Hospital Customer Service in a Changing Healthcare World: Does It Matter?EXECUTIVE SUMMARY
The healthcare industry is undergoing a rapid transformation to meet the ever-increasing needs and demands of the patient population. Employers and health plans such as HMOs are demanding better service and higher quality care, and hospitals are trying to tackle reimbursement Reimbursement
Payment made to someone for out-of-pocket expenses has incurred. cutbacks, streamline services, and serve a diverse population. Hospitals have begun to realize that to overcome these obstacles and meet the needs of the health plans and consumers, they must focus on the demands of the customer. Customer service initiatives increase patient satisfaction and loyalty and overall hospital quality, and many hospitals have found that consumer demands can be met through initiating and maintaining a customer service program. This article describes how the administrator can create, implement, and manage customer service initiatives within the hospital.
The healthcare industry is undergoing a rapid transformation to meet the ever-increasing needs and demands of their patient population. Hospitals have shifted from viewing patients as uneducated and with little healthcare choice, to recognizing that the educated consumer has many service demands and healthcare choices available. "Before six years ago if you asked hospital employees or administrators, "Do you have customers?" they would have responded with outrage OUTRAGE. A grave injury; a serious wrong. This is a generic word which is applied to everything, which is injurious, in great degree, to the honor or rights of another. . The word customer implies an economic relationship and they were just making people well" (Petrini 1989). Today, hospitals are confronted with numerous environmental changes that influence the scope of services, including reimbursement cutbacks and managed care adaptations. Hospitals must compete in markets that are growing more complex and competitive every day. Administrators have begun to realize that 80 percent of their decisions are influenced by consumer demands (Prager 1998), and the recruitment of new customers is five times more costly than retaining an existing client base (Mittal and Lassar 1998). Other service industries have already discovered this and are building customer loyalty, satisfaction, and product quality through a customer-oriented approach. Unfortunately, the hospital segment of the healthcare industry has been slow to adapt to this "customer-service" reformation Reformation, religious revolution that took place in Western Europe in the 16th cent. It arose from objections to doctrines and practices in the medieval church (see Roman Catholic Church) and ultimately led to the freedom of dissent (see Protestantism). . In many hospitals the main problem is that "customer service is a skill for which we hold our staff accountable but in which they have never formally been trained" (Mayer et al. 1998).
This article will identify how hospital managers can create, implement, and manage a customer service plan to establish quality initiatives that increase consumer loyalty and satisfaction as well as the overall quality of their organizations. First, the benefits of quality strategies focused on customer service are identified. Second, the creation and implementation of customer service initiatives are discussed. Third, the management of customer service initiatives to ensure continuous quality and organizational improvement are discussed. Finally, proposed customer service initiatives based on literature reviews and organizational examples are presented. The author will specifically reference activities of St. John's Hospital St. John's Hospital may refer to:
In the United Kingdom:
Santa Monica is a coastal city in western Los Angeles County, California, USA. Situated on Santa Monica Bay of the Pacific Ocean, it is surrounded by the City of Los Angeles — Pacific Palisades and Brentwood on the north, , East Jefferson Hospital in Metarie, Louisiana, and The Children's Hospital A children's hospital is a hospital which offers its services exclusively to children. The number of children's hospitals proliferated in the 20th century, as pediatric medical and surgical specialties separated from internal medicine and adult surgical specialties. of Denver, Colorado. These organizational examples are derived from literary case studies and the author's internship internship /in·tern·ship/ (in´tern-ship) the position or term of service of an intern in a hospital.
n the course work or practicum conducted in a professional dental clinic. experience at the Children's Hospital.
In the past decade the hospital industry has undergone major process restructuring restructuring - The transformation from one representation form to another at the same relative abstraction level, while preserving the subject system's external behaviour (functionality and semantics). in areas such as payment systems, reimbursement schedules, services, and lengths of stay. Hospitals were accustomed to receiving cost-based reimbursement. Unfortunately, reimbursement has become more restrictive, which has increased market competition for those patients who are very ill and insured. To survive these changes, hospitals must streamline services and cut back their workforce (Petrini 1989). In hospitals, healthcare professionals and support staff are beginning to feel the pressure of cutbacks and organizational change, and when stress increases, service decreases (Petrini 1989). In summary, in the past decade hospitals have "seen a massive shift from a provider-oriented industry--where people performed and made decisions in ways that were convenient for the hospital but not necessarily for the customer--to a customer-serviced industry" (Petrini 1989).
