Ensuring patient satisfaction and establishing good practice

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Ensuring patient satisfaction and establishing
good practice
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Introduction

• Patients are the foundation of our medical
  practice
• It is very obvious that they must be satisfied
• Do we always succeed?

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Some experiences Patients tell the truth
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• Quality service? I dont ask for much from my
  doctors. The woman, a business professional in
  her late 30s, seemed pleased to be asked. I
  dont want to wait endlessly, but I understand it
  if something comes up in the schedule to cause a
  delay just tell me about it! Im much more
  forgiving if someone keeps me informed.

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• I like to feel that I have my doctors attention
  during the visit. I dont expect a half hour of
  his time, just a sense of concern. My
  pediatrician is wonderful. He always remembers
  something personal about my child. When he talks
  to me, he looks right at me not at his paper
  work or forms or does not talk on phone

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• His staff is friendly. They make me feel welcome
  and not like an interruption in their day. He
  explains things so they make sense, and he gives
  me information that I can take home and read. Im
  not just a case to him.
• Patients dont care how much you know until
  they know how much you care - Sir William Osler

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• Dynamics of medical practice today
• Patient as a customer
• Doctor as a service provider

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In the past

• Doctor was God
• Supreme authority

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Medical practice as business activity

• Health care as one of the largest service sector
  industry
• Huge capital investments- expected returns
• Drivers technology, health regulations, health
  insurance, CPA, standard of living, influence of
  media, internet
• Customer service provider
• Customer is the king

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Patient satisfaction pays

• Greater profitability.
• Improved patient retention and patient loyalty.
• Increased patient referrals.
• Improved compliance.
• Improved productivity.
• Better staff morale.
• Patient satisfaction pays
• Reduced staff turnover.
• Improved collections.
• Greater efficiency.
• Reduced risk of malpractice suit.
• Personal and professional fulfillment.
• The process of ensuring patient satisfaction
• Patient Satisfaction
• Clinical Quality Service Quality
• TQM (Total Quality Management)

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The Quality Diamond Model of patient
satisfaction.
QUALITY MEDICAL CARE
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Customer
QUALITY MEDICAL CARE
Commitment
Continuity
Expectations
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The Customers types

• Difficult to deal with Demanding, annoying,
  unrealistic, loud and objectionable.
• Desirable pleasant, easygoing, intelligent,
  accommodating and knowledgeable
• Others timid, questioning, unprepared, lacking
  in knowledge and uncertain about what they want
  or need.
• Have to handle all

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Commitment

• Emotional and intellectual pledge to a course of
  action
• Your commitment to quality services must be 100.

If you are interested in something, you do it
when you have time. If you are committed to
something, you make time to do it.
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Guidelines to ensure commitment to quality

• The physician needs to be a participative leader
  with conviction.
• Have a statement of mission and vision for
  quality services and share it with the staff.
• Recruit a high performance staff
• Build a team which is committed to quality
  services.

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Ensure commitment

• Empower the employees to achieve goals of quality
  services
• Ensure staff satisfaction and motivation by
  various means like good salary, appreciation for
  good work and imparting a feeling of importance

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Ensure commitment

• Do some medico-social activities in the hospital
  premises or get involved with similar activities
  done by other organizations.
• Have accreditation by some regulatory authority
  or agency (e.g. ISO).

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Expectations

• (1) Medical (Clinical) expectations These relate
  to accurate diagnosis and treatment. This is
  dependent on the medical core competence.
• (2) Non-Medical expectations These relate to
  physical facilities and functional components of
  services.

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Few general expectations

• To have clinical core competence.
• Cure rate does matter
• Luxurious physical facilities cant substitute
• CME
• Good clinical methods
• Exude confidence
• Rational therapy
• Evidence based practices

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Few general expectations

• Honor the appointments. Appointment system should
  be accurate but flexible.
• 3. Communicate well with them in day to day
  language. Medical jargon should be avoided.
• 4. To listen to their problems patiently and give
  them enough time. Master the art of listening

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Few general expectations

• 5. Show personal concern for the patient.
• Body language ,greeting , a good first
  impression of a caring physician, make it visible
  that we are with them in their worst times too.
• 6. To explain everything about the illness and
  treatment.
• A short detour through the illness -
  etiology, pathology, clinical features,
  diagnostic investigations, treatment and
  prevention

