI. Unfortunately, I can’t promise exactly when radiology will be able to perform it. Once the study is completed, I’ll review the result and we’ll determine whether it changes your discharge plan.”

The second statement doesn’t make an unrealistic promise. It establishes expectations.

This principle applies to:

• consultant arrival times;
• laboratory results;
• imaging;
• procedures;
• discharge;
• medication changes;
• diet restrictions;
• transportation;
• follow-up appointments.

Never promise something the healthcare system cannot reliably deliver.

8. Explain Delays Before Patients Have to Ask

Silence creates uncertainty.

If discharge was expected at 10 a.m. but will now happen at 3 p.m., someone should explain why.

If a consultant hasn’t arrived, acknowledge it.

If imaging is delayed, tell the patient.

A patient may tolerate an unavoidable delay much better when they understand what is happening.

The useful formula is:

Acknowledge → Explain → Update → Set the next expectation.

For example:

“I know you’ve been waiting for the cardiologist. I’m sorry this is taking longer than expected. Their team has been contacted, and we’re waiting for their assessment before deciding whether it’s safe for you to leave. I’ll update you when I know more.”

9. Improve Communication Between Physicians and Nurses

Patient experience is not generated by an individual clinician alone.

Imagine that the physician tells a patient:

“You’re probably going home today.”

The nurse later says:

“I haven’t heard anything about discharge.”

Case management says:

“You may need another night.”

The consultant says:

“I thought you were leaving yesterday.”

Even if every individual clinician is technically correct, the patient experiences the system as disorganized.

Interdisciplinary communication, bedside rounds where appropriate, updated whiteboards, shared daily goals, and clear ownership of the discharge plan can reduce contradictory messaging.

AHRQ’s patient and family engagement guidance specifically identifies communication among patients, families, and clinicians as foundational to high-quality and safe care.

10. Make Discharge a Process, Not a Five-Minute Event

Discharge is one of the most vulnerable points in the hospitalization.

Before leaving, patients should understand:

Why they were hospitalized.

What was found.

What changed during hospitalization.

Which medications changed and why.

Which medications should be stopped.

What follow-up is required.

Which symptoms require urgent medical attention.

Who they should contact with questions.

A review of nursing-led patient-experience quality-improvement projects found improvements associated with interventions including nursing rounds, discharge nurses, follow-up calls, and continuing education, although the authors emphasized that much of the underlying evidence was low quality and based on single-site pre/post studies.

Therefore, hospitals should view discharge communication as an important improvement opportunity while avoiding claims that any single discharge intervention is guaranteed to improve scores.

11. Consider Purposeful Rounding—But Don’t Turn It Into a Checkbox

Purposeful rounding can help identify needs before they become frustrations.

Common rounding domains include:

Pain — Is discomfort adequately controlled?

Position — Is the patient comfortable and safe?

Personal needs — Does the patient need assistance with toileting or mobility?

Possessions — Are the call button, phone, water, glasses, and other needed items accessible?

But scripted rounding can fail when staff perceive it as another documentation requirement.

The interaction must remain authentic and clinically meaningful.

Evidence reviews have identified nursing rounding among potentially beneficial interventions, but the overall literature remains heterogeneous and includes many studies with methodological limitations.

12. Respond to Emotion Before Providing More Information

Patients don’t always need another explanation first.

Sometimes they need acknowledgment.

A patient saying:

“Nobody here knows what’s going on!”

may not benefit from immediately hearing a detailed description of the hospital workflow.

A better response might begin:

“I can understand why this has been frustrating. You’ve heard different information from several people. Let me clarify where things stand right now.”

Then provide the clinical explanation.

This approach does not require agreeing that the hospital or another clinician did something wrong. It simply recognizes the patient’s experience before moving toward problem solving.

13. Avoid Medical Jargon

Terms clinicians use routinely can be confusing or frightening:

“Positive margins.”

“Your cultures grew gram-negative rods.”

“We need to rule out PE.”

“You failed your swallow evaluation.”

“Your troponin is elevated.”

