Do you want to please your patients?
Do you want to please your patients?
Don't rely on occasional customer service
Unless a tradition of focusing on the patient is an integral part of the entire care delivery system, all the customer service programs in the world won't increase your patient satisfaction scores, warns Sharon Tanner, executive vice president and chief operating officer at Suburban Hospital in Bethesda, MD. Tanner, along with Jackie Lobien, clinical efficiency coordinator, spearheaded the hospital's Service Delivery/ Service Recovery initiative.
"You must weave the customer service mindset throughout every system. It must be paramount in selecting, orienting, training, rewarding, and evaluating all employees," she says. "Otherwise, that wonderful customer service program you've developed or invested in will soon be forgotten."
Lobien agrees. Without a comprehensive customer service initiative in place, the effects of putting employees through sporadic training "will last for awhile, but then the problems return," she says.
Tanner and Lobien know first-hand the inadequacies of approaching customer service in a piecemeal fashion.
"We had some good programs several years ago, but they slowly took a back seat to other concerns. We realized we needed to institutionalize the concept of customer service," says Tanner.
Customer service should depend on principles, not personalities, she adds. "Employees can come, employees can go, but you will still have a tradition of service excellence because it is exactly that - a tradition."
Tanner and Lobien offer nine tips on developing a thorough initiative.
1. Set clear standards as well as specific behaviors.
At Suburban, the seven core standards for service excellence are based on the organization's values. But vague mission statements aren't enough, stresses Tanner. "You must state the specific behaviors that support each standard." (See list of standards and behaviors on p. 116.)
For example, under the courtesy category, employees are expected to call patients by their surnames or titles instead of first or nicknames.
2. Let patients help define these behaviors.
Talk to patients through interviews or focus groups to find out what they think are appropriate behaviors.
"For example, our facility is in the Washington, DC, area, which is very international," Tanner says. "So we have to be sensitive to how other cultures define courtesy. That's why we use the surname, rather than the given name, because in some cultures informality is considered a sign of disrespect." (For more information on patient-defined expectations, see related article on p. 118.)
3. Inform employees and volunteers about appropriate behaviors.
"Every employee and volunteer went through mandatory customer service training in which we explained the standards and behaviors," Tanner says.
There is separate training for managers and employees. "In the training for managers, we really stress the fact that employees will mirror their manager. We tell them we can train employees about expectations, but if they walk around with a disgruntled look on their face and treat co-workers badly, that same attitude will filter down to the front line," says Lisa Tracey, RN, partner in Odyssey Partners, a health care management firm in Atlanta.
4. Capture the insights of new hires.
After newly hired employees receive two hours of orientation on customer service, they also receive a pocket-sized notebook to record thoughts about how to focus on the patient. "We realized that for the first several months, these new employees are seeing the organization through new eyes," Tanner says. "After that, they may not notice."
Beginning this September, every new employee also will be assigned a customer service mentor. "For 90 days, they will meet periodically to discuss any questions they have as well as offer advice on how we can provide better service," she says.
5. Establish a customer service recovery program.
Realize you can't please everybody all the time - and plan for it, stress Tanner and Lobien.
"A good customer service recovery program can help you mitigate unexpected episodes of patient dissatisfaction as well as pinpoint opportunities for process improvements," says Tanner.
Suburban's philosophy is that the cost of keeping a customer is small compared to the cost of replacing one. So employees have a mechanism by which they can "recover" the customer's trust. (See basic steps to service recovery on p. 117.)
With this program, all employees have a system to act on behalf of the customer. "They don't need the manager's permission or approval to make a recovery whenever they deem it is appropriate," Lobien says.
Each month, employees give away small gifts ranging from $5 to $10 dollars in value to patients or family members who voice a complaint. Gifts include a card of regret, meal passes to the hospital restaurant and gourmet coffee service, and gift certificates for a gourmet grocery store, McDonald's, and the hospital's gift shop.
"The intent is not to give expensive gifts, but to get the message across that the employee is listening and is responsive to the patient's needs," Lobien says.
It also encourages employees to take responsibility on the spot for the patient's dissatisfaction - whether it occurred in their areas or not. Territoriality and passing the buck are often barriers to customer service excellence, notes Tracy. "We're task-oriented. We get our jobs done within our boundaries and consider anything that happens outside them to be not our fault," she says.
This mindset forces unhappy patients to take their complaints all the way up the administrative line, growing angrier with each management level they must plow through.
The service recovery program teaches employees to act as a representative of the organization, to say "'I really apologize for what happened; we are working to see that it doesn't happen again," adds Tracey.
6. Tie recoveries into process improvement.
But unless you carefully track who gives the gifts and for what reason, you'll merely be putting a Band-Aid on problems, warns Tanner.
With each gift, employees must fill out a form stating where and how the incident occurred and forward it to risk management within 24 hours. "As you would expect, one of our biggest complaints is about delays and communication," says Tanner. "We are looking at why the delays are occurring and how to adjust scheduling." She also points out that employees are encouraged to keep patients and family members informed during a delay. "If you leave people sitting for long periods of time without telling them why, you only exacerbate their anger," she says.
In addition to capturing such data as the name of the customer, type of service breakdown and recovery action, the form also contains a space for employees to note their recommendations to prevent future occurrence.
"Sometimes the front-line people have the best ideas, because they are the ones who see what is actually happening," Tanner says.
The forms, which are kept in each manager's office along with the gift items, also have a place for employees to note whether the recovery occurred with vendor, inpatient or outpatient, employee, or physician.
"We stress that this is not to point fingers but to take responsibility for a problem," Tracy says.
Discover the real problem
Tracking the location is essential for process improvement, she adds.
"You may be dealing with a frustrated customer on a medical floor and find that their anger evolves around an extended wait time in the emergency department. So the emergency department would be the initial area of focus, not the medical unit," she says.
7. Tie customer service to performance evaluation.
At Suburban, these customer service behaviors make up 50% of the performance evaluation. "Be very clear in advance about the behaviors that define customer service," Tracy says. "We want to show we are not just giving lip service to customer service."
8. Put your money where your mouth is.
Starting July 1, Suburban began offering an annual bonus for each employee based on patient satisfaction.
9. Honor employees who exceed expectations.
"Recognizing employees not only shows your appreciation but also encourages and reinforces the standards of service excellence for others," Tanner says.
In addition to simple gestures such as writing a note or praising the employee in public, managers and employees can use "Quality Spotlight" gifts similar to those given to patients. These awards are also tracked, says Tracey.
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