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Few general expectations

• 7. Staff which shows care, concern, courtesy and
  empathy.
• Patients spend more time with paramedical staff
• Behaviour and attitude of the staff
• Ask to go beyond the rules of duty to help
• Handle personal and telephonic conversations
• Promptness in all responses
• Emergency case, admissions

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Few general expectations

• 8. Provide reasonably good physical facilities.
• Both outdoor as well as indoor
• Approachable location with good parking facility
• Child friendly environment, cleanliness,
  facilities for recreation (library, toys, music,
  TV etc.)
• Proper place for eating
• Enough space for various facilities.
• 9. Impart health education handouts, video
  examples.

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Few general expectations

• 10 Proper documentation.
• Good legible prescriptions, a detailed discharge
  summary, certificates, prompt issue of papers for
  mediclaim
• Clear explanation for administration of medicine
  to ensure compliance.
• 11.To provide hospital information brochure and
  to have informative sign boards.

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Few general expectations

• 12. To have transparency in financial matters.
• One of the major causes for dissatisfaction
• Proper display of routine consultation and indoor
  charges
• Should be properly informed about the expected
  expenditure before any procedure or admission.

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Few general expectations

• 13. To use modern technology.
• Computerization and adaptation to new technology
  for diagnostic and therapeutic purposes.
• 14. To have easy flow between various services.
• Patient should not be wasting time to avail of
  various services.

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Factors affecting expectations

• Nature of medical illness.
• Past experience in the same set up.
• Experience at other set up.
• Financial and social standing.
• Level of education.

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Measuring expectations

• 1. Direct approach Simple but effective
  technique. Can be used by doctor as well as the
  staff.
• 2. Questionnaire This can be designed according
  to the services provided.
• Suggestion Box
• Outdoor as well as indoor facilities
• This box should be periodically opened.

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Measuring expectations

• Listening to the staff Patients often talk more
  freely with the paramedical staff.
• Listening to the patient Their past experiences
  at other hospitals, a valuable insight into
  causes of dissatisfaction
• Analyzing a discharge against medical advise An
  opportunity to analyze the short comings in the
  services and improving upon them.

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Meeting expectations - few principles

• 1. Have systems in place to meet general
  expectations. This involves hospital
  administration.
• 2. Be flexible because expectations keep
  changing.
• 3. May not be able to meet all expectations, but
  one must try to manage. Managing expectations
  means patient listening and then explaining as to
  why we can not meet those expectations.

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Meeting expectations - few principles

• Unrealistic expectations may be gently managed
  through patient education.
• 5. Take a walk in your patient shoes. Look at the
  whole set up from patients point of view and
  find out good and bad things about our set up.
  This helps us to delete the negatives and enhance
  the positives.

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Meeting expectations - few principles

• 6.Delight the customer is the buzz word .Going
  beyond the patients expectations. Anticipatory
  guidance or asking the nurse to supervise and
  train a mother for breast feeding in an OPD visit
• 7.Master the art of handling difficult patients.
  Consider them as the people who are testing the
  quality of your services.

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Meeting expectations - few principles

• 8. Service Recovery (when things go wrong)
• Apply the triple A action plan. The steps are
  Acknowledge, Apologize and Amend.
• Accept that mistakes do occur, but should make
  all efforts to prevent them.
• Analyze the factors leading to mistakes and try
  to correct them.
• Differentiate between the wrong act and the doer.
  Criticize the wrong act and not the doer.

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Continuity

• Loop-closer in the quality diamond model.
• A method for ensuring continuous, consistent,
  ever-improving and never ending service quality.
• All the ways and means of measuring, evaluating
  and monitoring the progress.

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Continuity

• It ensures that services get better day after
  day.
• Can we do better? is the guiding question
• It is about accepting the fact that what you do
  today may not be appropriate or effective
  tomorrow.
• Things do change.

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Continuity

• Benchmarking.
• Looking beyond to other setups for better
  services and customer satisfaction.
• Opens windows of our mind and let in new ideas.
• Setting standard of service for all aspects
• Continuity also requires monitoring patient
  satisfaction. A formal comprehensive process for
  determining patient satisfaction, may be in form
  of questionnaire

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Thanks