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Case Study 1 (St. Luke's Hospital data)1 In the fast‐paced world of health care, small fluctuations in the quarterly patient (mean) satisfaction scores may not raise any red flags. But that quickly changed for St. Luke's Hospital in Cedar Rapids, Iowa, during a leadership retreat in spring 2004. Here, managers received a shocking surprise, the effects of which are still driving improvement efforts today. The hospital's inpatient satisfaction measures, which appeared flat, had actually dipped to the 64th percentile when compared to other hospitals in the country.

People were shocked because they thought St. Luke's should be in the 80th or 90th percentiles, explains Kent Jackson, director of children's specialty services, and the leader of the hospital's patient and family experience team. “What became more significant was that in the second quarter of 2004, the hospital dropped to the 49th percentile [for inpatient satisfaction]. So, about the time that people were shocked, it was about to get worse,” Jackson recalls.