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The perfect patient satisfaction survey
The survey helps practices identify their strengths and weaknesses, and provides an index that can be used as a base for planning improvements.
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In the quest to improve our practices or perhaps mimic the competition, many ophthalmic practices have struggled to develop the ideal tool to assess patient satisfaction. It’s an admirable goal, and service leaders in many industries have turned customer surveys into a strategic advantage. Of course, Disney, Ritz Carlton and Microsoft can devote millions of dollars each year to develop, refine and act on surveys, while your best option for developing a patient satisfaction survey is to tap your beleaguered office manager.
Our practice has struggled with the patient satisfaction survey process for over a decade, drawing on approaches that ranged from telephoning random selected patients to organizing formal focus groups. We have surveyed clinic patients, optical customers, referring physicians and even rural hospitals that host our monthly outpatient clinics. We’ve alternately taken and ignored the advice of our long-time management consultant, but it seems we have finally found something that works.
Perfect survey approach
Through all of our struggles, we have developed the perfect patient satisfaction survey tool. Well, it’s not really a tool, but rather an approach to developing a survey tool. The perfect approach will work in any practice, for any application, in any operating climate. The perfect satisfaction survey:
- Is easily understandable by both patients and employees.
- Includes questions that are relevant to physicians, supervisors and employees.
- Is consistently distributed so it provides internal benchmarking opportunities.
- Allows results to be quickly measured and distributed to physicians and staff.
- Is used as a basis to change behavior and/or recognize high achievement.
Industry standards
Within the health care industry, Press Ganey Associates (www.pressganey.com) and National Research Corporation (www.nationalresearch.com) appear to be two of the market leaders in performing satisfaction surveys, primarily for client hospitals. Press Ganey’s Web site indicates that its tools are used by 30% of all U.S. hospitals and 40% of all U.S. hospitals over 100 beds, so their tremendous reach provides excellent benchmarking tools. Both Press Ganey and National Research have now expanded into physician visit surveying, and they may be a viable option for practices that demand benchmarking data, would like to outsource the entire process and can swallow the significant price tag.
While attending the 2002 American College of Healthcare Executives Congress, I saw many hospital CEO’s comparing their Press Ganey results, in public hallways no less, so it seems to be a valid and widely respected tool. However, at the same meeting, I also listened to a presentation by the CEO of Griffin Hospital in Derby, Conn., a small community hospital with seven competitors (including Yale Medical School) within 20 miles of their campus. Griffin Hospital’s solution for measuring patient satisfaction may also be a great option for your practice.
Secured Customer Index
In the 1980’s, Griffin Hospital was losing money, market share and referring physicians. A 1980 community survey ranked Griffin last among the eight local hospitals, and 30% of respondents said they would avoid Griffin if they needed care. By refocusing the hospital’s employees on patient-centered care, Griffin was able to restore profitability and become the “hospital of choice” in their community. Griffin earned a spot on Fortune Magazine’s Top 100 Companies to Work For lists in from 2000 to 2002 and now boasts one of the highest patient satisfaction ratings of any hospital in the country.
In the late 1990’s, after making dramatic service improvements, Griffin’s management discovered that having patients check off “satisfied” on a survey form was, by itself, no longer a helpful tool in assessing patient satisfaction and the likelihood of repeat business.
Nearly all survey forms are subject to grading bias; one patient might grade a service as a “3” or “average,” while a second less-demanding patient, receiving exactly the same service level, might grade his experience as a “5” or “excellent.”
To address this problem, Griffin management implemented a patient satisfaction measurement system that was more tangible and useful than any they had reviewed. The measurement system, called the Secured Customer Index (SCI), focuses on a patient’s answer to three questions.
The SCI measures the percentage of patients who give the highest rankings to all three of these questions. Griffin’s assumption is that these patients not only represent guaranteed future income to their hospital, but they also become advocates and promoters for the hospital — just the sort of unpaid advertising that every health care facility can use. By using SCI as its measure of patient satisfaction, Griffin has been able to refine its customer service and marketing programs to further increase its percentage of loyal customers.
Tough grading, solid results
Traditional satisfaction surveys often provide glowing results but provide little fodder for improvement. Within our practice, 98 to 99% of patients report they are satisfied or very satisfied, yet we know we need to improve our customer service experience. The SCI approach provides a tougher grading system and more room for improvement.
For example, while 98% of our contact lens patients are “satisfied” or “very satisfied,” the department’s SCI hovers near 62%. The SCI mark confirmed what we suspected: nearly 40% of our customers are willing to look for other contact lens sellers because our service levels aren’t top notch. The SCI helps explain why our contact lens sales have been sliding for 2 years and provides us with an objective method to measure the results of new customer service initiatives.
Please understand that an SCI-based survey does not consist of just three questions. Each practice or department has specific questions that need to be addressed — such as “How long did you wait before you were called to an exam room?” or “Did the physician answer all of your questions?” — and these will provide clues to good or bad SCI results. Without good supporting questions, an SCI-based survey won’t provide direction on how to improve your results.
Surveys in action
Our practice has been surveying 50 patients for each physician every 2 months for the past year, as well as 200 patients each month in our Spectacles and Contact Lens departments. Once a physician or an optical location has approximately 50 cumulative responses, the results tend to be reliable, but they will certainly differ between providers and departments.
For example, the SCI results for our physicians range between 62% and 90%. We distribute the physician SCI scores to all of our physicians to promote healthy competition, but we’re not yet comfortable in distributing the individual physician results to our employees. We distribute optical survey results to every departmental employee, and we provide complete results of all surveys to our management team.
Previous satisfaction measurements have been terribly time-consuming, but we’ve settled into a nice routine for these new surveys. A manager performs a quick query each month, randomly selects the patients needed and then prints off mailing labels. Our receptionists prepare the surveys for mailing during slow clinic days, and then sort them by physician and department when the surveys are returned in postage-paid envelopes. Our office secretary tabulates the survey results and prepares a typed summary of all written patient comments. I prepare a written overview of each month’s results and ensure that any patient complaints are addressed immediately.
Within a few months, we’ll have SCI-based surveys for five areas of our practice. Soon I hope to see my managers and physicians in the hallways comparing their monthly SCI scores, and then plotting how to improve them. Those stuffy hospital CEO’s don’t have a thing on us.
For Your Information:
- Griffin Hospital’s dramatic turnaround was aided in part by their decision to adopt the patient-focused care espoused by the National Planetree Alliance. More information on the Planetree approach is available at www.planetree.org. Contact Jay Slagle at jslagle@midwesteyecare.com if you would like him to e-mail a sample SCI survey form to you in Microsoft Word format.