Got a complaint? Use it to your advantage

Make necessary changes

Next time you get a complaint, don't let it ruin your day. Instead, find a way to make a customer's dissatisfaction work to your advantage.

Jacob Lopez, manager of patient registration at Wuesthoff Health Systems in Rockledge, FL, says that he used to cringe every time staff, patients, or administration presented a complaint.

"When you look at it with an open mind, though, you start to realize that this is a perfect avenue for you to re-evaluate your areas and processes," says Lopez. "Some complaints are beneficial to be informed about. This is especially true for areas that you think are running smoothly."

Patients often complained about wait times. "Our outpatient lobby used to have several patients waiting in line at any given time," says Lopez. "We started to analyze this in many different ways."

The immediate solution was to bulk staff up when surges in volume occurred, but this was only a temporary fix. "We knew that other resources were necessary, but we were not quite sure which ones were the best fit for us," says Lopez.

Staff began to give pagers to waiting patients, so they wouldn't feel as though others were skipping to the front of the line. When a patient arrived at the front desk, the registrar would take the person's name and the time he or she presented, and hand the patient a pager.

"When a registrar was available, the front desk staff would activate the pager to signal that we were ready for the patient," says Lopez. "This is similar to when you provide your name at a restaurant and wait for a table."

The pagers seemed to work at first, and eliminated the lines, Lopez says. However, bottlenecks of patients were now sitting in the lobby.

"We dug deeper. We started to track wait times, from door to desk. This information provided more specific data," says Lopez. These showed how long a patient waited in the lobby, at a registration desk, and when they departed to the testing department.

The data revealed that some registrars did not work as quickly as others. "So we moved the fastest ones in when the surges occurred, to process the patients through," says Lopez. "Once we had consistent data to track and trend with, we set expectation wait time goals for the staff."

Steady patient flow

The next step involved the process for pre-registration. "We wanted to get patients to assist with the registration process earlier," Lopez says.

Kiosks were considered, but ultimately rejected. "We understood that this may work in other hospitals or organizations, but for us, this was not the appropriate tool," Lopez says.

Wuesthoff's patient access leaders realized that the necessary information was simple enough that it could be obtained at pre-registration. This way, a patient would get through the process quicker. "Why spend the money on a kiosk if a process adjustment would work?" Lopez says.

Instead, the department's first approach was to look carefully at its dismal numbers, Lopez says. Data showed that less than 50% of accounts were completed, meaning that one out of every two patients was not pre-registered.

"We reviewed our schedules and targeted the patients that were scheduled at the beginning of the day and continued afterwards at hourly intervals," says Lopez. "We focused heavily on the earlier cases to maintain a steady patient flow, especially in the peak hours. We also realized that we had a large population of lab patients, so we focused on those as well."

Currently, more than 80% of patients are pre-registered, and this is trending upward. "All of this stemmed from patient complaints," notes Lopez. "All circumstances are unique, but the patient concept is the same no matter where you are located."

The next step was creating a fast pass program for patients. "Patients are given a number, which they present at check-in. They literally sign and go to their testing destination," says Lopez. "Patients love this service."

Data allow Lopez to focus educational efforts on individual staff members, instead of overall processes. "This makes it easier for management to discipline, coach, or re-train associates," he says. "Before, patients would complain that they were frustrated with the wait, and other things like questions regarding their bill would be lost in the translation. Now, those questions can be addressed."

"Patient complaints should always be used as an opportunity to see how things are being done, and what can be done differently," says Lisa A. Cox, CHAM, admitting manager at Maine Medical Center in Portland. "There is always a chance to improve."

If a patient or family member complains about a particular individual, the access staff person involved in the encounter might be the best person to resolve it.

"If done appropriately, this can be viewed in a positive way by the customer," says Cox. In one case, she says, a patient called to say the access representative was rude on the phone and made her feel rushed. When the woman arrived at the hospital for a scheduled procedure the following day, the access representative personally greeted her to apologize for the way she came across on the phone.

A patient may call and tell you, "Sue was rude when I asked her why she was calling me on a Sunday." After you explain that the department's policy is for staff to ask whether this is a convenient time for the patient before proceeding, you can then ask whether the patient would like for Sue herself to call and apologize, Cox says.

"We would not do this with all patients, but if we feel it would be appropriate, we ask the patient," says Cox. "Some do not feel it is necessary, since the manager has already apologized. The patients that did accept liked that the employee acknowledged their feelings."

The staff are receptive to this practice as well, because they don't want patients to feel they were treated poorly, she says. "We want to ensure patients understand that it was not their intent to sound rude or make them uncomfortable with any situation," says Cox. "We have no scripts, but we ask the employees to acknowledge the patient's feelings and to let them know they are truly sorry. We let them know not to make any excuses, only to apologize."

[For more information, contact;

Lisa A Cox, CHAM, Admitting Manager, Maine Medical Center, Portland. Phone: (207) 662-4413. E-mail: coxla@mmc.org.

Jacob Lopez, Manager, Patient Registration, Wuesthoff Health Systems, Rockledge, FL. Phone: (321) 636-2211, ext. 2823. E-mail: jacob.lopez@wuesthoff.org.]