PATIENT SATISFACTION

Dr. Suskhan, SpOG(K)

Divisi Uroginekologi
Departemen Obstetri dan Ginekologi
FKUI-RSCM
Objectives

The participant will be able to:

Describe the characteristics of the “new
healthcare consumer”
Describe healthcare consumer expectations
Explain the difference between patients and
customers
List two questions from an ED patient
satisfaction survey
Objectives, Continued

The participant will be able to

 Describe how sitting down during the physician-
patient interaction affects patients' perception of
that encounter
 Define
"scripting" in the context of an Emergency
Department encounter with a patient or family
 Discuss a minimum length of time a physician
should allow a patient the opportunity to talk
before interrupting
 Describe “managing up” coworkers
Why are we here?
The New Healthcare Consumer
Today’s patient is more discerning and demanding.
She also has more access to information and a
wider array of choices.
In many ways, today’s patient shouldn’t be thought
of as a patient, but as a consumer.
She wants to know the quality of care provided by
her doctor and hospital and how much procedures
will cost.
The New Healthcare Consumer

In some cases she can find that out with the click of a
mouse. A savvy Internet user, the new consumer also
expects health care to adopt the same functionalities
as other industries that allow her to buy movie tickets,
book a hotel room and pay a bill online.
If she doesn’t like what she sees, she is more likely
now than in the past to shop around with her health
care dollars.
The New Healthcare Consumer:The

According to research by Press Ganey Associates Inc.,

people between the ages of 35 and 49—a major part of the
new consumer cohort—have the lowest patient
satisfaction scores compared with other age groups.
They are more likely to have health problems than
younger people, so they have more encounters with health
care providers.
They also tend to be more computer-literate than older
consumers and are more comfortable looking for health
care information.
What Do Patients/Clients Want?
The new healthcare consumer:
Wants empathy
Wants positive outcomes
Wants relief from symptoms
Wants information
Is Internet active
Is empowered
Insists on customer service
Insists on control
What Do Patients/Clients Want?
Consumers find it easy to attribute both positive and
negative experiences to the hospital itself—for
example, holding the hospital responsible for the
behavior of those who work there.
So if bedrooms and bathrooms are not kept clean, if
nurses fail to deliver medication on time, if staff
physicians rush through examinations or
explanations, someone in a leadership position must
be held responsible for seeing that the problems are
corrected.
Five Things that
Matter Most to Patients
Doctors treat patients with courtesy and respect.
Doctors explain the facts in a way that patients can
understand.
Doctors, nurses and other hospital staff do
everything they can to help patients with their pain.
The hospital room and bathroom are kept clean.
Patients get information in writing about symptoms
or health problems to look for after they leave the
hospital.
What Do Patients / Clients
Expect?
Retail shops, hotels and the Internet have
all influenced consumer expectations
about health care and, by extension,
hospitals. They have primed consumers
to value customer service, convenience
and easy access to information.
What Do Patients / Clients
Expect?

Hospitals should have better amenities

When they are staying overnight in a hospital, many
patients expect hotel-like amenities.
Many hospitals are starting to implement changes that
will improve the patient/consumer’s experience,
including improved food service (such as improved
menu options for patients), concierge services, spa
treatments such as massage, and Wi-Fi connections in
the hospital. A hospital that offers this type of customer
service may have better patient satisfaction and loyalty
than competitors without such services.
Patients’ Expectations
Expectations Experience + Needs +
Communication = Expectation
If Perception exceeds expectations:
Satisfaction
If Expectations are less than perception:
Dissatisfaction
Patients or Customers
Patient or Customer?
The “Patient- Custometer”

Horizontal – Patient
Vertical – Customer
Patient Satisfaction Surveys
Survey Questions

Press Ganey – ED Providers: Nurses

Courtesy of the nurses
Degree to which the nurses took the time to listen to
you
Nurses' attention to your needs
Nurses' concern to keep you informed about your
treatment
Nurses' concern for your privacy
Survey Questions
Press Ganey – ED Providers: Doctors
Courtesy of the doctor
Degree to which the doctor took the time to
listen to you
Doctor's concern to keep you informed about
your treatment
Doctor's concern for your comfort while
treating you
The Likert Scale

1 =Completely Disagree
2 = Disagree
3 = Neutral
4 = Agree
5 = Completely Agree
The Likert Scale: Example

The staff did a good job at answering my

questions.
1 = No
2 = Somewhat
3 = Satisfactory
4 = Very Good
5 = Excellent
The Likert Scale: Example

The nurse explained the procedure clearly

1 = Not at All
2 = Not Really
3 = Somewhat
4 = Yes
5 = Exceeded My Expectations
Raw Score and Percentile
Ranking
Raw Score
Percentile Ranking
Comparative Databases
 Small ED
 Small and Large ED
 Network Hospitals
 AHA Region
So, what’s our plan?
Quality Service
The Four Key Elements of Quality Service:

