From detractors to promoters: a comparative analysis of patient experience drivers across Net Promoter Score subcategories

Corey Adams*, Reema Harrison, Maha Pervaz Iqbal, Anthony Schembri, Ramesh Walpola

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Background: The utilization of patient experience surveying by health care institutions has become increasingly prevalent, yet its effectiveness in promoting quality improvement remains uncertain. To enhance the utility of patient feedback, the examination of free-text comments may provide valuable insights to guide patient experience strategy. Aims: This study aims to explore the utility of free-text comments and identify key differences for patient experience drivers between Net Promoter Score (NPS) subcategories of Detractors, Passives, and Promoters. Methods: Evaluation and classification of comments was conducted using the eight Picker Principles of Person Centred Care, with descriptive analysis of patient comments performed on the NPS data. Results: Analysis of patient NPS comments can be classified into three key drivers: “feeling well-treated” (for Detractors), “feeling comfortable” (for Passives), and “feeling valued” (for Promoters). Specifically, Detractor comments provided the most comprehensive and detailed feedback to guide patient experience improvement activities. Conclusion: This study highlights differences between NPS subcategories, particularly regarding aspects of safety, comfort, and feeling valued. Comments from Detractor respondents may be especially useful for guiding quality improvements due to increased specificity and insights. These results also emphasize the essential nature of empathy and compassionate interactions between patients and clinicians to achieve the highest level of patient satisfaction and experience.

Original languageEnglish
Article numbere13197
Pages (from-to)1-9
Number of pages9
JournalInternational Journal of Nursing Practice
Issue number1
Early online date30 Aug 2023
Publication statusPublished - Feb 2024

Bibliographical note

Copyright the Author(s) 2023. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • Net Promoter Score
  • nursing
  • patient experience
  • patient feedback
  • quality improvement


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