Customer Service in the Ambulatory

SettingDavid W. Mountjoy, MHA, FACHE

Executive Director-Ambulatory Care

University of Missouri Health Care

University of Missouri Health Care Clinic System

51 Outpatient Clinics-Primary Care and Specialty Care 600,000 Clinic Visits Annually 400+ Physicians-Mix of Full and Part Time Faculty 585 Clinic Staff Clinics Reviewable by Centers for Medicare and

Medicaid Services (CMS) and The Joint Commission Clinic Management Model Requires Collaboration

between Hospitals, School of Medicine, and University Physicians Practice Plan

Clinic Organizational Chart

Customer Service in UMHC Clinics

History as a Teacher Who Owns Customer Service? Getting Organized Buy-In Voice of the Customer

Why Focus On Customer Service?

Competition Revenue and Finance CG-CAHPS Reputation/Marketing Most Important…”It’s the Right Thing to Do”

Core Components of Customer Service

Leadership Service Goals and Expectations Responsibility and Accountability Communication Education Service Recovery Reinforce Behaviors Measure Satisfaction Action Planning

Education and Training

Ritz Carleton Model Patient and Family Centered Care (PFCC) Clinic Front Desk Training Interpret Survey Results Action Planning-It Takes a Team

Measurement Tools

Clinic Free-For-All Surveys Press Ganey Survey-Pluses and Minuses NRC Picker Clinic Pulse Surveys

Press Ganey

28 Questions Some Questions not Relevant Low Response Rates Timeliness of Results User Friendly CG-CAHPS

NRC Picker

Guaranteed Response Rate Web-based Timely Results Custom Reports Stoplight Reporting Sample Action Steps for each Question Shared Action Planning

Clinic Pulse Survey

Simple and Brief-2 Questions Timely Results-ARC High Response Rate Rapid Action Planning Inexpensive

The Good, The Bad, and The Ugly

Examples of Less Than Desirable Practices Examples of “Works in Progress” Examples of Great Successes

Patient Expectations in Clinics

The Visit Through the Eyes of the Patient Greeting and Welcome Wait Times-Waiting Room and Exam Room Provider Encounter Clinic Environment Technology

Speaking of Technology…

Phones and Phone Management Smart Phones Email Social Media Telemedicine EMR/HIE

Example of ACD Report

Patient Portals

Book Clinic Appointments 24/7 View Previous Appointments View Lab Results View Medical Record Communicate with Provider Receive Appointment Reminders Prescription Refill Requests Patient Education Material

Strategies For Customer Service to Improve Patient Satisfaction

Communication with Patients Staff Training and Engagement Physician Training Other Tools

Communication With Patients

Appointment Delays-Be Honest and Timely Reminders Cancellations/Rescheduling Utilize Wait Time No Surprises-Don’t “Blindside” Patients Patients Care about their Care

Staff Training and Engagement

Patient Satisfaction-Incorporate into Performance Evals Phone “Scripting” Phone Etiquette-”Smile over the phone” 5/10 Rule Body Language Manage Up Appropriate Attire and Appearance Partner with the Patient Be a Resource

Physician Training

Review Clinic Schedules/Appointment Access Distribute and Review Physician-Specific Patient

Satisfaction Scores PFCC for Physicians-Mandatory Incorporate Patient Satisfaction into Incentive

Plans

Other Tools

Communication Boards in Clinics Share Best Practice in Clinic Staff Meetings Do Follow-Up Phone Calls Review Clinic Space for Best Workflow Clinic Environment-Art, PCs, Clean, and Safe Stand Behind Your “Brand” Rounding For Outcomes Innovate

Results

NRC Picker Pulse Surveys

Patient Experience – Our Journey

Made Goal 3 out of 9

times

Made Goal 6 out of 6

times

Clinic Pulse Surveys

Question 1: Based on today’s visit, I would recommend this practice to family and friends. Options: Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree

Question 2: What, if anything, could have been improved today? Options: No Problems, Scheduling Appt., Check In/Arrival Process, Care Provider, Lab/X-Ray/Other Service, Nurse, Wait Time, Comfort/Cleanliness, Check-out Process

Survey Period-11/05/12-11/09/12 (5 working days) Response: 35% of all patients seen completed survey

Clinic Pulse Surveys

Mean Score for Q1 for 3517 responses: 4.4 (5=Strongly Agree) Q2 Results: 1. No Problems=2946

2. Scheduling=64

3. Check In/Arrival=87

4. Care Provider=36

5. Lab/X-Ray/Other=23

6. Nurse=22

7. Wait Time=351

8. Comfort/Cleanliness=52

9. Check-out=36

Suggested Readings

Hardwiring Excellence-Purpose, Worthwhile Work, & Making a Difference. Quint Studer

Front Office Success-How to Satisfy Patients and Boost the Bottom Line. Elizabeth W. Woodcock

Mastering Patient Flow-Elizabeth W. Woodcock. Second Edition If Disney Ran Your Hospital-9 ½ Things You Can Do Differently. Fred Lee.

2006 Customer Service in Health Care-Optimizing Your Patient’s Experience.

Karen A. Meek. The Six Elements of Customer Service-Gail Scott 8 Customer Service Ideas to Enhance Patient Satisfaction. MGMA

Journal. March 2010