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The
Economist reported that only 15 percent of Americans have a great deal
of confidence in healthcare organizations. Unable to perennially lower
healthcare costs, managed care must contend with intense public
scrutiny. Physicians are caught in the middle, tasked with providing
quality care while controlling costs. To stay a provider of choice,
managed-care companies must invest in more customer-friendly
solutions. In addition to growth, health care services are now
focusing on efficiency, competition, and productivity to gain a
competitive advantage.
Well-handled
complaints can create loyal patients and increase profits. There is
always something positive that can be done about a complaint. The
focus of an organization is to create and keep patients - and
effectively addressing a complaint is really an opportunity to create
a positive experience with customers - in addition to preventing them
from going to a competing clinic or hospital. At the very least, a
complaint is an opportunity to strengthen your relationship with the
complaining patient. Resolving patient complaints makes for a
healthier the bottom line as the cost to replace a current patient can
be 10 times the cost of keeping them.
I.
Make it easy for your patients to complain
A patient complaint is tangible
evidence of what they expect you to do to meet their wants and needs
in order to continue to use your hospital services. You need to make
it as easy to complain as possible. If you make it difficult for
patients to complain, you will never know what you could have done
differently and keep their business. They will drift away to the
competition and you will lose invaluable feedback that can help you
improve your organization’s ability to satisfy and keep patients
returning for additional services over time.
Make it easy for patients to submit
a complaint through the extensive use of
centralized customer
help-lines, 1-800 numbers, complaint/comment cards at the point of
service, and easy-to-use customer appeal processes. Web forms and even
simple emails addressed to specific mailboxes for complaints give your
patients 24/7 access to your hospital staff.
II. Use Complaints
to Implement Systematic Process Improvements
Complaints can be the symptom of
deeper, underlying process problems, so you can’t afford to lose them.
There a number of ways to handle a complaint: 1) You can ignore it. 2)
You can respond politely to the customer then still change nothing. 3)
You can solve the issue by slapping on a Band-Aid fix. Or,4) you can
use the complaint to make permanent process changes to prevent the
issue from recurring.
People sometimes confuse
process improvement with problem solving (aka Band-Aids). They think
that if they find a problem in the process and fix it, they're
improving the process. While problem solving may be a first step, it
rarely results in an improved process. Problem solving fails to
consider how solutions relate to one another, to the process as a
whole, or to the outcomes of a process. Process improvement, on the
other hand, considers the entire process, maintaining a steady focus
on what outcomes the patient receives.
The best-in-business health care
organizations design their complaint management processes with input
from both patients and staff. They develop a culture that supports
teamwork with the patient as part of the team. The complaint
management process is designed with commitment from top management,
performance goals that are measured and carefully monitored, and a
direct link to core processes.
One organization has their patient
relations personnel monitor feedback gathered from patients. They
select a small number of items that patients complained about most
often as target issues. Once these issues are identified, individual
patient satisfaction committees are formed that link those issues with
mission objectives. The complaint process is monitored to correct root
causes of dissatisfaction, and the results for these target issues are
reported regularly to the Executive Committee. This is a “best in
business” kind of approach.
III. Respond to
complaints quickly and courteously with common sense and you will
improve patient loyalty.
When patients have a negative encounter
with a health care provider, they are less likely to use that provider
again, more likely to talk negatively about the provider, and more
likely to shop for and switch to another provider. One way an
organization can ensure repeat business is by developing a strong
customer service program that includes service recovery as an
essential component.
Service recovery means that the service
provider takes responsive action to "recover" lost or dissatisfied
customers and convert them into satisfied customers. Service recovery
cannot take place if the provider is unaware of dissatisfied
customers. However, only 5-10 percent of unhappy patients actually
complain following an unsatisfactory experience. Instead, many leave
silently with the intention of never returning, and the organization
loses the opportunity of addressing the problem.
In a study supported by the Agency for
Healthcare Research and Quality (HS09446), researchers identified six
steps involved in using complaint management as an effective service
recovery tool:
1.
Encourage complaints as a
quality improvement tool (rather than a staff disciplinary tool).
2.
Establish a team of
representatives to handle complaints.
3.
Resolve customer problems
quickly and effectively.
4.
Develop a complaint database
to identify trends and generate regular reports to hospital
management/staff.
5.
Commit to identifying
failure points in the service system.
6.
Track trends and use
information to improve service processes and minimize future
complaints.
For more information, see "The role of
complaint management in the service recovery process," by Drs. Bendall-Lyon
and Powers, in the May 2001 Joint Commission Journal on Quality
Improvement 27(5), pp. 278-286.
