Quality Through the Eye of the Beholder: How your patients perceive your organization

Imagine walking into Nordstrom's or Macy's, expecting to enjoy a quality shopping experience. Instead, you find clothing crumpled on the ground, sticky fingerprints all over the display cabinets, and inattentive salespeople taking personal calls on their cell phones. You'd almost have to go back outside and check the sign above the door to make sure that you'd walked into the right store, as the experience inside clearly isn't living up to the store's reputation or the image that its advertising projects.

Consumers today are almost conditioned to notice inconsistencies such as these. They expect quality merchandise and service at Nordstrom's, they expect fast, inexpensive food at McDonalds, and they expect a wide range of hot drink choices at Starbucks. These organizations have established those expectations through their brand promises. And they know that it's up to their employees to deliver on those expectations during every customer interaction.

In the same way, healthcare organizations have been attempting to shape consumer expectations for quality when they tout their patient satisfaction or quality scores. But what does "best patient satisfaction" or "highest quality indicators" mean to the average healthcare consumer? What constitutes a quality healthcare experience for the average patient and her family? And how do you go about ensuring that quality experience for every patient, during every encounter, every day?

Differing Definitions of Quality

To a healthcare organization, quality is usually defined as a statistical score, a point on a graph, or some numerical progress towards a goal. Healthcare organizations invest a lot of time and effort into achieving quality goals and comparing their scores with national benchmarks.

These objective benchmarks of quality are very useful to healthcare organizations. They help us determine if we're living up to our missions and achieving organizational goals. Furthermore, it helps us keep up with the latest clinical standards.

But are they the same definitions of quality that healthcare consumers have? If you asked a consumer to define "quality healthcare in a hospital setting," she'd most likely mention things like bedside manner of the nurses and doctors, responsiveness to concerns, or pain control. That's because she expects the hospital and the providers to deliver clinically competent care. Similarly, if you ask a consumer to gauge quality in a clinic setting, the response is going to be about access, courtesy, and clear, prompt information about lab results.

When Do Consumers Evaluate Quality?

When a healthcare organization reviews any of its quality indicator scores, it's often doing so months after the actual experiences took place.

Consumers, on the other hand, are mentally evaluating the quality of an organization the moment they first interact with it--whether it's a face-to-face, telephone, or online interaction. These moments of truth occur over and over again within a single encounter with an organization.

Much like the disappointing department store experience described earlier, healthcare consumers will be equally dismayed to enter a physician's office and find overflowing trash cans in the waiting room, paper signs curling off the walls, and inattentive staff eating at the front desk while discussing patients' charts.

Every single one of these moments of truth is an opportunity for your staff to build the consumer's trust in your organization and enhance your reputation for quality. Every day, a countless number of these prime opportunities are lost when employees make unwarranted comments or simply don't engage the patient with the right words or actions at the right times.

When a patient is expecting courteous, compassionate treatment, even a small gap between expectation and reality--such as minimal eye contact from a harried and distracted nurse--can leave an overall negative impression. Take a look at your organization through the eyes of your consumers. Is wayfinding clear? Do patients feel as if their privacy is guarded? Is information shared appropriately and in language that consumers can understand?

Everything that the patient experiences should instill trust in the organization. I am constantly reminding my clients and readers to filter their actions through the eyes of the consumer. Look around and answer this question; if everything speaks, what are you saying? Does the environment reflect high quality? Do the employees conduct themselves in a way that speaks quality?

Opportunities Abound

So what's the best way to close any gaps between your definition of quality and your consumers' definition? Start by making sure that everyone sees quality as their number one priority. The responsibility cannot rest solely with those whose job descriptions include responsibilities for quality. Make sure that everyone is accountable for the customer experience. Reward and recognize those who do it best and strive to create processes of support.

All employees need to view their jobs through the consumers' eyes. Each day, every employee encounters countless opportunities to ensure a quality experience for every patient. For example, to the consumer, a receptionist should answer the phone promptly with a friendly tone, address questions with clear answers, and exhibit empathy. A housekeeper should ensure that public areas are clean, inviting, and free of odors. And no matter what your title, consumers expect all employees to make eye contact and greet them in the halls as a standard.

The interview is the best place to start. Find out how the candidate sees his role in relation to service. During orientation, start encouraging employees to put themselves in their customers' shoes. Role playing various interactions, with new employees acting as the patients and family members, is a memorable way to inspire employees to look at their jobs from a different perspective.

Anytime a patient or family member writes a narrative comment on a survey or sends a letter to the organization is another opportunity to help employees understand that they're not just starting an IV or taking an x-ray. They're building the patient's trust in themselves, their department, and the organization. And, ultimately, they're helping to build a reputation for quality.

In the end, once we become adept at looking at healthcare experiences the same way as our patients, we're also helping to bolster those patient satisfaction and quality indicator scores that we use to define quality comparisons with our peers.

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