Hospitals are undergoing many workforce and economic changes and must design strategies to adopt a service orientation. In this age of service transition and increasing managed care market competition, hospitals must remain focused on quality and the consumer's needs, wants, and demands. As Wendy Leebov of Einstein Consulting Group stated,
the definition of great service in health care depends on customer requirements. Patients have certain requirements of hospitals, employees have other requirements, and physicians expect different things. Good customer service involves identifying the requirements of all the different groups of customers and lining up the environment, people, and systems to deliver on them. (Petrini 1989)
What hospitals have to realize is that in today's marketplace, good is not good enough (Petrini 1989). As one administrator said, "What we want to do is take the customer's breath away. When we've done that, we've achieved outstanding customer service" (Petrini 1989).
An outstanding customer service program has many benefits including an increase in patient satisfaction and the improvement of overall functional quality (quality of how service is delivered). After undergoing customer service training, a Trauma I emergency room saw an increase in patient satisfaction levels in these areas: overall quality of care, skill of physician and nurse, overall satisfaction concerning the likelihood of returning, overall respect, wait time, and overall discharge process (Mayer et al. 1998). The hypothesis formed in this study was "a formal customer service training/program can dramatically decrease patient complaints, increase patient compliments, and improve patient satisfaction" (Mayer et al. 1998). In this study period, patient complaints dropped more than 70 percent and compliments actually exceeded complaints (Mayer et al. 1998). Customer service has also been linked to functional quality, which is measured by attributes of quality that are easier for consumers to evaluate. Functional quality characteristics as listed by Mittal and Lassar (1998) include
* Responsiveness: willingness to help and provide service;
* Assurance: knowledge and courtesy of staff;
* Empathy empathy
Ability to imagine oneself in another's place and understand the other's feelings, desires, ideas, and actions. The empathic actor or singer is one who genuinely feels the part he or she is performing. : caring, individualized in·di·vid·u·al·ize
tr.v. in·di·vid·u·al·ized, in·di·vid·u·al·iz·ing, in·di·vid·u·al·iz·es
1. To give individuality to.
2. To consider or treat individually; particularize.
3. attention; and
* Tangibles: equipment and appearance of physical environment.
These qualities are the foundation of good customer service and are critical components in achieving patient satisfaction and service quality. Because the customer's perception of the organization's functional quality is made in the first contact experience, hospitals must obtain a threshold level Noun 1. threshold level - the intensity level that is just barely perceptible
intensity, intensity level, strength - the amount of energy transmitted (as by acoustic or electromagnetic radiation); "he adjusted the intensity of the sound"; "they measured the of functional quality to achieve the first step in customer satisfaction (Mittal and Lassar 1998). For example, if the receptionist or nurse treats an individual in an uncaring manner, the individual will still be dissatisfied dis·sat·is·fied
Feeling or exhibiting a lack of contentment or satisfaction.
dis·satis·fied with the functional quality of the experience even if the medical problem is resolved. If hospitals focus on customer service, the functional needs of their consumers will be met and the first step toward satisfaction will be achieved.
A customer service program also has financial benefits. As Mittal and Lassar (1998) have stated, "the cost of recruiting a new customer is five times more than the cost of retaining an existing customer." Mittal and Lassar found that focusing on existing customers saves the hospital time and money in several areas:
* Cost of advertising;
* Cost of personnel selling to physicians; and
* Cost of setting up new patient accounts and explaining hospital procedures and treatment guidelines guidelines,
n.pl a set of standards, criteria, or specifications to be used or followed in the performance of certain tasks. .
Continuing customers also profit the hospital. As the revenues increase from the existing customer, the cost of providing the same service decreases. This relationship, for any company, signifies long-term business success and profitability (Mittal and Lassar 1998).
Quality strategies based on customer service also have been found to have a consistent positive link with bottom-line performance. The three factors most positively affected by quality strategies selected by hospital CEOs were market share, overall financial performance, and growth in net revenues (Rapert and Wren wren, small, plump perching songbird of the family Troglodytidae. There are about 60 wren species, and all except one are restricted to the New World. The plumage is usually brown or reddish above and white, gray, or buff, often streaked, below. 1998). The same study found that service quality, as it relates to customer service, can build a competitive positional advantage Positional advantage is a combative position relative to an opponent. It is used extensively to describe a situation of significant tactical advatage over an opponent in open-hand (ie without weapons) conflict in William Cheung's Traditional Wing Chun Kung Fu and Ian Protheroe's Classical for the hospital. If a hospital is committed and offers high-quality customer service, its individualized plan and organizational commitment In the study of organizational behavior and Industrial/Organizational Psychology, organizational commitment is, in a general sense, the employee's psychological attachment to the organization. are inimitable in·im·i·ta·ble
Defying imitation; matchless.
[Middle English, from Latin inimit and create a reputation that differentiates it from its competitors (Rapert and Wren 1998).
