Safety: The soul of patient experience

In healthcare, we often say that safety comes first. But in 2025, it’s time we recognize a deeper truth: Safety is the backbone of the patient experience. When patients feel safe, they trust their care team. When they trust their care team, they engage in their treatment. And when they engage in their treatment, their outcomes improve.

Our new report, "Patient experience 2025,” underscores what many of us have long believed: The patient experience (PX) is inextricably linked to safety, equity, communication, and human connection. And it is only when these elements work together, consistently and visibly, that we earn the trust of those we serve.

Perceptions of safety are key to trust

Yes, it is our responsibility to keep patients safe. But it is equally our responsibility to make sure they feel safe. That distinction is more than semantics. It’s the bridge between physical safety and emotional well-being. When patients feel unsafe, they experience emotional harm. And like all forms of harm, emotional harm erodes trust and undermines the healing process.

The data shows us just how high the stakes are. When inpatients report feeling “very safe,” top-box "Likelihood to Recommend" (LTR) scores soar to 85.3. When they don’t? Those scores plummet to 34.6—below the first percentile.

This isn’t about theoretical risk. It’s about the lived, moment-to-moment reality of care. Patients are constantly scanning the environment and analyzing each interaction for cues—about coordination, cleanliness, consistency—that signal whether (or not) they can trust the system to protect them. A well-executed bedside shift report is as much a psychological anchor as a marker of operational excellence. A quiet, clean room is as much a visual representation of safety as it is a pleasant environment.

And yet, far too often, we aren’t asking patients about safety. In fact, the number of hospitals measuring perceptions of safety on patient experience surveys has been declining. That’s a trend we urgently need to reverse.

If we’re serious about the goal of zero harm, we must treat patients as experts in their own experience of safety. That means embedding safety-related questions into PX surveys. It means partnering with patient and family advisory councils and patient focus groups. And it means routinely surfacing insights and lessons learned in conversations with executives.

Equity and reliability: 2 essential allies

Unfortunately, we’re seeing wide gaps in safety perception across race, age, and admission type. Patients from historically marginalized communities, older adults, and those with unplanned visits are more likely to feel unsafe. These equity failures directly erode trust and reinforce structural disparities that compromise patient outcomes.

Organizations that have most successfully closed these gaps focus on the fundamentals. And they get those fundamentals right every time, for every patient. They treat bedside handoffs, follow-up calls, and empathetic communication not as “extras,” but as core safety practices. They segment data, listen deeply, and act with intention.

Critically, they also measure the reliability of these practices. Take nurse leader rounding, for example. When done consistently and well for all patients, the impact is transformative. For patients with unplanned admissions, nurse leader rounding boosts “Recommend the Hospital” scores by 30.1 points—and by 20.2 points for those with planned admissions. "Rate the hospital 0–10” scores see even greater improvement: 31 and 24 points, respectively. These are not marginal gains. They are the measurable outcomes of highly reliable care.

The impact of nurse leader rounding isn’t felt equally—it can be even more powerful for historically underserved populations. For example, one Press Ganey client examined its effect by race and found top-box “Recommend the Hospital” scores were 47.5 points higher among Black patients and 34.6 higher among White patients who reported leader rounding. In fact, across nearly every measure, nurse leader rounding had a greater impact on Black patients. These results underscore a critical truth: Reliability and equity go hand in hand.

We have to make equity, and achieving true parity, part of every safety conversation. Because our goal of zero harm means zero harm for all.

Safety as a critical PX strategy

The good news is that patient experience metrics are improving. Nationally, HCAHPS “recommend the hospital” scores climbed to 70.4 in 2025. Key drivers like teamwork and communication are trending upward.

To make a real impact, we must expand our safety lens to include perception. We must consider psychological safety as much as physical safety. We must use technologies like AI not to replace empathy, but to scale it. And we must invest in our people—because there is no patient experience without the employee experience.

As healthcare safety leaders, our charge is clear. Make safety seen and felt. Embed best practices into routines. Make equity measurable. And, above all, make trust nonnegotiable.

Because safety isn’t just the absence of harm. It’s what gives patients confidence and clarity. It’s what transforms care from competent to compassionate. And it’s the foundation upon which the Human Experience is built.

For the latest data, download “Patient experience 2025.” Or to discuss our findings 1:1, reach out to a safety and high reliability expert.