Eliminate the negative. Managers should optimize rather than maximize performance to enhance patient satisfaction.

Performance on a particular attribute has an asymmetric impact on patient satisfaction. Gaining insight into this asymmetric effect can help refine management tools such as impact analysis. For overall satisfaction, negative performance on an attribute will have a much larger impact than positive performance. Therefore, managers should optimize, rather than maximize attribute-level performance to maximize patient satisfaction. Because of this asymmetry, the benefit from eliminating negative performance may be larger than the benefit gained from increasing positive performance on an attribute. So you can increase overall satisfaction faster by eliminating the negatives.