Agile Affinity Mapping: Healthcare Case Study

From Confusion to Clarity: Enhancing Patient Experience at a Regional Hospital

A hospital administration team analyzed patient discharge surveys to identify and remedy key communication gaps, leading to higher patient satisfaction scores and a reduction in preventable readmissions.

The Challenge

Patient satisfaction scores (HCAHPS) for the discharge process were consistently below the national average, impacting the hospital’s reputation and reimbursement rates. The administration had access to hundreds of written comments from surveys but struggled to see the forest for the trees, making it difficult to launch a targeted improvement initiative.

The Process: From Chaos to Clarity

Before the Planner: Gathering Raw Data

A dedicated patient experience coordinator compiled all narrative comments from the last quarter’s discharge surveys. The raw data was a mix of emotional, clinical, and logistical feedback, covering everything from communication with nurses to confusion about complex medication schedules.

Step 1: Prepare for Affinity Mapping

In the “Prepare” step of the planner, a clinical and impactful goal was defined: “Identify the top 3 recurring themes in negative patient discharge feedback to inform a new process improvement initiative for Q4.” The team included the coordinator, a head nurse, a hospital administrator, and a pharmacist to ensure a holistic view of the process.

Step 2: Conduct the Mapping Session

The “Conduct” plan outlined a 3-hour workshop where each patient comment would be reviewed and assigned to a broad category (e.g., Communication, Environment, Process). The plan then specified breaking these down into more granular sub-groups to find the most specific, actionable issues.

Step 3: Analyze and Prioritize Groups

For ‘Analyze and Prioritize,’ the plan was to use a simple frequency count to identify the largest themes. The key activity was to then map these themes to a timeline of the patient discharge journey. This would reveal when and where in the process the critical failures were occurring, which was more important than just knowing what they were.

Step 4: Implement and Monitor Actions

The “Implement” plan was highly focused. It involved creating a formal task force for the #1 identified issue. This task force would be responsible for designing and piloting a change. The target metric was specific and measurable: “Increase the ‘Clarity of Discharge Instructions’ survey score by 10 points within six months.”
After the Planner: Running the Workshop

The workshop, guided by the generated report, was a revelation for the team. The affinity mapping clearly revealed that the biggest cluster of negative comments related to “confusion about post-discharge medication instructions.” Mapping this to the patient journey showed the issue stemmed from instructions being given too quickly, often filled with jargon, and without family members present. The task force was immediately formed to develop and pilot a new “teach-back” method for nurses to confirm patient understanding before they left the hospital.

The Results

The structured planning process allowed the hospital to pinpoint a critical, specific failure point in their discharge process that was having an outsized negative impact on the patient experience. They moved from a general problem (“scores are low”) to a specific, solvable cause.

• Implemented a new, mandatory ‘teach-back’ nursing protocol for medication instructions at discharge.
• Patient satisfaction scores for the discharge process increased by 15 points in the next quarter, exceeding their goal.
• The hospital saw a statistically significant reduction in 30-day readmission rates for patients with complex medication schedules.
• The success of the initiative led to the adoption of the affinity mapping process in two other hospital departments.