Translate clinical terminology into language patients can understand.

For example:

“Your blood test suggests there may have been stress or injury to the heart, but that result alone doesn’t necessarily mean you had a heart attack. We’re looking at your symptoms, ECG, and repeat blood tests together.”

Clear communication improves understanding without oversimplifying medicine.

14. Improve Physician Communication Through Coaching, Not Email Reminders

Hospitals sometimes respond to poor patient-experience scores by sending clinicians emails:

“Remember to communicate better.”

Evidence suggests that this is unlikely to be enough.

The 2025 systematic review of provider communication interventions found evidence supporting more substantial communication-skills training and shadow coaching, whereas very brief training and simple communication-etiquette reminders did not demonstrate meaningful improvements in the included studies.

A stronger program might include:

1. baseline patient-experience data;
2. direct observation;
3. individual coaching;
4. communication-skills workshops;
5. peer role-playing;
6. individualized feedback;
7. repeat observation;
8. booster training;
9. ongoing measurement.

Improvement requires behavior change, not slogans.

15. Don’t Chase the Overall Press Ganey Number

A hospital might say:

“Our Press Ganey score is 72. We need to get it to 80.”

That identifies the outcome but not necessarily the problem.

Instead, analyze performance by specific domains and questions.

For example:

Physician communication

Nursing communication

Responsiveness

Medication communication

Discharge communication

Care coordination

Quietness

Cleanliness

Overall rating/recommendation

CMS’s HCAHPS framework similarly measures distinct components of the hospital experience, including communication with physicians and nurses, staff responsiveness, care coordination, medication communication, discharge information, restfulness, cleanliness, overall hospital rating, and willingness to recommend.

Find the lowest-performing actionable domain and investigate why it is low.

16. Read Patient Comments, Not Just Percentiles

Quantitative scores tell you where a problem exists.

Patient narratives can help explain why.

AHRQ notes that narrative feedback can reveal problems involving communication, coordination, discharge, and patient safety that may not be apparent from numerical scores alone. Research highlighted by AHRQ also suggests that patient narratives can generate actionable ideas for improvement.

Hospitals should therefore review patient comments systematically.

For example, code complaints into categories:

Patient feedback	Potential system issue
“Nobody told me what was happening.”	Communication
“Every doctor told me something different.”	Care coordination
“I waited hours after they said I could leave.”	Discharge workflow
“Nobody answered the call light.”	Responsiveness
“I didn’t understand my medications.”	Medication education
“The doctor seemed rushed.”	Clinician communication
“It was impossible to sleep.”	Hospital environment

Patterns are more useful than isolated comments.

17. Use PDSA Cycles Rather Than Hospital-Wide Mandates

One of the biggest mistakes is launching ten interventions simultaneously across an entire hospital.

If scores improve, nobody knows which intervention worked.

If they don’t improve, nobody knows why.

AHRQ recommends established quality-improvement methods, including the Plan-Do-Study-Act (PDSA) cycle and starting with smaller clinical microsystems before spreading successful changes.

For example:

Plan: Test structured bedside communication on one hospitalist unit.

Do: Ten hospitalists use the approach for four weeks.

Study: Compare patient feedback, communication scores, adoption, rounding time, and staff feedback.

Act: Modify the intervention based on results.

Then repeat.

Only after demonstrating feasibility and benefit should the intervention be scaled.

18. Measure Process Reliability Alongside Survey Scores

Patient-experience surveys are important outcome measures, but they often arrive after the patient has left.

Teams therefore need process measures they can observe more rapidly.

Examples include:

• percentage of patients receiving daily-plan explanations;
• percentage able to identify their attending physician;
• percentage receiving teach-back before discharge;
• percentage receiving medication reconciliation education;
• percentage receiving discharge follow-up;
• percentage of interdisciplinary rounds completed;
• call-light response times;
• percentage of communication-coaching observations completed.

This allows teams to distinguish between two situations:

“Our intervention doesn’t work.”

and

“Our intervention was never reliably implemented.”

