SEPTEMBER 3 & 4, 2015 SEDONA HOTEL YANGON, MYANMAR

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1 SEPTEMBER 3 & 4, 2015 SEDONA HOTEL YANGON, MYANMAR

2 The Seven Deadly Sins of Customer Service in Hospitals Prof. Rene T. Domingo Asian Institute of Management

3 IS PATIENT SATISFACTION IMPORTANT IN YOUR HOSPITAL?

4 IN YOUR OPINION, WHICH IS MORE IMPORTANT? CLINICAL QUALITY? SERVICE QUALITY?

5 IN YOUR OPINION, WHICH IS MORE IMPORTANT TO PATIENTS SATISFACTION? CLINICAL QUALITY? SERVICE QUALITY?

6 What is outstanding customer service?

7 fun pleasant memorable shared

8 Delighted patient

9

10 IN YOUR OPINION, MOST HOSPITALS ARE: DOCTOR-CENTERED? PATIENT-CENTERED?

11 THE DOCTORS PATIENTS PRESIDENT VICE PRESIDENT VICE PRESIDENT VICE PRESIDENT MANAGER MANAGER MANAGER MANAGER MANAGER MANAGER

12 A HOSPITAL IS SIMILAR TO WHICH KIND OF BUSINESS OR ORGANIZATION?

13 HOTEL check-in check-out room service room rate housekeeping HOSPITAL? REPAIR SHOP major, minor repairs check up, back job PRISON visiting hours same uniform same food subject to orders confinement isolation

14 Patient-Driven Quality according to Importance (US survey) 11 factors Explanation in terms we can understand Easy to find physical facility Care first and then paperwork Knowledgeable personnel State of the art equipment Immediate attention and triage Ancillary support readily available Friendly staff and bedside manner Enough staff Clean facility Explanations if you have to wait Source: The Quality Connection in Health Care by Lynne Cunningham

15 Patient-Driven Quality according to Importance (US survey) 1. Immediate attention and triage Care first and then paperwork Knowledgeable personnel Explanation in terms we can understand Explanations if you have to wait Friendly staff and bedside manner Enough staff Clean facility Ancillary support readily available Easy to find physical facility State of the art equipment 22 Source: The Quality Connection in Health Care by Lynne Cunningham

16 SOFT QUALITY vs. HARD QUALITY The soft skills of workers, rather than their hard skills and facilities, strongly influence patient satisfaction. Doctors and nurses account for 34%, 43%, and 50% of the overall experience ratings of inpatients, emergency patients, and outpatients respectively. ** * * Patient Satisfaction Influenced More by Hospital Staff than by the Hospital Facilities.

17 IS YOUR QUALITY / SAFETY SCALEABLE? ONE-TO-ONE ONE-TO-MANY MANY-TO-MANY

18

19 HOSPITAL A QUALITY / SAFETY HOSPITAL B NUMBER OF BEDS / OCCUPANY RATE/ PATIENT VOLUME Prof. Rene T. Domingo

20 The Seven Common Pitfalls of Customer Service in Hospitals 1. Multiple handoffs 2. Lack of transparency 3. One-size-fits-all 4. Lack of empathy 5. Reactive approach 6. Failure to serve the patient s extensions 7. Overworked staff

21 1 MULTIPLE HANDOFFS

22 multiple patient information collection

23 multiple contact personnel

24 ADMINISTRATOR MED. DIRECTOR MANAGER MANAGER MANAGER MANAGER dual management

25 A CUSTOMER-DRIVEN ORGANIZATION Looking at the customer as one.

26 "lost" customers no patient ownership

27 2 LACK OF TRANSPARENCY

28

29 Need for more transparency

30 When is my doctor coming back? A repeat X-ray? why? Where s my food? Is my bill ready? When can I go home? Is my blood test result ready? NO APOLOGIES NO EXPLANATION What side effects? What? $2,000 for this?!!

31 HOSPITAL ROUNDS

32 Types of Nurse calls 40% 30% 25% 5% housekeeping check IV call for MD others Prof. Rene T. Domingo

33 3 ONE-SIZE-FITS-ALL

34 PATIENTS ARE CUSTOMERS

35 CUSTOMER CUSTOM CUSTOMIZE

36 They can have it any color they want, so long as it s black. --Henry Ford ( )

37

38 Barnes-Jewish Hospital in St. Louis special (bigger, wider, longer) beds, gowns, wheelchairs, slippers, operating beds, CT scans, syringes, doorways, even body-bags for obese patients Associated Press, March 31, 2006

39 University of Michigan Medical Center ART CART CHOOSE YOUR ROOM PAINTING

40 4 LACK OF EMPATHY

41

42 door-to-door or room-to-room

43 "Evaluations of the appearance of the meals may be more important than the actual quality of the food. "Hospital Food: Ingredient in Patient Satisfaction?", Healthcare, November 19, 2002, by Rick Blizzard, Healthcare Consultant, The Gallup Organization

44

45 WHICH IS MORE IMPORTANT? TO WASH YOUR HANDS BEFORE TOUCHING THE PATIENT? TO BE SEEN WASHING YOUR HANDS BEFORE TOUCHING THE PATIENT?

46 5 REACTIVE APPROACH

47

48 NURSE CALLS: RESPOND FAST OR REDUCE CALLS?

49 6 FAILURE TO SERVE THE PATIENT S EXTENSIONS

50 VISITOR-UNFRIENDLY HOSPITAL

51

52 7 OVERWORKED STAFF

53

54 FATIGUE AFFECTS PERFORMANCE Prof. Rene T. Domingo

55 % of pilots who agree Fatigue affects performance 64% % of surgeons who agree 18% Error, stress, and teamwork in medicine and aviation: cross sectional surveys, BMJ Prof. Rene T. Domingo

56 EFFECT OF LONG SHIFT HOURS A research study showed that nurse shift hours beyond 13 hours led to higher patient dissatisfaction.* Another study showed that the risk of nurses making mistakes more than doubles if the shift length is 12.5 hours or more.** * Stimpfel, Amy Witkoski et al. The Longer The Shifts For Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction. Health Affairs, November 2012: ** Scott LD et all. Effects Of Critical Care Nurses' Work Hours On Vigilance And Patients' Safety. American Journal of Critical Care, January 2006, Volume 15, No. 1:

57 Research study conducted in 2004 on Registered Nurses in Texas "69 percent reported exhaustion and 54 percent reported frustration; almost 43 percent of the RNs reported that, on most days, they often have more work than they can safely handle." November 2006 Publication No , Center for Health Statistics, Health Professions Resource Center, Texas Center for Nursing Workforce Studies, Statewide Health Coordinating Council

58 Customer service training

59

60 The Seven Common Pitfalls of Customer Service in Hospitals 1. Multiple handoffs 2. Lack of transparency 3. One-size-fits-all 4. Lack of empathy 5. Reactive approach 6. Failure to serve the patient s extensions 7. Overworked staff

61 World Class Hospital 1. One-stop-shop, seamless service 2. Transparent 3. Flexible, personalized 4. Caring, empathetic 5. Proactive, Anticipatory 6. Visitor-friendly 7. Highly motivated staff

62 Radar chart for 5-star Service rating Medical 2 Ancillary 3 Nursing 4.5 Finance Housekeeping 4 3.5

63 The Seven Deadly Sins of Customer Service in Hospitals Prof. Rene T. Domingo Asian Institute of Management

December 20, Thursday. 7 am. 12 pm. 20 Thursday. December 2012 SuMo TuWe Th Fr Sa 1. January 2013 SuMo TuWe Th Fr Sa

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