Efforts by health systems to provide care in the most appropriate, lowest cost setting coupled with advances in minimally invasive techniques have shifted many hospital cases to the outpatient setting over recent years. As a result, the quality of the care provided in this setting is becoming an integral component of any health system's success.
Carole Guinane, RN, MBA, vice president of ambulatory surgery center operations for Winston-Salem, N.C.-based Novant Health, and author of "Improving Quality in Outpatient Services" (CRC Press, 2011), has spent much of her career in the outpatient and acute-care world overseeing quality initiatives and improvement. In her book, Ms. Guinane discusses numerous facets of outpatient quality and shares best practices for improving care. One important facet of quality she highlights is customer service; she believes customer service impacts not only a patient's perceived quality of a service but also clinical quality.
"When you have a good service program in place, you have a comfort level and opportunity for dialogue," she says. "When you don't have that service in place, patients don't have the ability to ask questions and maybe go away without having all their questions answered or fully understanding the care plan."
Chapter four of her book outlines 10 "Common Sense Principles" for customer service, which when applied to outpatient processes and operations, can significantly improve the perceived and clinical quality of outpatient care. While these principles are intuitive, Ms. Guinane says they "require practice to achieve perfection."
1. Keep wait times to a minimum. As much as possible, keep wait times under 10 minutes or less. If something happens that increases wait times, share information with patients as soon as possible. Ms. Guinane recommends training reception staff to always share expected wait times with patients when they arrive and promise to keep them apprised of any bottlenecks. The receptionist should also encourage patients to feel free to ask for updates if they've had to wait past the expected time and don't receive an update.
"Wait times are one of the biggest barriers to the 'wow' levels of customer satisfaction and engagement," says Ms. Guinane. She likens outpatient wait times and their impact on customer experience to a delayed flight. "When you have folks getting on the intercom keeping you apprised of the situation all along the way, people may be upset, but they are sitting down and appreciative of the updates. If not apprised, people get madder and madder," she says.
2. Make a good impression. "It is said that 50 percent of a patient's opinion of a doctor or business is based on the first impression," says Ms. Guinane. "Overcoming bad first impressions is very hard to do."
Outpatient providers should ensure that the reception staff is professional and trained on appropriately welcoming patients. Instead of barely acknowledging patients and simply asking them to sign in, reception staff should welcome the patient warmly and communicate to the patient that he or she was expected.
Ms. Guinane warns that many healthcare providers do not put enough effort into hiring or training front desk staff. "Many times we pay them the lowest, their job descriptions are menial and we have not spent anytime whatsoever to help them understand how important it is to greet patients properly," she says.
3. Be open and honest. Outpatient providers and non-clinical staff alike should learn to listen carefully to patients and give honest feedback. Consider the customer's perspective when sharing both clinical and non-clinical information. These actions contribute to positive customer interactions, says Ms. Guinane.
4. Don't blame the customer. As with many customer-oriented businesses, the customer is (nearly) always right. Train staff to remediate errors and mistakes immediately and bar them from blaming the patient. Blaming patients erodes patients' trust and confidence. "Treat your customers as valued ambassadors of your business," she says.
5. Ask questions. Encourage patients and their families to ask questions. Doing so will "contribute to a well-rounded care pathway that is dynamic and pertinent," says Ms. Guinane. "Creating an environment that encourages questions and seeks appropriate answers is priceless."
6. It's not a meat market. Many outpatient centers, for good reason, focus on efficiency and "Lean" service delivery. However, Ms. Guinane cautions that a focus on efficiency should not result in a "conveyor line" or "meat market" mentality. Provide service that has a "wow" factor that goes beyond just moving patients through. "People have thoughts, feelings and voices. Take time to be human," she says.
7. Follow through. Hold staff accountable for following through on any promises they make to patients, patients' families or other staff. "Do what you say you are going to do, and make sure others do what they say they are going to do," says Ms. Guinane. "Don't hand off the customer to others and make them sort out care on their own. Help people navigate our confusing and cumbersome system of care."
8. No medical mumbo jumbo. One of the best ways to engage patients in their care — and improve outcomes — is to ensure they understand the information you share with them. "Say what you mean in language non-clinical people can understand," says Ms. Guinane. "Respect [patients]; don't talk down to them."
9. Work as a team. Rather than examining care from siloed clinical and operational perspectives, take a team-based approach to providing care. Ms. Guinane recommends process mapping to illustrate how patients interface with various parts of the center and then working with staff to optimize each process. "Know how things are connected and interrelated and how the customer is impacted," she says.
10. Relate to the person. Finally, outpatient service providers should relate to their patients both during their communications with them and in designing services for them. "Know what makes them tick and what they respond to; what will deliver that 'wow' factor of service for them?" asks Ms. Guinane.
In her book, Ms. Guinane describes how a mammography center 'wowed' its patients by attempting to make a mammogram as low stress an experience as possible. By relating to its patients, the center recognized that a mammogram can be a high-stress situation for many women. To counteract this, the center sought to provide its mammogram services in a peaceful environment. The waiting room had dim lighting and a waterfall, mimicking spa-like surroundings. After the mammogram, patients were escorted to an area — complete with toiletries — where they could refresh before being taken to a meditation room before leaving the center.
