Table of Contents
Abstract
In the ever-changing world of healthcare, where patient outcomes impact the bottom dollar of healthcare organizations, we have transitioned into a world where patients have become customers. With the changes in healthcare laws and the demands placed upon clinical and administrative staff to ensure compliance with government agencies, obtain reimbursements, and ensure positive patient outcomes, healthcare companies must place customer service at the core of their values and operations. For companies to successfully provide exceptional customer service as part of the overall patient experience, the importance of customer service must start at the top of an organization. This paradigm shift can be a challenge for healthcare providers as it entails a new level of knowledge and understanding. For healthcare providers to obtain a better understanding of customer service and the role it plays in the overall patient experience, the development of robust customer service training programs and regular customer service training for employees must occur.
Introduction
As healthcare companies are faced with new healthcare laws and increasing demands to provide exceptional patient care, customer service must become a top priority. As the rise in customer service becomes, a focus, we cannot ignore the fact that healthcare is a business. As noted in a recent article, Customer service vs. patient care (Torpie, 2014, para 1-2), with any other business, the success of a company is dependent on its customers. While healthcare is a business, it is unlike other businesses and patients are unlike other consumers. With the continual changes and developments in a regulated healthcare system, it is becoming progressively crucial for healthcare professionals to know what patients expect as it relates to service.
Patients are not like traditional consumers. Traditional customers are typically in their environment by choice where healthcare customers are not in their environment by choice but forced into a situation where there is a level of fear and uncertainty where they need reassurance. To address patient’s fear of the unknown and reduce the stress of uncertainty, it takes customer service skills, (e.g., empathy and listening). Clinicians have to listen and have empathy towards a patient and the patient’s family. It is the small things that make a significant impact on a patients perception of satisfaction. These small gestures and actions are the things needed to turn a mediocre patient experience into an exceptional patient experience. In reading, Customer service in healthcare optimizing your patient’s experience, an example was given of how the small things make a huge impact. As one patient in the article stated: I went in for a cataract treatment. There were several of us, all sitting in a cold, stale room with nothing to keep us warm while we waited and waited for our procedures.
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I had to track down a nurse to get a blanket. We didn’t have anything to drink or eat. I could tell others were very uncomfortable, too. (Meek, 2012, para 7) Something as simple as having blankets readily available for patients and providing a warm atmosphere can completely change a patient’s experience. In today’s competitive market, for healthcare organizations to stand out from their competitors and viewed by patients as a premium healthcare provider, they have to have experienced employees who exhibit excellent soft skills and understand healthcare. (Slater, 2016, para 5) Customer service skills are the skills that impact a patient on an emotional level like a warm atmosphere. Patient satisfaction is the thing that impacts a patient on a physical level, (e.g., pain management). While patient satisfaction is paramount, it is only a piece of the patient experience. Customer service is the other component needed to complete the overall patient experience.
Method
The information and research used to devise this paper is a combination of previous professional writings, personal interviews, case studies, and surveys. The information allows a better understanding of the importance of healthcare providers transforming into a customer-service organization. The outcomes of this research provide a good reflection of the importance customer service plays in the overall patient experience.
Study 1
In the first study, the method used was a combination of writings in healthcare journals by subject matter experts in the fields of healthcare and patient satisfaction. Additionally, through internet research, The Huffington Post and the Bloomberg website offered additional information to support the authors’ articles. The information provided in the reference material helped to provide a better understanding of customer service as it relates to patient care. (Torpie, 2014) Customer service relates to patient care because patients who report having an excellent customer service experience, experience shorter recovery times, reduced hospital readmits, and better adherence to care plans. Clinicians must make customer service a primary focus to provide an exceptional patient experience and improve patient care.
Study 2
In the second study, the method used was to review survey feedback from 40 individual patient case studies.The information from the study centered around the patient’s level of satisfaction during their hospital visit, and the impact of the patient experience. The process used to collect the data was looking at results from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys given out to discharged patients. After reviewing the survey feedback, it was necessary to look at the correlation between the patient’s experience, and how they scored their inpatient experience while at the facility. After reviewing the data on both subjective and objective experiences, observations of staff, and other details such as the availability of a translator, cleanliness, attentiveness, and interactions with clinical staff. (Price, Elliott, Zaslavsky, Hays, Lehrman, Rybowski, Edgman-Levitan, Cleary, 2014)
Study 3
In the third study, the method used was personal interviews. The participants in the interview were, Caroline Shanklin, RN, MSN and Kevin Humphrey, MS, RDN. Both Shanklin and Humphrey work at the Veterans hospital located in Nashville, Tennessee. During the interview, they were each asked the following five questions. a)Define patient experience and customer experience in healthcare. Is there a difference?
