Unlike beauty, customer service isn't skin deep

Happy staff equal happy customers

Everyone knows that the key to success in a competitive market is differentiation. So as the market developed in Nashua, NH, - a town where each of the two hospitals owns practices and competes for about 150,000 potential patients - Steven Boyle, MBA, director of operations at the 75-provider Foundation Medical Partners, began to talk with the practice president about ways they could let patients know they were different.

"I used to be a consultant, and one thing I learned was that patients didn't distinguish between whether they got better care from one provider or another," says Boyle. "They know if they get better, but in a primary care scenario, they don't differentiate between the kind of care they get. What they do assess is if calls are answered quickly, if receptionists greet them in a friendly manner, if they have to wait, if they have to wait to get an appointment. Those things determine if they stay with a provider, or if they recommend a provider to others."

Customer service works from inside out

What Boyle and his management team came up with was a customer service program that would start internally and work its way out. "We felt that if people were grumbling inside, if people were at each others' throats, then you can't accomplish the goal of external customer service," Boyle explains. "The external part often is dependent on how the internal staff work with each other."

Nine months after the training began, Boyle doesn't have any data to prove the program has worked, but he is spending less time referring complaints and running interference with staff. They are more cooperative with each other, and Boyle thinks there has been an improvement in morale at the practices.

He is currently gathering patient satisfaction data, and Boyle says he anticipates there will be a positive impact from the training there, too - one which can be measured.

Boyle started by putting together a customer service committee of 10 people - administrators, front-line staff, nurses, and the medical director - although the latter was involved only as her schedule permitted. A trainer from the affiliated Southern New Hampshire Regional Medical Center also participated.

Over the course of six months, the group developed a mission statement and program goals. Those goals were that attendees could:

· explain how to provide exceptional service;

· identify the practice's customer service initiative;

· know who their customers are;

· diagnose customer service issues and explain how to handle them;

· identify different kinds of difficult customers and explain a process for handling those tough situations.

Managers were given some basic training on coaching skills and staff reviewing procedures prior to the customer service training. Then last fall the program was rolled out. Some 25 managers were trained during a one-day retreat, and 120 staff were subsequently pulled out in groups of 15 to 20 for the same training. Providers were not exempt. They also went through the course but attended sessions in the early morning hours which were led by the medical director.

Although the training was initially segmented into management, staff, and providers, Boyle says that now that each of the 25 sites in the practice has the tools, customer service training will be held regularly, with all staff and practitioners present at once. "I hope they make it part of their regular monthly staff meetings, where they can discuss actual situations that have arisen and how they dealt with them."

The training included an ice breaker, a discussion of the relationship between customer service and the strategic goals of the practice, and an outline of how the initiative will affect each staff member's expected standards of performance and reviews. There were case discussions of customer service situations and a session on dealing with difficult customers.

The case studies came from a survey done of staff and providers about problem areas that have arisen between the two. Boyle says that can be a common source of friction.

One of the main sources of information Boyle and his team used to develop the program was the Disney Co. "There isn't a lot of information on customer service in health care out there," he says. "So we took information from Disney's book, Inside the Magic Kingdom. We had everyone read it." (For a list of other reading material which might be helpful, see list, above.)

Health care has often lagged behind the rest of society in terms of delivering customer service, Boyle continues. He wants his staff to understand that society's expectations are continuously increasing for everyone, including health care providers. "But to get them to understand that, we had to go to other companies for information"

While Boyle says there were some physicians who weren't happy about the training initially - they said it was ironic that staff were being pulled away from work for customer service training when their very absence would adversely affect customer service -most have come around. "I'd be lying to say everyone is 100% on board," he says. "The key to getting the providers on board has been the medical director. We have one who is behind the program, is well respected in the community, and she has been great at doing the provider sessions and selling this idea. It sells because a working physician is doing this, not some administrator."

And the program has had an impact. For instance, there was one physician who prior to the training would expect staff to stay until the last patient had left, even if that physician was running way behind. "That doctor didn't understand that the front office person had to get home, that many staff members are single moms with day care commitments who have to pick up their children by a certain time. There was no respect for their needs, nor any knowledge of them."

Part of the training included a profile of the typical staff person - who the staff are and what their lives are like outside work. "That was really eye opening. They just weren't aware." Now that physician may run late, says Boyle, but the staff member is allowed to leave on time.

Staff are more aware of great customer service and are being rewarded for extra efforts. The practice gives out small inexpensive presents, like mugs, and posts employees' names on a bulletin board when they do something exceptional. For instance, a recent recipient was a staff member who knew a patient was going to Boston to have a leg amputated. "That staff member went down to Boston on her own time on the weekend and spent the entire day with that patient."

Employees also know that in the future, their ability to provide excellent customer will be evaluated.

While Boyle says the program is already proving valuable, he recommends that others anticipating such training get buy-in from the top and make sure the providers are on board before starting a program. He also suggests that you look at other industries for customer service excellence - at least until more health care organizations catch on to the idea of patients as customers.

· Steven Boyle, MBA, Director of Operations, Foundation Medical Partners, Nashua, NH. Telephone: (603) 577-3432.