While not every outpatient experience can mimic a trip to the spa, following the 10 common sense principles for outstanding customer service will help outpatient providers ensure their patients will leave satisfied and — perhaps more importantly — tell others about the outstanding care they received.
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Carole Guinane, RN, MBA, vice president of ambulatory surgery center operations for Winston-Salem, N.C.-based Novant Health, and author of "Improving Quality in Outpatient Services" (CRC Press, 2011), has spent much of her career in the outpatient and acute-care world overseeing quality initiatives and improvement. In her book, Ms. Guinane discusses numerous facets of outpatient quality and shares best practices for improving care. One important facet of quality she highlights is customer service; she believes customer service impacts not only a patient's perceived quality of a service but also clinical quality.
"When you have a good service program in place, you have a comfort level and opportunity for dialogue," she says. "When you don't have that service in place, patients don't have the ability to ask questions and maybe go away without having all their questions answered or fully understanding the care plan."
Chapter four of her book outlines 10 "Common Sense Principles" for customer service, which when applied to outpatient processes and operations, can significantly improve the perceived and clinical quality of outpatient care. While these principles are intuitive, Ms. Guinane says they "require practice to achieve perfection."
1. Keep wait times to a minimum. As much as possible, keep wait times under 10 minutes or less. If something happens that increases wait times, share information with patients as soon as possible. Ms. Guinane recommends training reception staff to always share expected wait times with patients when they arrive and promise to keep them apprised of any bottlenecks. The receptionist should also encourage patients to feel free to ask for updates if they've had to wait past the expected time and don't receive an update.
"Wait times are one of the biggest barriers to the 'wow' levels of customer satisfaction and engagement," says Ms. Guinane. She likens outpatient wait times and their impact on customer experience to a delayed flight. "When you have folks getting on the intercom keeping you apprised of the situation all along the way, people may be upset, but they are sitting down and appreciative of the updates. If not apprised, people get madder and madder," she says.
2. Make a good impression. "It is said that 50 percent of a patient's opinion of a doctor or business is based on the first impression," says Ms. Guinane. "Overcoming bad first impressions is very hard to do."
Outpatient providers should ensure that the reception staff is professional and trained on appropriately welcoming patients. Instead of barely acknowledging patients and simply asking them to sign in, reception staff should welcome the patient warmly and communicate to the patient that he or she was expected.
Ms. Guinane warns that many healthcare providers do not put enough effort into hiring or training front desk staff. "Many times we pay them the lowest, their job descriptions are menial and we have not spent anytime whatsoever to help them understand how important it is to greet patients properly," she says.
3. Be open and honest. Outpatient providers and non-clinical staff alike should learn to listen carefully to patients and give honest feedback. Consider the customer's perspective when sharing both clinical and non-clinical information. These actions contribute to positive customer interactions, says Ms. Guinane.
4. Don't blame the customer. As with many customer-oriented businesses, the customer is (nearly) always right. Train staff to remediate errors and mistakes immediately and bar them from blaming the patient. Blaming patients erodes patients' trust and confidence. "Treat your customers as valued ambassadors of your business," she says.
5. Ask questions. Encourage patients and their families to ask questions. Doing so will "contribute to a well-rounded care pathway that is dynamic and pertinent," says Ms. Guinane. "Creating an environment that encourages questions and seeks appropriate answers is priceless."
6. It's not a meat market. Many outpatient centers, for good reason, focus on efficiency and "Lean" service delivery. However, Ms. Guinane cautions that a focus on efficiency should not result in a "conveyor line" or "meat market" mentality. Provide service that has a "wow" factor that goes beyond just moving patients through. "People have thoughts, feelings and voices. Take time to be human," she says.
7. Follow through. Hold staff accountable for following through on any promises they make to patients, patients' families or other staff. "Do what you say you are going to do, and make sure others do what they say they are going to do," says Ms. Guinane. "Don't hand off the customer to others and make them sort out care on their own. Help people navigate our confusing and cumbersome system of care."
8. No medical mumbo jumbo. One of the best ways to engage patients in their care — and improve outcomes — is to ensure they understand the information you share with them. "Say what you mean in language non-clinical people can understand," says Ms. Guinane. "Respect [patients]; don't talk down to them."
9. Work as a team. Rather than examining care from siloed clinical and operational perspectives, take a team-based approach to providing care. Ms. Guinane recommends process mapping to illustrate how patients interface with various parts of the center and then working with staff to optimize each process. "Know how things are connected and interrelated and how the customer is impacted," she says.
10. Relate to the person. Finally, outpatient service providers should relate to their patients both during their communications with them and in designing services for them. "Know what makes them tick and what they respond to; what will deliver that 'wow' factor of service for them?" asks Ms. Guinane.
In her book, Ms. Guinane describes how a mammography center 'wowed' its patients by attempting to make a mammogram as low stress an experience as possible. By relating to its patients, the center recognized that a mammogram can be a high-stress situation for many women. To counteract this, the center sought to provide its mammogram services in a peaceful environment. The waiting room had dim lighting and a waterfall, mimicking spa-like surroundings. After the mammogram, patients were escorted to an area — complete with toiletries — where they could refresh before being taken to a meditation room before leaving the center.
While not every outpatient experience can mimic a trip to the spa, following the 10 common sense principles for outstanding customer service will help outpatient providers ensure their patients will leave satisfied and — perhaps more importantly — tell others about the outstanding care they received.
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