Service Delivery vs. Service Excellence


Carrie Stiles Head ShotBy Carrie Stiles

William R. Johnson, the System Director of Patient Experience for Memorial Health System in Springfield, IL, led an excellent session designed to help us deliver exceptional experiences for our patients. Healthcare is facing a changing reimbursement model in which patient satisfaction is key. Right away I could tell that this wasn’t just another version of the same customer satisfaction classes that I’ve been to a hundred times before. William started it off by saying something that really clicked with me. He said that we can’t technique our way to the 99th percentile. It’s the culture and the experience that really connects with our patients. So much of what we know and what we teach to our staff revolves around techniques, such as  AIDET, Scripting, Key Words at Key Times, etc. While those all have a place in the customer satisfaction toolbox , they can’t be the only tool we use. We need to do better than that and truly connect with our patients and have a genuine connection with them. This session gave me the tools to do this in a much better way.

Besides patient satisfaction being the right thing to do, it has several positives for us as well such as: improved quality and safety outcomes, enhanced market share and competitiveness, improved financial performance, improved CAHPS performance, improved patient clinical outcomes, and increased employee satisfaction and retention. Our reimbursement model is changing from the old way of volume equals revenue to one where we get a capitated fee for what we do and then there is money at risk. Depending on how we do in regards to patient experience we will either win that additional money or lose it.

William also talked about Service Delivery (delivery of care) versus Service Excellence (delivery of caring), and how this is a left brain/right brain thing. I’d never heard it described this way before, but it’s totally true. The clinical side of patient care is the left brain side, the mechanics of what we do. It’s the policies and procedures, the delivery algorithms and care pathways. The patient’s expectations, perceptions, and experiences are very much the right brain side and the “humanics” of what we do. We are always working to improve upon the delivery of care, but if we want to improve the patient experience we need to strengthen the culture’s delivery of caring. Both the mechanics and the “humanics” come together to create the patient experience. Out of the two, “humanics” is by far the strongest driver of patient satisfaction.

A patient’s perceptions are filtered by their expectations and emotions, and those perceptions exceed, meet or fall below their expectations. When their perceptions fall below their expectations the patient/family will usually react emotionally. The huge risk is having the environment (our staff) respond or behave emotionally. I am sure all of us have seen this happen before and it is certainly not pretty.

We went over both verbal and non-verbal behaviors and were reminded that our actions speak louder than our words. Our staff must always demonstrate appropriate non-verbal behaviors anywhere they are being observed by patients, families, or visitors. Delivery of the spoken word is important as well. We need to express appreciation during conversations and speak warmly, slowly, and briefly while also listening deeply. Most patients just want to be heard, and we have to keep in mind that we never truly know what they are dealing with.

The session wrapped up with a discussion about action plans. When William said that we can’t assume that our staff know how to smile correctly or make eye contact I was shocked! This seems obvious in retrospect, but I know this isn’t something that I’ve been taught in the hospitals I’ve worked at. It’s crucial that we create action plans for both verbal and non-verbal behaviors. They help describe and explain behavioral expectations. That way everyone is on the same page, and the patients receive a consistent experience. The action plans must be specific! We can never assume that staff know what to do. Once the action plans have been created, intellectual training must take place. Following that, leadership needs to help staff connect their head to their heart. The training can never stop. This needs to be a continual process, and we as leaders need to be role models so that our staff know what we expect from them.

Whether we like it or not change is coming to healthcare and the customer experience is more important now than ever before. Resources must be allocated to strengthening the “humanics” of service delivery, and we have to be explicit about our expectations. I really enjoyed this session and came away from it with a whole new thought process about the patient experience. Customer satisfaction has always been my passion, and I love the fact that I learned so many new things. If we can work on truly having heart to heart connections with our patients, healthcare will be a much better place for not only our patients but for us as healthcare providers as well.

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