No Excellence, No Patients


Of all the quality and performance measures hospitals must tackle, patient experience (satisfaction) is one of the most challenging.  While process and outcome measures have dramatically improved in recent years, a fix has yet to be found for creating a fail-proof excellent patient experience. Consider that during a typical three-to-four-day hospital stay, a patient may interact with 50-60 employees, and it’s easy to see the many opportunities for things to go wrong.


Pay-for-performance, which entails measuring patient satisfaction, won’t be going away anytime soon, and so it behooves hospital leaders to understand and address the roadblocks to achieving excellence in the patient experience. Whether it’s outdated or unenforced policies, a poor culture, or bad attitudes or behaviors, hospitals must get to the heart of these matters to build a solid service excellence- oriented organizational culture.  


For hospitals struggling to maintain market share, patient satisfaction is not only the key to their success but to their survival.  


Improving interpersonal skills

Hospitals can take tangible steps to enhance patient satisfaction, and not all of them are large undertakings. One of the most important indicators to determine the patient satisfaction outcome is the doctor-patient interaction. Improving physicians’ interpersonal skills can increase patient satisfaction, which is likely to have a positive effect on treatment adherence and health outcomes.


According to a National Research Corporation (NRC) survey, patients listed “willingness to explain things” as the most important criterion in selecting a physician. Other factors in the study were reasonable fees, phone access, friendly staff, and convenient locations, among others. The willingness to explain things was given a rating of 9.6 (out of a possible 10), well above the other criteria listed.


In some hospitals, physician bonuses are linked to patient evaluations of their doctor’s personal interaction with them. They have recognized that higher patient satisfaction benefits the hospital in many ways, including:


•    Patients who improve with care make staff happier. The happier the staff, the happier the patient.


•    Increased patient satisfaction leads to greater patient loyalty.


•    Satisfied patients are less vulnerable to competitive pricing. In a study conducted in Voluntary Hospital of America, nearly 70 percent of patients were willing to pay more if necessary to consult with a quality physician of their choice.


•    Improved staff morale with reduced staff turnover leads to increased productivity.



Better workplaces & cultures

Martin Makary, M.D., M.P.H, an associate professor of surgery at the Johns Hopkins University School of Medicine, has written, “The better the workplace culture for staff, the more satisfied the patients. In any industry, if the employees feel good about their workplace, they are more likely to have satisfied customers.”

Poor patient satisfaction can have a devastating impact. According to the Technical Assistant Research Programs (TARPs), if we satisfy one customer, the information reaches four others. If we alienate one customer, we will have to satisfy three other patients to stay even. It’s estimated that the loss of a patient due to dissatisfaction can result in the loss of over $200,000 in income over the lifetime of a physician practice.

While excellent customer service doesn’t ensure patients will remain loyal to the doctor or hospital, it is a high motivation factor. And, without excellence, there are no patients. Delivery of patient-focused care requires that we provide care in a particular way, not just sometimes or usually, but always - every patient, every day, every time.

The single most important contributing factor to hospital success is that hospital leaders embrace, drive and model service excellence for the organization. This culture of service excellence must be continuously nurtured to achieve high marks in patient satisfaction.

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