Customer service is important today because of the increase in managed care contracting and customer choice of health plans. "Managed care is rapidly dominating the health care delivery system in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. , and today over 51 million individuals are enrolled in HMO's" (Kongstvedt 1997). Managed care organizations (MCOs) are creating integrated delivery systems integrated delivery system Integrated provider Medical practice A coordinated health care system formed by physician groups and hospitals which ↑ efficiency and ↓ redundancy in providing health care; IDSs coordinate delivery of a broad range of health to ensure that their enrollees can obtain the healthcare they need. Managed care organizations cannot include all hospitals in their systems because, "the more the MCO MCO Managed care organization, see there is willing to limit the number of participating hospitals, the greater its leverage in negotiating" (Kongstvedt 1997). When selecting hospitals, MCOs balance a number of variables including customer service (Kongstvedt 1997); therefore, hospitals must compete in their market area for the managed care contracts to ensure a customer base for their organization.
Another component of this relationship is the employer as the private purchaser of healthcare. Employers make decisions on health benefit plans for their employees (see Figure 1). Increasingly, employers are offering a choice of plans (Christianson 1998). Employers look for plans that include hospitals that have high NCQA NCQA National Committee on Quality Assurance, see there ratings, offer specialized spe·cial·ize
v. spe·cial·ized, spe·cial·iz·ing, spe·cial·iz·es
1. To pursue a special activity, occupation, or field of study.
2. services, and have a good customer service reputation (Kongstvedt 1997). Therefore, it is very important for health plans to contract with the hospitals that employers believe offer high-quality customer focused care. As Kongstvedt states, "it does little good for an MCO to make an agreement with a hospital that is perceived as inferior" (Kongstvedt 1997).
[Figure 1 ILLUSTRATION OMITTED]
CREATION OF A CUSTOMER SERVICE PROGRAM
To develop a customer service plan the hospital must first understand and be able to identify the three levels of customer expectations about quality and the key customer service attributes. Hospitals can identify these components of customer service by analyzing their customer base. In level one, the expectations of the consumer are very simple and are usually assumed actions. For example, one would expect to get the correct blood for his or her blood transfusion blood transfusion, transfer of blood from one person to another, or from one animal to another of the same species. Transfusions are performed to replace a substantial loss of blood and as supportive treatment in certain diseases and blood disorders. (Stamatis 1996). In level two, the consumer's expectations require the fulfillment ful·fill also ful·fil
tr.v. ful·filled, ful·fill·ing, ful·fills also ful·fils
1. To bring into actuality; effect: fulfilled their promises.
2. of expectations and requirements. In level three, the consumer requires "delightfulness or a service that is so good that it attracts them to it" (Stamatis 1996). For example, after physical therapy treatment a physician may call daily to see how the patient is feeling and check on their home progress. Stamatis (1996) declares key customer service attributes build from the acronym acronym: see abbreviation.
A word typically made up of the first letters of two or more words; for example, BASIC stands for "Beginners All purpose Symbolic Instruction Code. COMFORT: Comfort, Observant ob·ser·vant
1. Quick to perceive or apprehend; alert: an observant traveler. See Synonyms at careful.
2. , Mindful mind·ful
Attentive; heedful: always mindful of family responsibilities. See Synonyms at careful.
mind , Friendly, Obliging o·blig·ing
Ready to do favors for others; accommodating.
o·bliging·ly adv. , Responsible, Tactful tact·ful
Possessing or exhibiting tact; considerate and discreet: a tactful person; a tactful remark.
tact . "These characteristics are the most basic attributes of customer service and without them there can be no true service of any kind" (Stamatis 1996). The organization must also realize that all of these attributes depend on the communication and interpersonal skills "Interpersonal skills" refers to mental and communicative algorithms applied during social communications and interactions in order to reach certain effects or results. The term "interpersonal skills" is used often in business contexts to refer to the measure of a person's ability , knowledge, sensitivity and understanding of the workforce (Stamatis 1996). Finally, to create a successful customer service plan the hospital must have a team committed to attracting new customers, maintaining loyal customers, and improving customer retention (Stamatis 1996).
The development of a customer service plan follows a generic four-step framework (adapted from relevant literary sources and organizational examples) that can be applied to any organizational development process (Figure 2). Step one should focus on the organization's mission and support systems. A hospital's mission statement is a critical component in the creation of customer service initiatives because it provides the focus and rationale for customer service development. For example, the mission statement of Children's Hospital of Denver, Colorado states, "to improve the health of children in Denver, in Colorado, and in the region through the provision of high-quality, coordinated programs of patient care, education, research, and advocacy" (Children's 1998). The mission's focus, "to provide high-quality health care to children," provides the impetus for the development of customer service initiatives focused on obtaining "high-quality" healthcare that meets the needs of customers (Silberzweig and Giguere 1996). The second element of step one is to gain the support and commitment of senior management for the concept of "customer mindedness" (Caroselli and Edison 1997).
Four-Step Development Process of Customer Service Initiative
* Focus on hospital's mission to create the framework for the customer service initiative.
