Reliability Remains Healthcare's Greatest Opportunity, Qualtrics XM Institute Finds

Patients who encounter operational friction give recommendation scores up to 37 points lower

New State of Patient Experience 2026 report analyzes 43.1 million patient encounters

PROVO, Utah, Nov. 12, 2026 /PRNewswire/ -- Likelihood to Recommend (LTR) scores rose year over year in emergency departments, medical practices, ambulatory surgery, and inpatient care, but improving averages tell only part of the story, according to a new report from the Qualtrics XM Institute.

The State of Patient Experience 2026 report, which draws on data from more than 43.1 million patient encounters from organizations that partner with Qualtrics, finds that experiences vary widely by admission type and by whether patients encountered operational friction, such as delayed appointments and poorly coordinated handoffs. The most pressing challenge for leaders is making consistently positive experiences the norm, regardless of when, where, or how patients receive care.

Key facts

• Report name: State of Patient Experience 2026 from the Qualtrics XM Institute, the research and thought leadership arm of Qualtrics.
• Friction gap: Operational delays and poor handoffs drove the sharpest drops, not clinical care. Ambulatory surgery scores fell from 88.7 to 51.8 when patients reported friction.
• Planned vs. unplanned divide: The median gap in overall ratings between planned and unplanned admissions was 8.9 points at top-quartile hospitals, compared with 18.2 points at bottom-quartile hospitals.
• Teamwork and trust effect: Organizations in the top quartile for teamwork were 50 to 80 percent more likely to achieve top performance on key nursing quality measures, and hospital units with high employee-reported trust were 2.4 times as likely to earn top hospital ratings.
• Data source: Data from more than 43.1 million patient encounters from more than 2,500 hospitals and 490,000 medical office sites, including inpatient, emergency, ambulatory surgery, outpatient, and medical practice care in all nine American Hospital Association (AHA) regions.

Key findings in State of Patient Experience 2026

Friction drags recommendation scores down. Problems with access, scheduling, communication, and handoffs can make care hard to navigate. Across three care settings, patients who reported operational friction gave LTR scores 30 to 37 points lower than those who did not: 51.8 vs. 88.7 in ambulatory surgery, 60.3 vs. 96.4 in medical practices, and 60.3 vs. 90.6 in inpatient care.

Experiences are inconsistent across admission types. Patients at the same hospital can rate their care very differently depending on whether their admission was planned, especially at lower-rated hospitals. The median gap in overall ratings between planned and unplanned admissions was 18.2 points at bottom-quartile hospitals, more than twice the 8.9-point gap at top-quartile hospitals.

Patients notice when care teams work together. Patients rarely see the teamwork behind their care, but they feel it. There are telltale signs, such as a nurse who already knows what the physician discussed, consistent answers from different caregivers, and a handoff that doesn't make them repeat their story. In fact, hospital units in which employees reported strong teamwork were 1.9 times as likely to earn top patient experience ratings.

Completed post-discharge calls are associated with higher scores. On average, scores from patients who received a completed post-discharge call ranked 17 percentile points higher on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) overall hospital rating and 12 percentile points higher on LTR than scores from patients whose calls were attempted but not completed.

Emergency care ratings differ by race and ethnicity. In emergency departments, Native Hawaiian/Pacific Islander, American Indian/Alaska Native, Asian, and Black/African American patients consistently rated care below the overall averages at the facilities where they received care. The largest gap in overall ratings exceeded 8 points, with differences extending to courtesy, respect, communication, and listening.

The State of Patient Experience 2026 outlines nine priorities for healthcare leaders to focus on in 2027, including reducing operational friction through proven care practices, using AI to predict and mitigate poor experiences, and looking beyond overall averages to determine which patient groups are having the least favorable experiences.

"State of Patient Experience 2026 highlights that the patient experience bar keeps rising. Patients experience whether their care team is a real team, whether they are talking to each other, and whether someone checks on them after discharge," said Thomas H. Lee, MD, Executive Director of the Qualtrics XM Institute. "Healthcare is the ultimate Experience Management 'stress test.' When people are most vulnerable, they look for access, empathy, coordination, and cutting-edge care, delivered safely. I challenge leaders to look past the averages: find the moments where care breaks down for your patients, fix the systems behind them, and build experiences every patient can count on."

The data comes from organizations that partner with Qualtrics, representing more than 2,500 hospitals and 490,000 medical office sites across all nine AHA hospital regions. The analysis builds on a dataset with 40+ years of healthcare experience data from more than 41,000 facilities.

Download the report: https://www.qualtrics.com/research/state-of-patient-experience-2026/ 

About Qualtrics

Qualtrics created the Experience Management (XM) category. The Qualtrics XM Data & AI Platform produces trusted outcomes in the Experience Moments that matter, for each person, at any scale. It combines simulation, prediction, and Experience Agents, so organizations can close the Experience Gap, the distance between what people expect and what they receive, while there is still time to act. Learn more at https://www.qualtrics.com/

About Qualtrics XM Institute

The Qualtrics XM Institute is the research and thought leadership arm of Qualtrics. It publishes original research, data studies, and frameworks on customer, employee, and patient experience, and runs training and certification for Experience Management professionals. Thomas H. Lee, MD, is the executive director. Learn more at https://www.qualtrics.com/xm-institute/

Further information

Jason Maynard, Chief Executive Officer of Qualtrics; Thomas H. Lee, MD, Executive Director of the Qualtrics XM Institute; and Dr. Adrienne Boissy, Qualtrics Chief Medical Officer, are available for interviews about the report's findings.

Contact: Tyler Petersen, [email protected]

SOURCE Qualtrics, LLC