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Customer Service – Performance Satisfaction

Owen J. Dahl, MBA, FACHE, LSSMBBAnnual Conference

October 7, 2013

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Objectives

• Identify the concepts of customer service and recognize your customers– What goes into patient satisfaction?– Identify why patient satisfaction issues matter

• Build customer relationships– Discuss how good employees promote patient satisfaction

• Effectively manage telephone, Internet and in person interactions

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Three general goals in patient interaction

To provide quality health care• Satisfied with medical care

To make that care accessible• Ease of making an appointment or get a referral

To treat patients with courtesy and respect• Physicians and staff caring and compassionate

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Value is key today

• Value - a fair return or equivalent in goods, services, or money for something exchanged http://www.merriam-webster.com/dictionary/value

• Today the key buzz word is QUALITY• Every moment that customer interacts is a Moment of Truth!• Voice of the customer

– Customer has expectations, preferences, and aversions

V = R - E

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What do you expect when YOU go to a doctor’s office?

• • • • • • • • •

Your program model … 6 steps

1. Service must be part of mission, vision, values2. Focus on goals3. Hold self and all accountable for outcomes4. Reward and celebrate successes5. Communicate, communicate, communicate6. Do it!!! (yourself as best model)

Your DNA

• Define – what business are you in? Why? What do you expect to achieve?– Mission, values

• Nurture – staff, information and knowledge– Right people, skills, personality to FIT

• Allocate – resources necessary to achieve your goal– Systems, space, equipment, supplies

Simplify mission

• The best _____ (specialty) quality, service in ____ (your community)

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Culture

• A culture is a way of life of a group of people--the behaviors, beliefs, values, and symbols that they accept, generally without thinking about them, and that are passed along by communication and imitation from one generation to the next. http://www.tamu.edu/faculty/choudhury/culture.html

• Levels– Visible, observed– Ideals, goals, values– Unconscious, taken for granted beliefs and values

Best practices track

• Appointment availability• Bedside manner• Overall experience• Staff professionalism• Quality of care

Future – reputation is important?

“…practices that ignore signals and depend on reputation or ego might be surprised by new payer requirements. For example, I have heard that progressive payers are telling practices, in so many words: ‘show us what you can do today – and be able to prove it.’”

Bob Bohlman, MGMA Connexion supplement, October 2012

Reputation

• a: overall quality or character as seen or judged by people in general

• b: recognition by other people of some characteristic or ability <has the reputation of being clever>

• c: a place in public esteem or regard : good name <trying to protect his reputation>

http://www.merriam-webster.com/dictionary/reputation

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Quality Culture – 6 values

• We’re all in this together• No subordinates or superiors, colleagues only• Open, honest communication• Everyone has access to all information• Focus on processes• There are no successes or failures, just learning experiences

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We’re all in this together

• Not just buildings, assets, and employees– We have customers– We have suppliers

• Teams and teamwork• Loyalty

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No subordinates or superiors

• When and in what situations have you had positive work experiences?

• The existence of superiors creates subordinates– Colleagues create colleagues

• Attitude and approach rather than structure

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Open, honest communication

• Saying one thing and thinking another???

• Empathy– See the world from another’s perspective

• Listen– Lost art of communication

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Everyone has access to all information

• Get/give information to those who need it

• Good (the best) decisions are made when there is complete and full information available to all involved in making the decision

• No secrets, no wondering or surprises

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Focus on processes

• Turn inputs into outcomes

• Design and function

• Employees“I am a medical assistant” to “I am a care giver”

• Measure successes

• Continuous process improvement

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No successes or failures, just learning experiences

• Failure and success are value judgments determined after the fact!• Success = mutually satisfying outcomes• Failure = unsatisfying outcomes

• Why did this work? = Strengths• Why didn’t it? = Weakness• Successes and failures are valuable experiments to learn from

• Don’t rest on your wins • Learn from every experience

Five Fundamentals of Customer Service --- AIDET

• A = Acknowledge the patient, last name

• I = Introduce yourself, your skill set, professional certification, and training

• D = Duration, how long will the process take

• E = Explanation of the tests and what happens next

• T = Thank you - for choosing our practice for your health care

Customers are detectives!