b)In your professional opinion, do you think the majority of healthcare providers think about or act upon the customer service aspect of the overall patient experience?
c)What type of training or other elements do you feel healthcare providers need to address and provide exceptional customer service to exceed patient and patient families’ expectations? Can these skills be taught to a person who does not naturally have these skills?
d)When thinking about patient outcomes, do you feel initial outcomes (and, long-term outcomes) are better for the patients who had both a good patient and customer experience vs. the patients who had a good patient experience?
e)When thinking about the future of healthcare as it relates to patient care, patient outcomes, and the continued demands on medical staff, do you think by focusing on customer service, it will improve the quality of healthcare, and the healthcare system for all parties involved (patients, patient families, administration, clinical staff, physicians, and the overall cost of healthcare)?
The questions asked in the interview are relevant to patient care as it provides feedback from clinicians who have direct interactions with patients on a day-to-day basis. As professional caregivers, their feedback helps others understand the need for customer service in healthcare to provide the best patient experience possible.
Study 4
In this study, the Agency for Healthcare Research and Quality Healthcare Innovations Exchange website reviewed 201 innovation profiles. An innovation profile is a scenario where a problem exists and describes what the innovation was to solve the problem, how well it worked, and who benefited. The innovation profiles included several factors. However, the single common denominator of the study was overall patient experience as an outcome. To obtain the information, they desired, a variety of qualitative analysis methods was utilized to evaluate the data. The majority of the methods were studying information based on a specific point in time, time trends, and control group comparisons. (Weinick, Quigley, Mayer, Sellers, 2014)
Study 5
In this study, a telephone survey was used to obtain feedback on discharged patient’s level of satisfaction. The survey was in respect to the patient’s perception of the hospital physicians and their ability to connect and communicate with the physician. The model used to confirm patients perceived quality of care and service was the Structural equations model (SEM). The three areas addressed in the survey were overall customer satisfaction, customer loyalty, and perception of service quality. After reviewing the survey feedback, it was broken out by patient groups based on loyalty and satisfaction. (Lonial & Raju, 2015)
Study 6
In this study, based on patient data to include CAHPS data, Harvard Pilgrim Healthcare developed a set of call center phone standards to improve the patient experience when calling their organization. The attributes reviewed in the study were measured by Abandonment Rates and Average Speed to Answer (ASA). Based on feedback obtained from focus group discussions, the organization created and implemented new metrics and standards. One of the new standards implemented states 90 percent of patients who call for an appointment will receive an appointment for the same day. Another metric implemented was answering all telephone calls within three rings. (Standards for Customer Service, 2015)
Results
Study 1
The results of this study found it is necessary to break down the numerous aspects of patient care into silos based on expertise and area of care (e.g., lab, pharmacy). Healthcare providers need to understand these silos must work together and are dependent on one another to provide an optimal patient experience. In recognizing these silos, the results provided essential actions that should be considered to enhance the overall patient experience. a)Placing focus on objectives and values. b)To achieve success, emphasize the importance of teamwork. c)Understanding it first takes people to make policies to succeed. d)Promote self-awareness to build better interpersonal and communication skills. e)Avoid silos by recognizing all aspects of the patient experience rely on other parts to achieve positive results. (Torpie, 2014)
Study 2
The results of the surveys provided insight as to how patients perceived things such as how well their pain levels were measured, wait times, and the provided outpatient documentation all directly impacted how the patient felt about their stay. (Price et al., 2014) Additionally, the review of the surveys determined that better patient experiences provide a positive impact on patient outcomes. The results also found that good patient experiences lead to higher levels of patient adherence in regards to prevention measure and treatment care plans; better medical outcomes, especially with inpatients; and better patient safety measures.
