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7-8 September 2016 | Sheraton Hotel & Towers | Ho Chi Minh City, Vietnam www.hospitalmanagementasia.com
7-8 September 2016 | Sheraton Hotel & Towers | Ho Chi Minh City, Vietnamwww.hospitalmanagementasia.com
The Seven Deadly Sins of Customer Service in Hospitals
Prof. Rene T. DomingoAsian Institute of Management
IS PATIENT SATISFACTION IMPORTANT IN YOUR
HOSPITAL?
IN YOUR OPINION, WHICH IS MORE IMPORTANT?
• CLINICAL QUALITY?
• SERVICE QUALITY?
IN YOUR OPINION, WHICH IS MORE IMPORTANT TO PATIENTS SATISFACTION?
• CLINICAL QUALITY?
• SERVICE QUALITY?
What is outstanding customer service?
funpleasant
memorableshared
Delighted patient
IN YOUR OPINION, MOST HOSPITALS ARE:
• DOCTOR-CENTERED?• PATIENT-CENTERED?
MANAGER MANAGER
VICE PRESIDENT
MANAGER MANAGER
VICE PRESIDENT
MANAGER MANAGER
VICE PRESIDENT
PRESIDENT
THE DOCTORSTHE PATIENTS
A HOSPITAL IS SIMILAR TO WHICH KIND OF
BUSINESS OR ORGANIZATION?
HOSPITAL ?
HOTEL
“check-in”“check-out”“room service”“room rate”“housekeeping”
PRISON
“visiting hours”“same uniform”“same food”“subject to orders”“confinement”“isolation”“major, minor repairs”
“check up”, “back job”
REPAIR SHOP
Patient-Driven Quality according to Importance (US survey) – 11 factors
Source: The Quality Connection in Health Care by Lynne Cunningham
Immediate attention and triage
Care first and then paperwork
Knowledgeable personnel
Explanation in terms we can understand
Explanations if you have to wait
Friendly staff and bedside mannerEnough staff
Clean facility
Ancillary support readily available
Easy to find physical facility
State of the art equipment
Patient-Driven Quality according to Importance (US survey)
Source: The Quality Connection in Health Care by Lynne Cunningham
1. Immediate attention and triage 812. Care first and then paperwork 673. Knowledgeable personnel 624. Explanation in terms we can understand 605. Explanations if you have to wait 576. Friendly staff and bedside manner 567. Enough staff 488. Clean facility 349. Ancillary support readily available 3310. Easy to find physical facility 3111. State of the art equipment 22
The soft skills of workers, rather than their hard skills and facilities, strongly influence patient satisfaction.
SOFT QUALITY vs. HARD QUALITY
* * “Patient Satisfaction Influenced More by Hospital Staff than by the Hospital Facilities.” www.jdpower.com/press-releases/2012-national-patient-experience-study.
Doctors and nurses account for 34%, 43%, and 50% of the overall experience ratings of inpatients, emergency patients, and outpatients respectively. **
IS YOUR QUALITY / SAFETY SCALEABLE?
ONE-TO-ONE
MANY-TO-MANY
ONE-TO-MANY
NUMBER OF BEDS / OCCUPANY RATE/ PATIENT VOLUME
QU
ALI
TY /
SAFE
TY
Prof. Rene T. Domingowww.rtdonline.com
HOSPITAL A
HOSPITAL B
The Seven Common Pitfalls of Customer Service in Hospitals
1. Multiple handoffs2. Lack of transparency3. One-size-fits-all4. Lack of empathy5. Reactive approach6. Failure to serve the patient’s
extensions7. Overworked staff
MULTIPLE HANDOFFS
1
multiple patient information collection
multiple contact personnel
MANAGER MANAGER
ADMINISTRATOR
MANAGER MANAGER
MED. DIRECTOR
dual management
A CUSTOMER-DRIVEN ORGANIZATION
“Looking at the customer as one.”
