Customer Satisfaction in the Healthcare Setting ASQ Tutorial March 15, 2005

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Customer Satisfaction in the Healthcare
SettingASQ Tutorial March 15, 2005

• Dr. Lillian R. Eriksen, Associate Professor
• University of Texas at Houston, HSC
• School of Nursing

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Why Customer Satisfaction?

• Two Sides of Quality Measurement Needed
  Professional Customer
• Professionals review the technical/clinical side
  of healthcare procedures and their outcomes
• Mortality and morbidity
• Infection rates
• Errors
• Review of incidents for breaks in established
  techniques or procedures

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Why Customer Satisfaction?

• Customer Side of Quality Measurement
• Represents the customers perception of quality
  (expectations vs. experience)
• Healthcare consumers expectations are formed in
  various ways
• TV shows, commercials
• Other media newspapers, books, movies
• Previous experiences as patient or visitor
• Stories of relatives and friends

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Who Are Customers?

• Customers can be external or internal
• Patients are external customers of the entire
  healthcare system
• Internal customers in the healthcare system can
  also be considered customers of each other at
  times
• Physicians
• Nurses
• Pharmacists
• Physical/Occupational Therapists
• Social Workers
• Many kinds of technicians and support staff

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Internal Customer Satisfaction

• Generally ignored in the past
• More recent emphasis on employee work
  satisfaction
• Particularly noted in nursing with the issue of
  the increasing shortage
• Effects of unsatisfied workers on external
  customers
• Need to confront organizational and behavioral
  barriers within organizations

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Internal Marketing

• Efforts at internal marketing of customer
  satisfaction may be needed to
• break down barriers to developing customer
  satisfaction for the external customer
• happy campers
• workplace of choice

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What will satisfy customers?

• Positive affect
• Enhances problem solving
• Better decision-making
• Leads to cognitive processing that is
• Flexible
• Innovative
• Creative
• Thorough
• Efficient

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Cognitive Effects of Positive Affect

• Leads To
• Helping
• Generosity
• Interpersonal understanding
• Thus the work environment and people in it affect
  the satisfaction of the external customers

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What is Customer Satisfaction?

• What it that we are concerned about in relation
  to customers?
• The perception of the quality of
  care/service/product
• The varying degree to which expectations are not
  met, are met or even exceeded
• Maintaining the relationship for the opportunity
  to do business again.
• Hospital- projected increased revenue of 2.3
  million if satisfaction increased slightly

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What do external customers want?

• Please! A little respect and common courtesy.
• To be taken seriously, not dismissed.
• A responsive attitude when asking for something.
• Presence of providers when administering care.
• Continuity Timeliness
• Safe clean error free environment

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Example Hospital Stay

• Admission process
• Couldnt locate previous admission records
• MD that we were told to have paged was not the
  one on-call
• Room not ready
• Extremely uncomfortable (pain and chills)
• Requested blanket- not available
• Required to go to the holding unit even though
  not necessary as room was ready

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Example contd

• On the unit
• Unit admission
• Nurse 1 Who is the patient?
• Patient in a lot of pain
• Kept asking health history questions
• Nurse 2 starts IV
• Leaves trash on table
• Nurse 1 returns with IV pain medication
• Proceeds to clean up the table, discard materials
  instead of administering pain med.
• Administers pain med and proceeds to complete
  the history as I will get in trouble for not
  finishing it on my shift.
• Patient indicates unwillingness to continue until
  the next morning.
• Patient resolves never to return

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Key Reliable Valid Measurement

• We pay attention to what we measure.
• Measured things end up in reports
• Reports get circulated
• Visual displays very useful
• http//www.brighamandwomens.org/family/qualitycare
  /satisfaction.asp

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Press Ganey Survey

• Admissions
• Meals
• Rooms
• Discharge
• Physicians
• Nurses
• Visitors and Family
• Tests and Treatments
• Personal Issues
• Overall Assessment

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We Pay Attention To What We Measure
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We Pay Attention To What We Measure
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Brigham Womens Hospital
Press Ganey report posted on the hospital website
http//www.brighamandwomens.org/family/qualitycare
/satisfaction.asp
http//www.pressganey.com/
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Resources

• Rand Corporation
• http//www.rand.org/health/surveys/patient.english
  survey.pdf
• http//www.rand.org/health/surveys/patient.spanish
  survey.pdf