Study 3
The personal interviews suggested that patient outcomes are better for patients who have had a good customer experience. According to Shanklin, “patients are more likely to listen and comply with their plan of care if they feel they can trust and depend on their healthcare team.” At the conclusion of the interview with Humphrey, he concurred with Shanklin’s theory, “Customer experience is important and can lead to better outcomes.” The overall theme of both interviews was the emphasis on customer service training and documentation. Both Shanklin and Humphrey feel excellent customer service skills do not always come naturally to many people. During the interview with Shanklin, she went on to say she feels that colleges should revisit all curriculums to incorporate customer service and soft skills training. (Humphrey, B., Shanklin, C., 2018)
Study 4
The results of this study reported that less than half of the innovations were used to measure patient experience. Out of 120 innovations used to collect direct patient satisfaction, the majority used surveys to obtained their desired feedback. Only 6 of the 120 innovations used a CAHPS measure to collect patient feedback on recent hospital stays. CAHPS measures more than direct patient feedback; they measure results at a broader level. CAHPS not only measures all patient-related criteria but organizational processes as well. While CAHPS is an excellent tool to measure patient satisfaction, surveys provide a better solution for direct patient feedback. (Weinick et al., 2014)
Study 5
The results of this study revealed there is a direct correlation between high and low patient satisfaction scores based on the levels of customer service provided to the patient. Further, the study exposed, when providing exceptional levels of customer service not only is satisfaction improved, patient loyalty is higher. The study suggests when organizations identify and focus on critical customer service skills and incorporate those skills into their customer service training, it is incredibly beneficial to the company. (Lonial & Raju, 2015)
Study 6
The results of this study were an adjustment in the current metrics and goals Harvard Pilgrim Healthcare had in place. They revised their metrics to improve patient satisfaction. Another measure they took was to expand their days and hours of operations. They adjusted staffing to accommodate for peer call times and increased staff and manager training. When developing training material, there was a significant focus placed on how to respond to patients in a more customer-driven manner. During training, some of the examples they used were “ Instead of…”No, I don’t have the time”, Say…”Yes! I can help you in five minutes” (Agency of Healthcare Research and Quality). Lastly, they updated and improved their documentation for both the staff, managers, and patients. (Standards for Customer Service, 2015)
Conclusion
From the time a patient realizes the need for medical care and reaches out to schedule an appointment, customer service is key to the patient’s perception of care and satisfaction. Throughout this research, the studies have shown the positive impact customer service has on the overall patient experience and patient outcomes. “To address the needs of the expert patient, and to start the transition of healthcare to a demand-driven model, some of the world’s leading hospitals are placing the patient firmly at the center of everything they do” (CGI Group 2014). Healthcare providers need to understand that without values centered on customer service, the idea of providing exceptional patient experiences, will never exist. Healthcare organizations should heavily consider placing customer service as the foundation of their business. The importance and priority of customer service have to start at the top of the organization.
As some of the outcomes from the studies mentioned in this paper reflect, exceptional patient experiences increase patient loyalty; patients are more apt to follow their care plans and trust their healthcare team. Executive leaders need to exhibit exceptional customer service skills and ensure all employees understand the expectation to deliver better customer service. Many organizations already have mature customer service training programs in place. For those organizations who do not provide customer service training, it is essential to work with customer service professions to devise robust training programs. Customer service training needs to address those critical soft skills needed in a healthcare environment. The critical soft skills needed by healthcare professionals are the ability to listen, show compassion, exhibit empathy, and express excellent communication skills on all levels.
As part of soft skills training, healthcare professions need to be taught the impact of first impressions and know when and how to apologize with sincerity. As some of the results of this research paper show, when developing training material, it is critical that the material be customer-focused. In healthcare, there are core competencies which are needed to improve the patient experience. Healthcare organizations must exhibit two of the primary core competencies, empowerment, and accountability. With any organization, when leaders meet with employees to discuss performance and training, managers should ensure each employee has a customer-focused goal to improve patient satisfaction.
By giving employees customer service goals, it can provide a positive influence on how they meet the company’s objectives. Once customer-focused goals are given to employees, employees should be held accountable to meet the goals. (Rabert, 2012) All levels within an organization, from leadership to line staff, the sense of urgency and importance regarding customer service should remain the same. If not, it will be impossible for a company to achieve the customer-driven culture they desire. There is no way around it; the healthcare organization has become a service industry. For healthcare companies to succeed and meet the needs of the patient as the customer, they must adopt customer service philosophies to provide exceptional patient experiences, improve patient outcomes, and build trust.
Without the adoption of customer service principles; it will be difficult for companies to obtain customer loyalty and satisfaction. In this age, all healthcare providers should view patients as not only patients but customers who have choices as it relates to addressing their healthcare needs. Customer Service is the key to exceeding patient expectations and improving the overall patient experience and quality of care.
