Why Do Top Box Scores Matter in the EMS Industry?

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Patient Experience Scores, Top Box, and Percentiles:How to Use Metrics for Measuring, Reporting and Goal Setting Webcast Journal of Emergency Medical Services (JEMS) 

In honor of National EMS Week, EMS Survey Team (EMSST) joined JEMS for a webcast that covered the importance of patient experience scores, and top box analysis scores. In this post we will explore one of the patient experience survey metrics – top box scores – and how this metric is useful in patient survey data analysis.


What is a Top Box Score?

The sum of percentages for the highest possible rating on a customer satisfaction survey. The top box scoring method only accounts for the percentage of customers who have selected the highest, or “top,” possible ratings in response to a rated question.

  • For our survey, the top box response is “Very Good”
  • The HCAHPS survey is “Always”
  • In CAHPS for physician practices it’s “Definitely Yes”


The Advantages of Using Top Box Scores

  •  Top box scores add more variation to your results. Rather than referencing only the mean score– the top box score easily identifies areas of low performance (referencing only the mean score may make this difficult to identify)
  • While competition may share the same mean score, top box scores could be very different
  • Encourages higher goal setting for those who are performing well with existing mean scores
  • When seeing consistent results in each response category, helps determine where movement can be made


The Limitations of Using Top Box Scores

  • The top box score can mask other trends as it is limited to only one value
  • Can lead management to focus only on the highest or lowest ranked scores, rather than include data that falls within the middle of the scale

While this post focuses on top box scores, it’s important that we recognize the need to pay attention to all of metrics that we report. EMSST’s Lyn Evans describes patient experience metrics as “pieces of a puzzle.” When you’re only looking at one piece of that puzzle, it becomes impossible to see the big picture.

“It’s only when you bring those together that you begin to see the bigger picture of the patient’s experience,” says Evans.


Want More? 

To learn more about the topics covered in this post, watch our recorded webcast, Patient Experience Scores, Top Box, and Percentiles: How to Use Metrics for Measuring, Reporting and Goal Setting, today.

About EMS Survey Team

EMS Survey Team collects and measures the quality of both patient experiences and employee engagement, to provide actionable data for EMS leaders. Learn more about our survey solutions here.

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