Customer
Commitment
Expectations
Continuity
Patient Satisfaction Tools &
Techniques
Sit Down and Listen
Sit Down and Listen

Patient satisfaction surveys ask respondents to

evaluate “The degree to which the physician took
time to listen to you”

Optimizing patient responses can be

accomplished by increasing the frequency of
specific physician behaviors: an introduction,
sitting down, use of scripted phrases, and
multiple encounters.
Sit Down and Listen

There are effective ways to demonstrate

concern for a patient even when you’re
trying to do things quickly.
How You Enter the Exam Room is
Important

Walk into the room with a smile,

Apologize for the wait,
Introduce yourself to all those assembled
(remember to include the family),
Shake the patient’s hand,
Call the patient by name and
When possible and appropriate, sit down.
Sit Down

Sitting down places the physician at or

below eye level and reassures the patient
that you are paying attention (listening)

Sitting down relaxes the patient so that he

or she will communicate more openly
Now That You’ve Set The Stage, It’s
Time To Listen

After a general prompt about the reason for

their visit to the ED, let the patient talk for a
minute without interruption – you will get
information you otherwise might have missed
When the patient has finished speaking,
paraphrase what they’ve said to confirm that
you correctly understand their concerns
Scripting
It Helps To Have and Use
Effective Communication Tools

The consistent use of conversation that has

been proven successful in advancing patient
satisfaction is called “scripting’

You may want to consider utilizing one or more

of these phrases as part of the patient
encounter
It Helps To Have and Use
Effective Communication Tools

“How can I help you?”

“I’m sorry this happened to you.”
“Do you have any questions? I have plenty of
time.”
“You’ll probably think of some questions. Here’s a
notepad to write them down.”
“Have you thought of any other information I might
need to know?”
“Come back any time. We never close.”
“I’m going to be here all night.
Check Back Frequently
Give Evidence of Your Continuing
Interest in and Involvement with the
Patient’s Care

Check on the patient’s progress with multiple, brief

encounters.
When things are busy, at least stick your head in an
exam room and let the patient know you’ll be with
them soon
As information becomes available, provide an update
to the patient
Service Recovery and the Blameless
Apology
Service Recovery

If you have made a mistake, or the patient

has perceived an error:
Listen
Apologize
Fix it
Something Extra
Follow Through
Follow Up
Managing Up
Advantages of Managing Up Self, Skill Set,
Experience and Certifications

Communicate that we are health care

professionals

Create patient confidence and trust in healthcare

provider

Another opportunity for key words … connect the

dots
Advantages of Managing Up
Coworkers
Patient feels better about their next care giver
The patient feels more at ease with the
handoff, thus their coordination of care
Co-worker has a head start in winning
confidence
Manage Up Coworkers

“Hello Mrs. Smith. I will be going home to my

family now. Ken is taking my place.
I just shared with Ken all your important
information. Ken is an excellent nurse and I
have worked with him for over seven years. I
hear such nice compliments about him from
his patients. . .”
Advantages of Managing Up Other
Departments
Reinforces coordination of care and teamwork

Positions other department well to reduce them

from having to win the patient over Decreases
patient anxiety and concern
Manage Up Other Departments

“Hello Mrs. Smith. I see this afternoon

you will be going down to the Radiology
department. Radiology has state of the
art technology and a very friendly and
courteous staff. They are aware you will
be down there this afternoon and are well
prepared for you.
”Advantages of Managing Up
Physicians
Shows coordination of care between staff
and physician
Lessens anxiety for the patient
Physicians will appreciate this being done
Hardwires positive word of mouth
Emphasizes “team”
Manage Up Physicians

“Mrs. Smith, I see Dr. Richards is your

physician. He is one of the best. He
explains things well and is so good at
listening and answering patient questions.
You are very fortunate he is your
physician.”
Summary

Introduce yourself in a professional fashion

Address family members - bring them into the
encounter
Establish a high level of professionalism and courtesy
Provide information as it becomes available with
frequent updates
Check the patient’s progress using multiple, brief
encounters
Sit down and listen
Manage Up your co-workers
Remember…
Patients won’t remember what you said to them
Patients won’t remember what you did to them
But they will always remember how you made
then feel
Sources
“Patient Satisfaction Scores: Improving Them in Your Emergency
Department” Presentation notes from a program at the ACEP
Scientific Assembly, October 18, 2004, Thom Mayer, MD, FACEP.
Leadership for Great Customer Service. Satisfied Patients,
Satisfied Employees. Health Administration Press 2004, Thom
Mayer and Robert Cates.
Hardwiring Excellence. Fire Starter Publishing 2003. Quint Studer.
“Variables Contributing to Emergency Department Patient
Satisfaction” Academic Emergency Medicine Volume 12, Number
5, Catherine A.
Marco “Towards a Bold Love for ED Systems: 25
Practical Strategies to Improve Emergency Department Patient
Satisfaction”, The Press Ganey Satisfaction Monitor, July / August
2000, James A. Espinosa, MD, FACEP
Questions and Comments?