NPS in hospitals: how to measure the patient experience

The definition of NPS is simple. Short for Net Promoter Score, it is a satisfaction survey used worldwide, across different industries. Essentially, it is an indicator of the level of satisfaction (or dissatisfaction) with a product or service.

Despite its conceptual simplicity, correctly understanding the results and turning them into effective decisions requires close attention from service, marketing and, above all, management teams.

In the hospital environment, marked by high care complexity, multiple services and different patient touchpoints, the strategic use of this indicator calls for extra attention. Throughout this article, you will see how to apply NPS in hospitals, with a focus on the patient experience and continuous process improvement.

How is the NPS survey applied?

The first step is to run a satisfaction survey with patients, using the standard Net Promoter Score question, with possible variations:

“On a scale of 0 to 10, how likely are you to recommend this hospital to a friend or family member?”

Based on the answers, patients are classified into three groups.

• Those who give scores of 9 or 10 are considered promoters, since they tend to actively recommend the institution.

• Scores of 7 and 8 identify passives, who show no dissatisfaction but do not act as brand advocates either.

• Patients who answer with scores between 0 and 6 are classified as detractors, indicating a negative experience or one that fell short of expectations.

With this segmentation, the percentage of promoters and detractors is calculated relative to the total number of valid responses.

Hypothetical scenario

A hospital collects responses from 100 patients.

There were 70 promoters, 20 passives and 10 detractors.

So the percentage of promoters will be 70% and that of detractors 10%.

The calculation is done by subtracting the percentage of detractors from the percentage of promoters. In this example, the result would be an NPS of 60 points (70% minus 10%).

The indicator can range from –100, when all respondents are detractors, to +100, when all are promoters.

Why is it important to use the NPS methodology?

More than the number itself, the relevance of NPS in the hospital environment lies in its ability to translate the patient’s perception into input for improving the service.

A positive NPS indicates there are more promoters than detractors, but interpreting the result must always take into account the care context, the profile of the service being evaluated and the point in the patient journey.

In hospitals, where the patient experience spans care, tests, hospital stay, discharge and post-discharge relationship, for example, NPS works as a general signal of perceived quality. Its real value, however, lies in the strategic use of the results to identify failures, prioritize improvements and guide management decisions focused on the patient experience.

What is considered a good NPS in hospitals?

According to CustomerGauge, a leading B2B customer experience management platform, the average NPS in healthcare worldwide is 58. Judging a number as good or bad depends on many factors, but in general terms any negative NPS is a very poor result; between 0 and 50, acceptable; above 50 indicates a level of quality; and above 75, a level of excellence.

Even so, it is essential to interpret NPS in hospitals in light of the care context. The type of service evaluated, the patient profile, the complexity of care and the point in the journey directly influence the result.

Comparisons only make sense between similar services and over time, tracking the hospital’s own progress.

What are the main mistakes when using NPS in hospitals?

Applying this methodology improperly can lead to distorted analyses and ineffective decisions. Here are some points to watch when applying and analyzing NPS in a hospital setting.

Biased or unrepresentative samples

One of the most common mistakes is working with samples that do not adequately represent the diversity of patients and services.

Collections concentrated at specific times, at a single point in the journey or restricted to certain care profiles tend to distort results and lead to mistaken interpretations of the patient experience.

Failing to survey likely detractors after a negative experience also undermines the reliability of the data collected, making it potentially misleading.

No segmentation by service and stage of the journey

Analyzing NPS in aggregate, without segmenting by unit, specialty or point of care, significantly reduces the indicator’s value. In hospitals, where urgent care, hospital stays, tests and outpatient clinics have different dynamics, the lack of segmentation prevents the identification of specific bottlenecks and improvement opportunities.

Punitive use of the indicator by leadership

When NPS starts being used as a tool to pressure or punish teams, it loses its strategic function. This punitive use compromises the quality of responses, encourages defensive behavior and pulls the indicator away from a culture focused on continuously improving the patient experience.

Isolated analysis, with no connection to other indicators

Another recurring mistake is interpreting NPS in isolation, without cross-referencing it with care, operational and administrative indicators. Without this correlation, the hospital misses the chance to understand the structural causes behind patient satisfaction or dissatisfaction.

No action plan or follow‑up

Finally, one of the most critical mistakes is using NPS only as a number in charts and tables, without building action plans from it. Without defined owners, prioritization of recurring problems and continuous follow-up, NPS loses its strategic function for hospital management.

How can artificial intelligence support NPS analysis in hospitals?

Applying AI expands the analytical value of NPS in hospitals, especially in institutions that handle large volumes of responses and multiple patient touchpoints.

Through natural language processing techniques, AI streamlines the analysis of open-ended comments at scale, and also helps identify recurring patterns of dissatisfaction and group similar perceptions in a structured way.

Another benefit is the ability to quickly cross-reference NPS data with care and operational information, such as waiting times, rework rates and administrative events.

The Rivio view

Rivio believes that data such as NPS only create value when they turn into practical decisions and improvements. AI applied to hospital management makes it possible to analyze large volumes of information, identify patterns invisible to manual analysis and support faster, more accurate decisions.

With Rivio’s AI platform, you can automate the entire hospital revenue cycle: from patient care and medical auditing to XML submission, including denial appeals after payer review.

The solution was built to identify discrepancies, prevent invisible losses, reduce denials and ensure the hospital receives the full amount it is entitled to. By contract, Rivio commits to reimbursing the hospital 100% if a denial is not reversed.