SENTIMENTANALYSISLINKING PATIENT SENTIMENT TO HEALTHCARE ENVIRONMENTS

GARY VANCE, AIA, FACHA, LEED APDANIEL BERGER, LEED AP, EDAC

Opinions and subjective thoughts are commonly referred to as one’s two

cents and are often difficult to quantify, but if they were quantified, the

value would certainly be much more than two cents. The new science

of sentiment and text analysis has emerged on the scene with all types

of products and services. It seeks to assign values to the thoughts

and feelings of an industries clientele. It now serves practically every

industry and even includes analysis of social media sites for companies

across the world.

Essentially, Sentiment Analysis is a way to quickly and precisely

quantify the “sentiments” provided by people in written word, digital

format, or voice recordings. The process explanation is very simple,

yet the software analysis and technical aspects are very complicated.

The beauty and value of Sentiment Analysis is that the end result

is information transformed into useful reports which are easy to

understand by business users.

The latest versions of sentiment analysis no longer require advanced

knowledge of statistics and linguistic programming. Through the use

of powerful software an incredible quantity of data can be analyzed

in minutes. This data is recorded verbatim and then categorized into

buckets, resulting in immediate reporting.

As the world continues to become smaller and

everything is instant and immediate, sentiment

analysis will provide intelligent data analysis

for companies and industries in an exact manner. The natural “next

step” for this information would be to link each sentiment back to the

root cause. Business leaders and designers alike would relish the

idea of having real-time information providing them with insight on

areas of improvement to better serve their clients. Through a strategic

relationship, Press Ganey and BSA LifeStructures are beginning to

research and develop these links.

Press Ganey has been in the patient experience industry since 1985

and is a current leader in the industry. It is the first organization to

provide satisfaction benchmarking. They are responsible for processing

over 10 million patient surveys per year and serve over 48% of the

nation’s hospitals over 50 beds. Because of this, Press Ganey was

able to collect data from 1,593 hospitals. This data included HCAHPS

surveys and un-edited comments written by patients. In a 19-month

period, they were able to amass 7,848,380 sentences to be analyzed

using sentiment analysis. These comments are then assigned sentiment

values based on the context and tone, providing quantitative data, which

allows the value of one’s sentiments to be objectified.

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Basic outline of the sentiment analysis process

what is sentiment analysis?“A picture is worth a thousand words.” If that’s true, then what is the value of the written word?

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links to the built environmentThrough its strategic relationship with Press Ganey, BSA LifeStructures is developing a process in which the initial data can be analyzed further and linked to the built environment. BSA LifeStructures will become the repository for all of this information, creating a database of Patient Satisfaction Evidence.

While basic assumptions can be made from the sentiment scores, further analysis is required to fully understand and identify the root causes of negative scores. BSA is tasked with developing the process in which these causes can be identified in greater detail, solutions can be proposed, and each solution can be evaluated and compared. Currently the process can be broken down into 3 basic steps as outlined in the graphic to the right.

Process for linking patient sentiment to the built environment

Identify1

Create2

Evaluate3

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IdentifyPress Ganey provides the initial round of data analysis by categorizing and assigning values to the data. Once the data has been collected, analyzed, and categorized, the values begin to identify a facilities strengths and weaknesses. These values can be categorized into Negative Attributes and Positive Attributes.

For the designer attempting to improve facility performance, the Negative Attributes are assessed to begin to determine what components of the hospital environment need to be addressed. Similarly, Positive Attributes could be used to identify and validate design decisions that were made at the beginning of a project.Noise is a common Negative Attribute registered on the surveys. The designer can take this information and begin looking at sources of noise within the built environment. To appropriately identify and diagnose the source of the Negative Attribute, the designer may need to perform field investigation, review case studies, or utilize existing metrics. Care must be taken to ensure that all sources are fully investigated and identified.

CreateUpon completing the Identify phase, the design team should begin to develop solutions to respond to the selected Negative or Positive Attributes. It is important that the team uses a multi-solution approach during this phase. One should not focus entirely on a single design solution. Multiple design solutions should be produced and developed. There are virtually unlimited design options that could be created in an attempt to solve a problem. Seldom is there only one solution to any given problem. Multiple solutions provide the client with the most options and flexibility.

Case studies and metrics should be used as a basis of design to ensure known, proven results are being applied to solve each Attribute. Alternately, untested designs could be utilized as long as these solutions are properly informed by existing research and metrics.

EvaluateThe key component to this approach is evaluation of each proposed design intervention. Each design solution is evaluated based on the initial cost and the time to completion. These two variables should be evaluated in a manner that allows direct comparison between design solutions for a given Attribute. This can be easily accomplished by comparing each value to the maximum value in that category. This would provide a percentage comparison that can be expressed as a decimal.

Three design solutions for a Negative Attribute cost $10,000, $20,000, and $30,000 each. The cost for each solution is divided by the maximum value for that Attribute. In this case $30,000 is the maximum value. So the solutions would rank 0.33, 0.67, and 1, respectively. This process is completed for each Negative Attribute for cost and time to completion.

Based on these two variables, the value of each design is assessed. For the purpose of this paper, value is defined as an inverse function of the variables time and cost; the longer the duration and the higher the cost of each intervention the lower the value. An appropriate equation should be developed to accurately assess the value of each solution. The results of these calculations can be displayed graphically. The simple chart below summarizes cost, time, and value in an easy to read format.

CA

SE

ST

UD

Y

Sample chart displaying cost, time and value comparisons for each proposed design solution

ROOM TO ROOM NOISE TRANSFER

• Reduce noise by replacing ceiling tiles with high performance acoustical tiles

• Apply anti-microbial sound absorptive finishes where possible (e.g., carpeted floors, fiber panels, etc.)

• Add sound attenuation batts between rooms (if not present) and above the ceiling

• Implement white noise devices to reduce the noise transmissions

Cost Time Value

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This form of evaluation gives the client a simple “menu” of design solutions to choose from.

In addition to time and cost, Life Cycle Cost should be applied where appropriate to accurately assess Value. It is important that all options are presented from the study. Some design solutions may not have the best value according to the variables selected, but may be appropriate for the client at a given period in time.

Some high cost, long duration items may still be viable solutions. They may provide a more permanent or more durable solution to the problem. For this reason, “low value” solutions should not be excluded.

next stepsThe above information begins to hint at the true potential of Patient Satisfaction Evidence. The most significant aspect of this evidence is that it directly reflects the sentiments of the most important user–the patient. Press Ganey and BSA LifeStructures, through their strategic relationship, will continue to research and develop the links between patient satisfaction and the built environment. These two industry leaders have developed new evidence and findings to contribute to healthcare research.

These planning, design and facility related findings are already being documented by BSA LifeStructures. The findings will become a repository of evidence and research for design professionals to use when making healthcare design decisions. The research and findings will continue to be shared with the industry as they are developed.

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