* Gain support of upper management to the concept of "customer mindedness."
* External Hospital Scan: Diagram contact points between customers and employees.
* Internal Hospital Scan: Recognize all departments that are involved in customer service.
* Conduct "strengths, weaknesses, opportunities, and threats" (SWOT) analysis.
* Look at other hospitals that excel in customer service and do a comparison analysis.
* Create a service audit to survey customers.
* Cross-functional teams In business, a cross-functional team is a group of people with different functional expertise working toward a common goal. It may include people from finance, marketing, operations, and human resources departments. create a tactical plan from data; therefore, follow organizational problem-solving approach to analyze the problematic situation and create a customer service initiative.
Adapted from D. Stamatis. 1996. Total Quality Service Principles, Practices, and Implementation. Delray Beach Delray Beach, resort city (1990 pop. 47,181), Palm Beach co., SE Fla., on the Atlantic coast; settled 1895, inc. 1911. Mostly residential, Delray Beach is also the trade center for a citrus-fruit and vegetable-growing region. , FL: St. Lucie St. Lucie may refer to:
Step two of the process should involve an external and internal organizational scan. In the external hospital scan, a diagram should be created that highlights all points of contact between external customers and internal hospital personnel (Stamatis 1996). The diagram identifies the "moments of truth," or points of contact in which a relationship is formed between the customer and the organization (Stamatis 1996). At this initial point of contact, the organization wants the external customer to receive the information, care, or direction he or she needs. For example, East Jefferson Hospital establishes its first point of contact by placing a red-jacketed guest relations representative in each parking vestibule vestibule /ves·ti·bule/ (ves´ti-bul) a space or cavity at the entrance to a canal.vestib´ular
vestibule of aorta a small space at root of the aorta. . This individual's responsibility is to greet the customers and direct them to their destination (Hiebeler, Kelly, and Ketteman 1998). This service prevents customers from becoming confused and frustrated frus·trate
tr.v. frus·trat·ed, frus·trat·ing, frus·trates
a. To prevent from accomplishing a purpose or fulfilling a desire; thwart: as they try to find their way through the maze maze, detail of landscape gardening based on the Greek labyrinth, consisting of intricate paths or alleys lined with high hedges and having a center and exit difficult to find. It was a prominent feature in the formal English gardens of the 17th and 18th cent. of hospital hallways.
In the internal hospital scan, the organization should identify all departments that are involved with customer service. To aid developers in the creation of the internal scan, hospitals should focus on answering questions such as, "how is the department doing?" (Hiebeler, Kelly, and Ketteman 1998). With a flow-chart diagram, the administrator should designate des·ig·nate
tr.v. des·ig·nat·ed, des·ig·nat·ing, des·ig·nates
1. To indicate or specify; point out.
2. To give a name or title to; characterize.
3. the strong and weak departments and assign a customer service quality improvement team to each area. These teams address significant internal problems and disseminate dis·sem·i·nate
v. dis·sem·i·nat·ed, dis·sem·i·nat·ing, dis·sem·i·nates
1. To scatter widely, as in sowing seed.
2. relevant customer feedback (Caroselli and Edison 1997).
Team development is an important step in the internal hospital scan. Today hospitals are using teams to increase cross-functional communication across departments (Caroselli and Edison 1997). In many organizations teams form when skilled employees volunteer to be a part of the group, and it is important to remember that members should be those who are the most knowledgeable about the process or problem (Caroselli and Edison 1997). Highly diversified diversified (di·verˑ·s cross-functional teams are usually highly effective because of the many different ideas that are brought to the discussion (Caroselli and Edison 1997). In a hospital environment it is also critical to involve the medical staff and include physicians or nursing staff in each group. Once a team is formed, it should follow the organization's mission and organizational change procedure to begin the problem-solving approach (Caroselli and Edison 1997). Teams should also remember to stay focused on their goal of improving the quality of service for the consumer.
In step three of the process the hospital should perform a comparison analysis to identify the strengths, weaknesses, opportunities, and threats (SWOT analysis SWOT Analysis
A tool that identifies the strengths, weaknesses, opportunities and threats of an organization. ) of the hospital (Stamatis 1996). After the SWOT analysis is complete, the hospital should compare itself with other organizations within the market. The hospital should look at organizational examples of hospitals that excel in customer service such as St. John's Hospital (Caroselli and Edison 1997) or East Jefferson Hospital (Hiebeler, Kelly, and Ketteman 1998). The hospital should then incorporate the comparison data into the organizational development strategy. The hospital should also use the collected data to create a service audit to discover its customers' opinions of current service quality (Stamatis 1996). Many organizations often choose to use a standardized standardized
pertaining to data that have been submitted to standardization procedures.
standardized morbidity rate
see morbidity rate.
standardized mortality rate
see mortality rate. survey tool to obtain customer feedback. Press-Ganey creates this type of product for around $18,000 to survey 24,000 individuals (Children's 1998).