Research has shown that customers
(patients) who have had problems with a company (hospital) or product
(service), but felt that the company (hospital) made honest efforts to
correct the problem, become some of the more vocal “evangelists” for
the company or product. “By resolving the customer’s (patient’s)
complaint using quality service, you can often move a customer
(patient) from “dissatisfied” to “completely satisfied” - and you can
usually get an increase in loyalty of 50 percentage points.”
Source: John Goodman, Jeff Manzal and Eden
Segal, Creating a Customer Relationship Feedback System that has
Maximum Bottom Line Impact, Customer Relationship Management,
March/April 2000 pp 289-296
Patients who have had their problems
satisfactorily and quickly solved often tell their friends and
neighbors, and they are not easily won over by the competition.
Patients therefore reward organizations that quickly solve problems by
remaining loyal to that organization. A speedy response can add 25
percent to customer loyalty.
The best complaint departments set goals
to fix the problem at hand, satisfy the patient and make systemic
improvements to prevent the problem from recurring. They strive to
prevent problems through revised procedures and have support for
on-the-spot and post-event complaints recovery from the front-line
staff and managers – and all the staff know how well they are meeting
this goal.
IV. Resolve
complaints on the first contact and (1) save money by eliminating
unnecessary additional contacts that escalate costs and (2) build
patient confidence.
In general, if you have to call the
patient back or the patient has to call a second time, satisfaction
and loyalty are decreased by 10 percentage points (and your costs are
doubled due to the second call and related telephone tag).
Source: John Goodman, Jeff Manzal and Eden
Segal, Creating a Customer Relationship Feedback System that has
Maximum Bottom Line Impact, Customer Relationship Management,
March/April 2000 pp 289-296
Without a well-designed front-line
resolution capability, complaints are often handed off to different
offices for response, delaying the remedy and increasing the cost of
the solution. Strive to provide one-stop resolution, and if hand-offs
are necessary, make them transparent to the patient. Remember, your
patient doesn’t care how you are organized; they aren’t interested in
hearing that the “matter has been sent to another department for
resolution.” Resolving the problem on the first phone call with the
patient is an element of world-class complaint handling.
V. Setting
patient expectations – an easy way to prevent complaints in the first
place
Everyone goes through an event with
expectations particular to their background and prior experiences.
Expectations are preconceived mental ‘scripts’ of how a patient thinks
things should happen while hospitalized. No matter how advanced your
technology, if the patient’s expectations are not met, they may still
complain – and not always to your organization.
So, how can you address a patient’s
expectations? Take time to give the patient a briefing as to what to
expect during their procedure and stay. Ask if they have any questions
that were unanswered during the briefing, and listen to and address
any fears or hesitations they might express. This sets the stage in
the patient’s mind of what they foresee happening.
Remember: Policies, processes and
procedures do not make a ‘patient-friendly’ hospital. Caring and
responsive staff who meet and exceed patient expectations do.
VI. Viewing
admitting physicians as customers
Health care organizations also need to
keep in mind that admitting physicians and staff are professionals who
can also impact the bottom-line. If enough admitting physicians get
fed up with problems and unheard complaints about your organization,
they may have other options and take their business elsewhere – a
competing hospital or specialty clinic. These issues have pushed the
emergence of specialty clinics and medical practices that take a large
bite out of hospital revenues.
Finding out what the real priorities of
your admitting physicians can help realign fiscal priorities and
reallocate dollars to upgrade technologies identified by physicians as
necessary.
Success in physician satisfaction can aid
your hospital in a number of areas: to recruit more established
practices, to retain referring doctors, to convince physician
residents to establish their private practices at the hospital, and
open up the possibility for gaining patient referrals from doctors
outside the current medical staff by sharing success stories in
marketing campaigns.
VII. Summary
When staff know that the health care
leadership is focused on doing a good job for the patient rather than
on finding someone to blame for problem, they respect managers and
concentrate on the serving the patient. This requires the right
“complaint culture” within your organization. It may take time to
change the ingrained negative feelings towards complaints. We all know
organizations that do little more than finger pointing when there is a
problem; however, the payoffs in improved quality, decreased costs
from “having to do it over,” as well as increased patient loyalty and
confidence over the long run are well worth the time, effort and
nurturing required.
Likewise, when admitting physicians feel
that the hospital listens to their suggestions regarding treatment
options and technology innovations, as well as pay heed to any
process-related complaints they may have, those physicians are likely
to keep referring patients to your organization. Better relations with
admitting physicians can produce yearly increases in inpatient
admissions and add physicians to your medical staff through
recommendations from existing medical staff members. Additional
benefits include increased occupancy rates, and experiencing favorable
financial results when other hospitals in the region are operating at
a loss or closing. |
