The Quality-Cost Connection Part 2 of 2: Responding to customer concerns improves quality

Four more steps to effective concern management

By Patrice Spath, RHIT
Brown-Spath & Associates
Forest Grove, OR

When patients have a negative encounter with a health care organization, they are less likely to use that provider again, more likely to talk negatively about the provider, and more likely to switch to another provider. One way an organization can ensure repeat business is by developing a strong customer service program that includes a concern management system. An effective concern management system involves five steps. The first step — document the concerns — was described in last month’s Quality-Co$t Connection column. The last four steps are described in this month’s column.

Once information about patient/family concerns is documented, the information needs to be organized. This can be done by recording the issues from each concern sequentially in a paper log or into a spreadsheet or database software program. The log or electronic database should have sufficient space for nine columns.

Although a patient or his or her family may have lodged only one concern, there may be more than one useful problem verbalized. The issues from each concern are recorded so that the problems can be analyzed separately. In Table 1, below, is a sample worksheet illustrating two issues voiced in one patient concern.

For each concern, identify the customer need behind the verbalization. For some concerns, more than one customer need may be identified. To help determine customer needs, it is often useful to start the need with the statement, "I need to . . ." (See Table 2, below.) Next, a clearly defined statement of what caused the customer need not to be satisfied is added in column 7.

After defining the problem, the affected processes and problem causes are analyzed. This involves finding the root cause, which should be a joint activity with people personally knowledgeable about the process. For the example in Table 2, people from the outpatient registration desk are consulted for ideas. The root cause is identified and documented in the worksheet. (See Table 3, below.) This step is completed for each customer need derived from a concern.

Maximize the value of concerns by exploiting or making use of the information to improve processes. Using information recorded on the worksheet, develop a basic list of unmet customer needs, as well as the number of times they were not met. (See chart, below.) The report also lists the processes/departments related to the unmet needs. A summary report such as this can be created quarterly or semiannually.

The report findings allow the organization to focus its immediate improvement efforts on high priority, unmet customer needs.

Analysis techniques such as failure mode and effect analysis can be used to detect failure modes and develop an initial prevention plan. For example, the failure of registration staff to follow procedures for admitting patients for laboratory test might be resolved by reviewing the procedures periodically with staff to avoid lack of observance.

Share the preventive steps you’ve taken with the person who initiated the concern. When a patient or family has a problem with a health care organization, but this problem is properly managed, it is highly probable that the customer will remain loyal to the organization. Acting on concerns makes customers feel respected and important. Along with an apology, the notification letter can include the identified need, the problem that was identified, its causes, and the corrective actions to be taken, as well as contact information of the person responsible for taking actions.

Health care organizations can’t afford to be casual about dealing with customers. Customer responsiveness should be a strategic issue because it differentiates your organization from competitors. Do people in your organization have an "I’ll get to it when I can" attitude, or are patient and family concerns a high priority?

Attitude has a lot to do with how people treat customers. What attitude do people in your organization convey to customers? Is it a casual one or is it a "customer-first" attitude?

To get at the heart of customer-relation problems, find out how staff members would answer the following questions:

  • When a customer voices a concern that requires a callback, how long does it take, on average, to get back to the person?
  • What are the organization’s policies regarding management of concerns?
  • How much training have you have had with regard to responding to customer concerns?
  • At what level in this organization are customer concerns handled?

Organizations should have a clear procedure to follow when a customer is concerned. Staff members must be taught to recognize concerns and respond promptly and appropriately.

Customer concerns make a difference

The process of responding to patient and family concerns must be transformed from a minor activity to a formal evaluation process. Concerns should not be viewed as a source of blame, but as a unique learning opportunity.

Excellent service only can be achieved when health care organizations have a good understanding of the evolving needs of patients and families. An effective process for analyzing and closing concerns is a critical success factor.

Maximize the value of concerns by communicating organizationwide the customer’s needs and expectations along with the possible resolution or outcome to the concern. This communication process will improves services and ensure a consistent customer service approach. The goal is to eliminate "reinventing the wheel" among multiple departments in one organization that may encounter the same concern.