In step four of the process the hospital creates the tactical plan. The cross-functional teams analyze the data through flow-chart analysis and cause-and-effect diagrams and then decide the best course of action for the organization (Hiebeler et al. 1998). Many hospitals, if they are not familiar with this team-orientated approach to problem solving problem solving
Process involved in finding a solution to a problem. Many animals routinely solve problems of locomotion, food finding, and shelter through trial and error. , can follow St. John's "Hospital Quality Improvement Process" as an organizational example (see Figure 3) (Caroselli and Edison 1997). When developing the tactical plan, the organization and teams must remain focused on their goals and customer service plan objectives. Focusing on the following questions can also help team members in developing the tactical plan (Caroselli and Edison 1997):
1. Who are the customers of the process?
2. What are the customers' expectations?
3. How are we meeting those expectations?
4. What could we do better to meet the expectations?
Team Problem-Solving Approach
1. Identify Quality Improvement Project
2. Assemble Team
3. Collaborate Ideas
* Study situation
* Obtain data
* Analyze where you are and where you want to be
* Identify causes of the organizational "road block"
4. Choose Best Course of Organizational Action
Adapted from M. Caroselli and L. Edison. 1997. Quality Care, Prescriptions for Injecting Quality into Health Care Systems. Boca Raton Boca Raton (bō`kə rətōn`), city (1990 pop. 61,492), Palm Beach co., SE Fla., on the Atlantic; inc. 1925. Boca Raton is a popular resort and retirement community that experienced significant industrial development in the 1970s and 80s. , FL: St. Lucie Press.
In the development process, hospitals must remember to focus on customer service issues that are pertinent PERTINENT, evidence. Those facts which tend to prove the allegations of the party offering them, are called pertinent; those which have no such tendency are called impertinent, 8 Toull. n. 22. By pertinent is also meant that which belongs. Willes, 319. to their unique organizational culture This article or section is written like an .
Please help [ rewrite this article] from a neutral point of view.
Mark blatant advertising for , using . . For example, St. John's Hospital customers were dissatisfied with the long wait time on the phone billing system. The hospital realized this was a problem by conducting an external customer survey audit. To improve this situation, the hospital focused on reorganizing schedules and adding music to the phone system. The changes resulted in an increase in patient satisfaction levels for the phone billing process (Caroselli and Edison 1997).
IMPLEMENTATION OF CUSTOMER SERVICE INITIATIVE
Implementation of the customer service initiative is a very critical step in creating an organization focused on providing excellent customer service. When implementing the program it is important to have an organizational focus. St. John's Hospital created a statement that outlined six values (compassion, customer delight, collaboration, clinical excellence, community health, and development and education) and listed guiding principles for continuous quality improvement (Caroselli and Edison 1997). Employees should have a copy of these principles and understand them. Employees should also know how their department or organization defines the quality approach. For example, St. John's defines quality as "doing the right things right." Hospitals that focus their quality initiative implementation on strong principles, organizational guidelines, and employee training are more successful in increasing customer satisfaction and organizational quality.
Training is the most important step in the implementation stage of customer service initiatives. "As health care increasingly emphasizes accountability for customer service in its staff, it is increasingly important that practical and effective customer service training is initially provided" (Mayer et al. 1998). Training in the hospital setting starts with the recruitment process. Hospitals should look for employees who are motivated mo·ti·vate
tr.v. mo·ti·vat·ed, mo·ti·vat·ing, mo·ti·vates
To provide with an incentive; move to action; impel.
mo to serve customers, who are good communicators, and who respond to the hospital's core values (Hiebeler, Kelly, and Ketteman 1998). Ideally, employees should all receive training at roughly the same time, but, as Philip Crosby states, "There will always be people coming and going and always be new knowledge to be acquired" (Caroselli and Edison 1997).
Training should be a continuous process. Employees should be sent to training seminars or retreats at least once a year to refresh (1) To continuously charge a device that cannot hold its content. CRTs must be refreshed, because the phosphors hold their glow for only a few milliseconds. Dynamic RAM chips require refreshing to maintain their charged bit patterns. See vertical scan frequency and redraw. their customer service skills. When paying for these sometimes expensive seminars hospitals must remember the cost effectiveness of fixing problems and preserving loyal customers rather than having to find new customers (Hiebeler, Kelly, and Ketteman 1998).