"lost" customersno patient ownership
LACK OF TRANSPARENCY
2
Need for more transparency
NO APOLOGIESNO EXPLANATION
When is my doctorcoming back?
Where’s my food?
Is my blood test result ready?
Is my bill ready?
When can I go home?A repeat X-ray? why?
What side effects?
What? $2,000 for this?!!
HOSPITAL ROUNDS
Types of Nurse calls
Prof. Rene T. Domingowww.rtdonline.com
40%
30%25%
5%
house-keeping
call for MD
check IV others
ONE-SIZE-FITS-ALL
3
PATIENTS ARE “CUSTOMERS”
“CUSTOMER”
“CUSTOM”
“CUSTOMIZE”
“They can have it any color they want, so long as it’s black.”
--Henry Ford (1863-1947)
Associated Press, March 31, 2006
special (bigger, wider, longer) beds, gowns, wheelchairs, slippers, operating beds, CT scans, syringes, doorways, even body-bags for obese patients
Barnes-Jewish Hospital in St. Louis
ART CART ‘CHOOSE YOUR ROOM PAINTING”
University of Michigan Medical Center
LACK OF EMPATHY
4
“door-to-door” or “room-to-room”
"Hospital Food: Ingredient in Patient Satisfaction?", Healthcare, November 19, 2002, by Rick Blizzard, Healthcare Consultant, The Gallup Organization
"Evaluations of the appearance of the meals may be more important than the actual quality of the food.”
WHICH IS MORE IMPORTANT?
• TO WASH YOUR HANDS BEFORE TOUCHING THE PATIENT?
• TO BE SEEN WASHING YOUR HANDS BEFORE TOUCHING THE PATIENT?
REACTIVE APPROACH
5
NURSE CALLS: RESPOND FAST OR REDUCE CALLS?
FAILURE TO SERVE THE PATIENT’S EXTENSIONS
6
VISITOR-UNFRIENDLY HOSPITAL
OVERWORKED STAFF
7
Prof. Rene T. Domingowww.rtdonline.com
“FATIGUE AFFECTS PERFORMANCE”
% of pilots who agree
% of surgeons who agree
“Fatigue affects performance” 64%
“Error, stress, and teamwork in medicine and aviation: cross sectional surveys”, BMJ
Prof. Rene T. Domingowww.rtdonline.com
18%
• A research study showed that nurse shift hours beyond 13 hours led to higher patient dissatisfaction.*
• Another study showed that the risk of nurses making mistakes more than doubles if the shift length is 12.5 hours or more.**
* Stimpfel, Amy Witkoski et al. “The Longer The Shifts For Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction.” Health Affairs, November 2012: 2501-2509.** Scott LD et all. “Effects Of Critical Care Nurses' Work Hours On Vigilance And Patients' Safety.” American Journal of Critical Care, January 2006, Volume 15, No. 1: 30-37.
EFFECT OF LONG SHIFT HOURS
"69 percent reported exhaustion and 54 percent reported frustration; almost 43 percent of the RNs reported that, on most days, they often have more work than they can safely handle."
November 2006 Publication No. 25-12505, Center for Health Statistics, Health Professions Resource Center, Texas Center for Nursing Workforce Studies, Statewide Health Coordinating Council
Research study conducted in 2004on Registered Nurses in Texas
Customer service training
The Seven Common Pitfalls of Customer Service in Hospitals
1. Multiple handoffs2. Lack of transparency3. One-size-fits-all4. Lack of empathy5. Reactive approach6. Failure to serve the patient’s
extensions7. Overworked staff
World Class Hospital
1. One-stop-shop, seamless service2. Transparent3. Flexible, personalized4. Caring, empathetic5. Proactive, Anticipatory6. Visitor-friendly7. Highly motivated staff
Medical
Nursing
Housekeeping
Ancillary
Finance
Radar chart for 5-star Service rating
3
2
4.5
4 3.5
The Seven Deadly Sins of Customer Service in Hospitals
Prof. Rene T. DomingoAsian Institute of Management
