Pseudo-measures have been important considerations in patient satisfaction for years. Pseudo-measures are those things that patients can judge for themselves and they use to help them create perceptions about their health care experience. Because the average patient cannot confidently judge the majority of clinical components of their experience, people have learned over the years to rely on pseudo-measures that they can judge to help them in developing perceptions about a healthcare provider. For example, the average patient cannot judge whether the medications that a doctor prescribes are the best ones for him, or whether he needs all the diagnostic tests that are ordered or whether appropriate interpretations have been made for those tests.

Patients have learned to rely on pseudo-measures such as the cleanliness of the building, the friendliness of the staff and the quality of the food to validate their choices in providers. If these aspects of the patient experience excel and the provider seems to strive for excellence in the details related to them, patients have historically made the leap in faith that the provider puts the same level of attention into its clinical care.

Providers need to know what pseudo-measures are valued by a given population and move them to great. Pseudo-measures should never be taken lightly because they are critical ingredients in building trust. Because most of the traditional pseudo-measures first occur fairly early in the patient experience, they can have a pretty significant impact on a patient's perceptions as he or she moves through his/her experience. As the patient has as many as eight encounters with a typical hospital before having his/her first clinical encounter, the tone can be set for whether the clinical experience gets off on the right foot. For example, if the building looks dirty and smells when the patient arrives, parking is a problem, the admission's clerk is rude and the lunch the patient gets while waiting for the doctor is cold, winning patient trust just got a whole lot harder for the clinical staff.

While the internet is making it easier for the average patient to access information that helps in understanding the clinical experience, pseudo-measures continue to be important and are actually growing in number. Timeliness, consistency from provider to provider, and the accuracy of the patient bill are becoming three additionally important pseudo-measures. Patients are learning that when healthcare providers do not work well together their potential to be the victims of errors and the likelihood of harm increases. As the number of hand-offs continue to grow because of technology and specialization and patients gain greater understanding of the risks they create, the ability to demonstrate effective teamwork and consistency will play a more critical role in patient satisfaction and the control of quality.

Consistency is becoming a more important pseudo-measure as younger patients who are exposed to systems of quality control in their own work environments know that variation is a major contributor to errors and current public concern about safety in the healthcare environment makes people more aware of the surroundings and the acts of their care givers.

As patients find themselves paying out of pocket for larger portions of their patient care, the accuracy and timeliness of their encounters and the bill will be more influential in creating patient perceptions. For example, providers need to better understand the thought processes that patients use to create perceptions about the billing process. Accuracy is a very important detail measure for the patient. Patients don't care about how prospective payment works. What they know is that the accuracy of the bill is important in every other aspect of their lives and is part of the quality of the service they receive. Naturally linking this thought process to health care, how are they to trust a provider to take the clinical care delivered seriously if it appears it doesn't care to get the bill right (which in the eyes of the patient is a simple piece of paper).

As the younger generations become more frequent consumers of healthcare services, timeliness, responsiveness, openness to improvement and follow-through will become important pseudo-measures. An effective patient satisfaction system helps a provider to better understand those pseudo-measures that its community and patients value so that it can ensure appropriate attention to details. While the pseudo-measures discussed in these paragraphs are common to a typical hospital, they can vary based on the type of provider, the demographics of the population served and the services offered. Every provider in the healthcare continuum has key pseudo-measures that impact the strength of patient perception.