The hospital setting is a unique environment that requires a detailed employee training process. Employees in the healthcare industry deal with customers who are confused, anxious, and hesitant hes·i·tant
Inclined or tending to hesitate.
hesi·tant·ly adv. to ask questions. A detailed training program ensures that employees know and understand customer's expectations, because "when service is delivered in a uncaring manner customers will be more dissatisfied than if the medical problem was resolved poorly" (Mayer et al. 1998). Employees in the healthcare setting must internalize internalize
To send a customer order from a brokerage firm to the firm's own specialist or market maker. Internalizing an order allows a broker to share in the profit (spread between the bid and ask) of executing the order. and understand the three reasons for this phenomenon (Mayer et al. 1998):
1. First impressions count;
2. Customers in pain are looking for Looking for
In the context of general equities, this describing a buy interest in which a dealer is asked to offer stock, often involving a capital commitment. Antithesis of in touch with. reassurance REASSURANCE. When an insurer is desirous of lessening his liability, he may procure some other insurer to insure him from loss, for the insurance he has made this is called reassurance. and comfort; and
3. Patients lack the technical expertise to judge how well they were medically treated, so their judgement of service is based on more functional quality characteristics like friendliness.
As Dr. Boeren states, "Everyone thrilled thrill
v. thrilled, thrill·ing, thrills
1. To cause to feel a sudden intense sensation; excite greatly.
2. To give great pleasure to; delight. See Synonyms at enrapture. with your practice and how they were treated will tell their next door neighbor, but everyone with a complaint will tell nine to ten people" (Zeff 1995). Finally, when starting customer service training, ask employees to view care from the patient's perspective. This ensures that employees fully understand the customer and therefore can create the optimal hospital care experience (Oxler 1997).
Many standardized customer service-training programs exist that hospitals can use to initialize To start anew, which typically involves clearing all or some part of memory or disk. the training process with employees. Many organizations such as the Medical Group Management Association, the Professional Associations of Health Care Managers, and the AMA's Financing and Practices Inc. offer educational seminars and training sessions focused on customer service (Zeff 1995). Figure 5 describes three training methods including those used by outside management consultants and two organizations.
MANAGEMENT OF CUSTOMER SERVICE INITIATIVES
The management of customer service initiatives to ensure continuous quality improvement is the final step in achieving an organization's quality goals and objectives. After an initiative passes the planning stages and the employees are given proper training, the initiative must be piloted in the organization. The managers or team leaders must then gather customer feedback through surveys, telephone interviews, or focus groups. This customer feedback should be distributed to all team members and any changes or improvements to the initiative's process should be made. Teams managers should define service standards for the quality initiative. The service standards should focus on the customer service operation, the processes to be changed and monitored, and the level of employee performance expected by management (Stamatis 1996). To gain support and understanding when making customer service changes in the organization, team leaders must remember to keep communication lines open (Hiebeler, Kelly, and Ketteman 1998).
Although communication alleviates some employees stress, team leaders must still know how to manage change and employee stress. Many team leaders can accomplish this by offering encouragement and incentives to employees that are actively incorporating the change into their daily work. Team leaders can also create employee quality-recognition programs for employees who excel in quality customer service. Organizations can also alleviate Alleviate
To make something easier to be endured.
Mentioned in: Kinesiology, Applied the stress of change by offering training seminars focused on educating employees on the benefits of change. Finally, organizations should remember that nothing happens overnight, and perseverance Perseverance
See also Determination.
redid dictionary manuscript burnt in fire. [Br. Hist.: Brewer Handbook, 752]
Call of the Wild, The
dogs trail steadfastly through Alaska’s tundra. [Am. Lit. is the key to quality success (Caroselli and Edison 1997).
ILLUSTRATIONS OF CUSTOMER SERVICE INITIATIVES
East Jefferson General Hospital East Jefferson General Hospital is a Hospital in Metairie, Louisiana. The hospital broke ground in 1975 and is still expanding. The facility serves the people of East Jefferson Parish. (Hiebeler, Kelly, and Ketteman 1998)
East Jefferson's CEO (1) (Chief Executive Officer) The highest individual in command of an organization. Typically the president of the company, the CEO reports to the Chairman of the Board. , Peter Betts, wanted his hospital to rediscover Re`dis`cov´er
v. t. 1. To discover again.
Verb 1. rediscover - discover again; "I rediscovered the books that I enjoyed as a child" customer service-oriented care. He attended a training seminar at the Walt Disney Noun 1. Walt Disney - United States film maker who pioneered animated cartoons and created such characters as Mickey Mouse and Donald Duck; founded Disneyland (1901-1966)
Disney, Walter Elias Disney Institute and was overwhelmed o·ver·whelm
tr.v. o·ver·whelmed, o·ver·whelm·ing, o·ver·whelms
1. To surge over and submerge; engulf: waves overwhelming the rocky shoreline.
a. with all that he learned. After returning, he started the customer service initiative process by forming cross-functional quality teams with a focus on looking at care from the customer's perspective. The teams designed and distributed a survey to customers to find out what they felt about service quality at East Jefferson. After surveying the customers, the teams first decided to change the outdated out·dat·ed
old-fashioned or obsolete
Adj. 1. hospital mapping system. The hospital made parking improvements, hospital signage changes, and created a guest relations representative position to help solve the problem. After implementing the changes East Jefferson received higher customer satisfaction ratings, and fewer patients got lost in the hospital halls.