• Customers can identify clues on the experience in the practice

• They process these clues into their impressions which evoke feelings about their experience

• This leads to initial and/or return visit decisions

CMS and satisfaction

• Consumer Assessment of Healthcare Providers and Systems (CAHPS)

• HCAHPS – hospitals– DRG payments reduced in 2013

• CGCAHPS – clinician and group– Testing

• Value Based Purchasing

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HCAHPS

• Hospital Consumer Assessment of Healthcare Providers and Systems – started in 2006

• Goals– National survey to produce comparable data– Public reporting to create incentives– And to enhance public accountability

• 27 items, 18 are “substantive”• Multi lingual• CMS has rules of participation and set minimum number of

responses

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Key points on a survey

A patient satisfaction survey can demonstrate that a practice is interested in quality and in doing things better.

When choosing (or designing) a survey questionnaire, look for three things: brevity, clarity and consistency.

Even an in-house survey can be statistically correct if practices stick to some basic rules.

Internet and Social Media

• Internet– “You believe everything on the internet!”

• Social Media – “forms of electronic communication through which users create online communities to share information, ideas, personal messages, and other content” (Merriam-Webster Dictionary)

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Internet “surveys” – involuntary!

• Healthgrades.com• Yelp.com• Vitals.com• Insiderpages.com• Localyahoo.com• Angieslist.com• Ucomparehealthcare.com• And many more . . . . .

Sites to use

• LinkedIn– On line resume; groups; control information

• Facebook– Largest; communities ; metrics

• You Tube– Education and branding

• Twitter– Reach large numbers quickly

• Blogs– Control of information

• Google+– Developing opportunity; related to search engines

Use and benefit

• Branding– Reputation building and protection

• Education• Communication

– Patients– Other professionals

• Interaction• Direct relationship through portal• Satisfaction and “grading”

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On line “grades”

• Regularly review sites, e.g., monthly

• If there are negatives look at date posted and talk to staff, typically negative postings are fairly concurrent with action

• Also any negative can be looked at as “what can we do better”

• In some cases, practices copy the negative, post in reception area, and tell patients what steps are being taken to improve the care process.

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Issues found

Long wait times

Rude staff

Unable to get through on the phone

Long time between call and appointment

Your examples:

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And you will do what and how with these issues?

Fix those that can be fixed!

How will the patient know that you fixed them?

Customer Service Process Audit

• Do you have good customer service processes in place?• Are the processes efficient?• Do the processes support staff in delivering excellent, customer-

related services?• Do staff members at all levels of the organization have the

opportunity to offer input for process improvement?• Are staff members encouraged to be innovative in improving

systems and processes?

“Raising the Bare on Service Excellence” Kristin Baird, RN, BSN, MHA

Patient Cycle Time

• Focus on patient experience• Right person, right job• Standardization• Facilities• Exploit technology• Communication

Employee process

• Step One – Hire right – “join a culture, not a job!!!”

• Personal values, attitude, talent, growth potential

• Step Two – Orientation (on boarding) and training

• Step Three– Culture acceptance: takes time up 3 to 5 years

• Coach, mentor

Attending to detail

• Managing the waiting area• Seating arrangements• Signage, lighting• Patient comes with stress –

– Where does patient spend most of their time?– Exam rooms– Procedure rooms

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Patient satisfaction survey – that you can do NOW!

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Harvard Business Review – Tip of the day (5/7/13)

Don’t Listen to Customers — Observe Them

Every business wants to know what influences their customers. So, they should just ask them, right? Not so fast. There’s a fundamental problem with asking people what will persuade them to change: Most of the time they won't know the answer. It's not that they won't give one. They'll give you plenty. But those answers are likely to be wrong. Asking someone to pinpoint what will influence them in the future is a bit like saying, "Tell me how you will behave when you are not thinking about what I have just asked you about." Instead of listening to your customers, watch them. Set up small field tests and controlled studies that observe what they actually do. In most instances, these experiments will be lot cheaper than traditional market research, and the insights will be much more revealing. ...

http://s.hbr.org/140fSDe

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Contact Information

Owen J. Dahlodahl@comcast.net832-260-4455

www.mpmnetwork.com