Guest Column: Delight internal customers with top-rate service

Know how to deal effectively with complaints

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

When people are unhappy with case management services, they will tell someone about it. In fact, research shows that people who have a problem are likely to tell eight to 10 other people about it.

However, fewer than one in 20 people who have a complaint will protest formally.

That’s why standard customer surveys and informal complaint systems can’t be relied on to uncover case management problems. The case management department that wants to provide top-rate service should encourage, even welcome, complaints. While often case managers view patients and their families as primary customers, it is important to remember that many customers are internal — physicians, nurses and other caregivers, billing and admissions staff, quality and risk management staff, pastoral care, and others. If these internal customers find a deaf ear when trying to explain about a problem with case management services, a feeling of ill well is created. Also, the department loses out on valuable feedback.

Good internal customer service should be a part of every case management department’s performance improvement strategy.

Complaints represent valuable information about recurrent problems. They can point the way to understanding the root causes of service problems and help the case management department target core functions that need improving. The department should make it easy for physicians and staff members to complain, even encourage complaints. Then, where appropriate, the department should bend over backwards to set things right and make changes so that future problems are eliminated. Effective handling of internal customers with problems is critical to the department’s reputation.

The case management department should have a customer service policy that addresses both external and internal customers. (See sample policy, below.) But statements about the importance of customers are only as good as their impact on behavior; case managers need to "walk the talk." The department director must motivate staff positively by listening to and acting on internal customer suggestions and rewarding employees’ customer service efforts. When customer satisfaction is viewed as important to the director, case managers are more likely to support the efforts. Every case manager should understand the customer-related requirements of their job and meet those requirements. Department policies should emphasize the importance of listening to internal customers when designing new services or changing existing procedures. This theme must be communicated throughout the case management department and made clear to every employee.

The goal should be to delight internal customers, not just meet basic needs. Don’t be casual about dealing with internal customers.

If staff in the department have an "I’ll get to it when I can" attitude, physicians and staff members won’t feel valued as customers. A customer-focused case management department encourages customers to complain. Often, if case management activities are not working well, it’s your internal customers who are the first to know, and this information is valuable to the department.

It makes good business sense to empower case managers to do what it takes to satisfy internal customers by ensuring they have sufficient authority, training, and responsibility. Sometimes, a careful explanation of the reason for a decision or empathetic listening along with an apology is all that is needed. In addition, when frontline case managers effectively resolve routine problems, the director can focus on enhancing core case management processes to improve service quality.

The case management department director shouldn’t use complaints to play "gotcha" with case managers. Most complaints are caused by case management procedures or policies that don’t meet the expectations of the internal customer. Complaints should be used to find and resolve the problem. Employee fear and resistance at sharing common complaints is greatly reduced when everyone knows the director is focusing on how the department can do better at meeting customer needs, rather than on finding someone to blame. In the right environment, case managers want to help find and fix the problems so that next time the expectations of internal customers are met.

Information about problematic interactions with physicians and other internal customers should be discussed at department meetings. Often simple changes can be made quickly to resolve problems. More complex issues may require formation of a performance improvement team comprised of case managers as well as the internal customers impacted by the problem.

Case management departments also should have a formal way to survey internal customers so that aggregate data can be used to measure performance and progress toward improvements. (See sample survey tool, below.)

A short survey such as this periodically can be distributed to internal customers to obtain standardized feedback about satisfaction with case management services. However, the survey tool should not replace the department’s complaint management process. By effectively responding to complaints, as well as analyzing occasional survey results, the case management department will be better prepared to exceed the expectations of internal customers.