Forming quality teams and implementing a service standard has made East Jefferson successful in its customer service focus. Following are a few examples of successful customer service standards as indicated by Hiebler, Kelly, and Ketteman (1998):
* Every customer with a complaint receives a personal phone call;
* One-half of each employee merit raise is based on customer service; and
* The hospital distributes questionnaires to each customer that leaves the hospital.
The hospital has increased its customer choice rating to 57 percent and has decreased its employee turnover rate to 11.2 percent, which is less than half of the industry turnover average. East Jefferson's quality initiatives have also attracted more than 100 other organizations to visit the hospital to learn about its techniques and quality methods. Peter Betts, CEO, summarizes his hospital's focus with the statement, "whatever we can do to improve their experience we're going to do it" (Hiebeler, Kelly, and Ketteman 1998).
The Children's Hospital of Denver Colorado (Children's 1998)
The Children's Hospital of Denver is an example of a specialty hospital that has just begun to focus on customer service quality. Many pediatric pediatric /pe·di·at·ric/ (pe?de-at´rik) pertaining to the health of children.
Of or relating to pediatrics. hospitals do not realize the importance of the relationship of customer service to their specialized services. Children's has realized that parents want the best healthcare possible for their children and will drive miles for that care. Children's recognizes that pediatric hospitals must cater to the unique needs of both the child and the parent to satisfy its patient population. Finally, Children's is creating a customer-friendly and child-friendly environment to meet the physical and psychological needs of the parent and child.
Customer service and meeting customers' needs has become paramount at Children's because of a dramatic increase of child healthcare competitors in the Denver market. Both the Centura and Columbia health systems are beginning to expand their services into child health. MCOs are beginning to look at the possibility of contracting with these large integrated delivery systems because of their ability to handle financial risk and their ability to provide healthcare to the whole family (Kongstvedt 1997).
Children's has decided to differentiate its healthcare services by increasing its customer service focus, and began the process by creating initiatives formed from the feedback of cross-functional quality teams called "task forces" (Children's 1998). These task forces identified patient Identified patient (IP)
The family member in whom the family's symptom has emerged or is most obvious.
Mentioned in: Family Therapy wait time as a customer service area that was in need of improvement. To analyze patient wait time in the outpatient outpatient /out·pa·tient/ (-pa-shent) a patient who comes to the hospital, clinic, or dispensary for diagnosis and/or treatment but does not occupy a bed.
n. clinics, a survey was created and distributed to 11 clinics and more than 2,000 customers (Children's 1998). The results of the survey showed that many of the clinic waiting rooms did not have enough for the children to do, and many times customers were not informed of how long their wait would be when they arrived. To address this customer service problem, the hospital is reengineering its employee training program and teaching employees to greet the customers and then inform them if their wait will be more than 15 minutes. The hospital is also purchasing a beeper beeper - pager system so the waiting parent and child can leave the wait room area and be paged when it is time for their visit. In addition, the hospital is renovating the wait rooms with computers and games to be more child-friendly and is making them more comfortable for the parents. Finally, the hospital is increasing its marketing campaign of the Creative Play Center (an area in which parents can drop off their other children to play, i.e., daycare) to decrease the number of additional "healthy" children found in many wait rooms. Because these changes are being piloted at the present time, no documented data currently exists on the increased customer satisfaction. The cost of this customer service initiative equals a total funding request of $38,000 (Children's 1998).
IMPLICATIONS AND CONCLUSIONS
In these changing times, customer service is the key to a hospital's long-term organizational success. Consumers affect 80 percent of all healthcare decisions and are beginning to expect better service from their community hospital (Prager 1998). The literature shows that customer service positively affects customer satisfaction and loyalty, overall financial performance, and quality of care. A strong customer service focus also eliminates many advertising and recruitment costs and helps to build a competitive organizational advantage (Rapert and Wren 1998). Without a solid customer service focus, hospitals may begin to lose important managed care contracts and contracting abilities and therefore lose a large percentage of their insured customer base and have trouble remaining competitive in their area. Hospital managers know that consumers who are dissatisfied because of poor customer service can switch to other hospitals affiliated with their plan, or switch plans altogether--actions that would leave some hospitals "out of the loop."
To develop a customer service plan, the hospital must first understand its customer base and leadership commitments. The hospital should then follow the four-step framework for customer service development to create a customer service initiative. In the four-step process hospitals must remember to always focus on their goals and customer service objectives and build a tactical plan from the foundation of the mission statement. Another important step in the developmental process is the creation of bilateral teams. These team members are important because they offer insight and gain the support of their departments for the customer service initiative.