Those are fundamentally different quality-improvement problems.

19. Don’t Manipulate Patients or the Survey

The objective should be improving care—not coaching patients to produce higher ratings.

Avoid behaviors such as:

“Please give us a 10.”

“Our goal is five stars.”

“Anything below excellent hurts us.”

Instead ask:

“Is there anything we could have explained more clearly or done differently today?”

That question generates actionable feedback while the organization may still have an opportunity to correct a genuine problem.

Patient experience should function as a measure of care quality, not a sales target.

20. Protect Clinical Judgment

High-quality patient experience does not require inappropriate prescribing, unnecessary testing, or agreeing with every patient request.

A patient can disagree with a medical decision and still experience excellent communication.

For example:

“I understand why you’re asking for antibiotics. Based on your examination and testing, I don’t think antibiotics will help this infection, and they could cause side effects. Let me explain what I think is happening and what we can do to help you feel better.”

The physician has maintained appropriate clinical judgment while demonstrating listening, respect, explanation, and shared understanding.

That distinction is fundamental.

A Practical Hospitalist Framework

A simple framework for daily bedside encounters is:

CONNECT → LISTEN → EXPLAIN → ALIGN → CLOSE

CONNECT

Introduce yourself, sit when practical, establish eye contact, and explain your role.

LISTEN

Ask what matters most to the patient today and listen without immediately redirecting.

EXPLAIN

Describe the diagnosis, progress, tests, medications, and uncertainties using plain language.

ALIGN

Clarify the day’s goals and ensure the physician, nurse, patient, and family understand the same plan.

CLOSE

Summarize what happens next and ask:

“What questions do you still have?”

rather than simply:

“Any questions?”

A 90-Day Patient-Experience Improvement Plan

For organizations seeking measurable improvement, a structured approach is preferable to isolated initiatives.

Days 1–30: Diagnose

Analyze Press Ganey/HCAHPS results by unit, service line, provider where statistically appropriate, survey question, shift, and patient population.

Review narrative comments and identify recurring themes.

Select one or two actionable domains, rather than attempting to improve everything simultaneously.

Establish baseline outcome, process, and balancing measures.

Days 31–60: Test

Choose one clinical unit.

Implement a small number of evidence-informed behaviors—for example:

structured physician introductions + daily-plan communication + patient-priority question + teach-back.

Train clinicians properly rather than relying on email reminders.

Use direct observation and coaching.

Collect real-time feedback from patients and staff.

Days 61–90: Refine and Scale

Evaluate:

Did patient experience improve?

Did staff consistently perform the behaviors?

Did the intervention increase rounding time or workload?

Which components were useful?

What did patients say?

Modify the intervention through additional PDSA cycles and expand only when implementation is reliable.

What the Evidence Does—and Does Not—Show

Healthcare organizations should be cautious about claims that a particular script, rounding technique, or communication mnemonic will automatically raise Press Ganey or HCAHPS scores.

Systematic reviews have found promising interventions, but the evidence base has historically been heterogeneous, with methodological limitations and relatively few highly generalizable interventions. A more recent systematic review provides stronger support for substantial communication training and coaching, while suggesting that brief training and reminders alone may be insufficient.

Therefore, the most evidence-aligned strategy is not:

“Use this script and your score will increase.”

It is:

Measure → identify the specific problem → implement an evidence-informed intervention → coach → measure implementation → evaluate outcomes → refine → scale.

Conclusion

Improving Press Ganey scores should ultimately be a consequence of improving the patient’s actual experience of care.

The most sustainable strategies focus on clear communication, active listening, expectation setting, coordinated care, understandable discharge education, meaningful patient engagement, clinician coaching, and disciplined quality-improvement methods.

Healthcare organizations should resist superficial approaches designed merely to influence survey responses. Instead, patient-experience data should be used to identify where the care system is failing to communicate, coordinate, educate, or respond reliably.

When patients understand who is caring for them, what is happening, why it is happening, and what happens next, the healthcare experience becomes safer, clearer, and more patient-centered—and improved survey performance can follow.