The implementation and management stages of the process focus on the employees and their ability to internalize the customer service initiative created by the upper management teams. The most critical component of the implementation stage is selecting the right training program. Many management consultant companies offer training programs for a designated fee. If hospitals have a limited budget, they should focus on developing their own employee training program. Important things to include in the training process are basic customer service principles, the organization's quality approach, recognition and understanding patients, stress and change management, communications skills, and empowerment em·pow·er
tr.v. em·pow·ered, em·pow·er·ing, em·pow·ers
1. To invest with power, especially legal power or official authority. See Synonyms at authorize.
2. (Mayer et al 1998). Hospitals should also incorporate team activities and group building exercises to increase communication and camaraderie ca·ma·ra·der·ie
Goodwill and lighthearted rapport between or among friends; comradeship.
[French, from camarade, comrade, from Old French, roommate; see comrade. within the organization. The management of customer service initiatives should focus on documenting the change, defining service standards, and providing employees with the resources and encouragement they need to accept the organizational initiative. In summary, hospitals still have many customer service road blocks to hurdle HURDLE, Eng. law. A species of sledge, used to draw traitors to execution. , but with a strong mission and organizational commitment they will reach their final goal of providing service that "takes the customer's breath away."
An example of this type of program is the Survival Skills[R] eight-hour customer service training. In this program, training is broken down into different modules that focus on basic customer service principles, recognition and understanding patients, stress management, communication skills, empowerment, and change management (Mayer et al. 1998).
St. John's Hospital of Santa Monica Santa Monica (săn`tə mŏn`ĭkə), city (1990 pop. 86,905), Los Angeles co., S Calif., on Santa Monica Bay; inc. 1886. Tourism and retailing are important, and the city has motion-picture, biotechnology, and software industries.
Organizations can also follow their own training format. St. John's used this approach and created a three-day training model that focused on topics such as understanding the hospital's mission and values, customer expectations, the quality improvement process, and team dynamics
Children's Hospital of Denver, Colorado
Organizations can also create a training program based on their unique quality initiative. Children's created a training program entitled en·ti·tle
tr.v. en·ti·tled, en·ti·tling, en·ti·tles
1. To give a name or title to.
2. To furnish with a right or claim to something: Train the Trainers (Case Study 1998). This program was used to train staff on a new EPIC interface computer system that was being installed to increase customer satisfaction with outpatient registration and scheduling (Case Study 1998). One lead trainer trained six individuals on the new system through demonstrations and screen testing. The individuals who attended the initial training sessions then went to their own departments to cross-train their staff. This approach allowed employees to train their own department who they felt comfortable working with and also created the opportunity to solve departmental problems without seeking outside assistance. After training, employees should feel empowered and encouraged by management to solve many points-of-contact customer problems (Hiebeler, Kelly, and Ketteman 1998).
Caroselli, M., and L. Edison. 1997. Quality Care, Prescriptions for Injecting Quality into Health Care Systems. Boca Raton, FL: St. Lucie Press.
Case Study: The Children's Hospital of Denver Colorado. 1998.
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New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of : Simon & Schuster Simon & Schuster
U.S. publishing company. It was founded in 1924 by Richard L. Simon (1899–1960) and M. Lincoln Schuster (1897–1970), whose initial project, the original crossword-puzzle book, was a best-seller. .
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aspen: see willow.
Aspen, city, United States
Aspen (ăs`pən), city (1990 pop. 5,049), alt. 7,850 ft (2,390 m), seat of Pitkin co., S central Colo. Publications.
Mayer, T., R. Cates n. pl. 1. Provisions; food; viands; especially, luxurious food; delicacies; dainties.
Cates for which Apicius could not pay.
Choicest cates and the fiagon's best spilth.
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Petrini, C. 1989. "Training for Service Quality." Training and Development Journal 43 (May): 20-27.
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tr.v. re·de·signed, re·de·sign·ing, re·de·signs
To make a revision in the appearance or function of.
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Zeff, P. 1995. "Naughty naugh·ty
adj. naugh·ti·er, naugh·ti·est
1. Behaving disobediently or mischievously: a naughty child.
2. Indecent; improper: a naughty wink. or Nice." American Medical News 38 (December): 13-14.
Julie Howard Julie Howard (born October 23, 1976 in Brantford, Ontario) is a former international butterfly and backstroke swimmer from Canada, who competed at two consequentive Summer Olympics for her native country, starting in 1992 in Barcelona, Spain. , undergraduate student, James Madison University “JMU” redirects here. For the university in Liverpool, England, see Liverpool John Moores University.
For the public-policy college at Michigan State University, see .