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© 2007 Studer Group
Patient Loyalty: Making a Difference
Barbara Hotko, RN, MPAStuder Group Coach
January 12, 2011
© 2010 Studer Group
Today’s Session
Patient loyalty – why?
Measure what matters most
Tools for success
© 2010 Studer Group
Patient Loyalty Pays: Treating patients with respect adds up to satisfaction & repeat visits
“Satisfied patients return for care, and the positive word of mouth from satisfied patients will bring new patients into the practice.” (Drain & Kaldenberg 1999, 32).
A better patient rating of information quality and physician quality was “associated with patients reporting that they would definitely return” for care. (Lechtzin, Rubin, White, et al 2002, 1326).
“The compassion with which care is provided appears to be the most important factor in influencing patient intentions to recommend/return, regardless of the setting in which care is provided.” Burroughs, Davies, Cira, Dunagan 1999
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
© 2010 Studer Group
Patient Loyalty Pays: Treating patients with respect adds up to satisfaction & repeat visits
“Treatment with respect, the rating of care received, and the helpfulness of the person at the front desk are the strongest predictors of patient satisfaction…patient satisfaction is highly correlated with intent to return and intent to recommend services.” Hill & Doddato (2002, 108)
“Patient satisfaction will significantly influence the intent to return and intent to recommend services to others; thereby serving as a determinant for repeated clinic visits, new patient visits, and program marketing.” Hill & Doddato (2002, 108)
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
© 2010 Studer Group
Patient Loyalty Pays: Satisfaction, Loyalty and Profitability are linked
Loyalty has been an area of focus both within and outside of the health care industry for sometime. The links between customer satisfaction, loyalty, and profitability have been well established. (Reichheld 1996)
High levels of satisfaction with a service relationship will override service failures, suppress shopping for another service provider, and maintain high compliance. (Forrester & Maute 2001)
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
© 2010 Studer Group
1 2
50%50%
1. Yes2. No
Health Managers Network: Building Patient Loyalty
Are you measuring patient satisfaction?
© 2010 Studer Group
1 2
79%
21%
1. Yes2. No
Health Managers Network: Building Patient Loyalty
Are you measuring patient turnover?
© 2010 Studer Group
1 2 3 4 5 6
56%
22%
9%
2%4%
7%
1. Insurance change2. Dissatisfaction with
provider and/or staff
3. Geographic location4. Disagreement with
treatment of care5. Wait time (while in
office)6. Appt. availability
Health Managers Network: Building Patient Loyalty
What is the #1 reason patients leave your practice?
© 2010 Studer Group
Patient Loyalty Pays …
A “high level of satisfaction will lead to greatly increased customer loyalty …And increased customer loyalty is the single most important driver of long-term financial performance.” (Jones & Sasser 1995, 88)
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
© 2010 Studer Group
The Cost of Dissatisfaction
The other side of the satisfaction-loyalty link is the link between dissatisfaction and loss of revenue due to patients who switch providers or hospitals. Through the Healthcare Financial Management Association reports:• For every one customer who complains, 20 dissatisfied customers do not.
• Of those dissatisfied customers who do not complain, 10% will return but 90% will not.
• Changing a poor customer service image takes 10 years average.
• It costs 10 times as much to attract new customers as it does to keep current ones.
• About 10% of revenue is lost to poor customer service.
• The average “wronged” customer will tell 25 others about the bad experience. Zimowski (2004)
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
© 2010 Studer Group
The Cost of Dissatisfaction
Patients dissatisfied with physician care and practice are more likely to leave. (vom Eigen, Delbanco, Phillips, 1998)
Conservative estimate: In a practice with 6,000 patients, if 5% are dissatisfied and leave with members of their household (assuming 3.5 members per household and 2.5 visits per year, this would be 8.75 visits per household per year), and the average visit averages $57 in payments, the cost of dissatisfaction is $149,625. Using the Consumer Price Index, this would equate to over $180,000 in 2006 dollars (http://www.measuringworth.com/uscompare/). Drain
and Kaldenberg (1999)
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
© 2010 Studer Group
Patient Loyalty
To earn patient loyalty, your staff will need to provide excellent care for every patient in every encounter.
In order to do so, staff will need:
Actionable Data
Tools
© 2010 Studer Group
AHMG surveys patients by clinic and by physician
Sample survey questions:
Staff make me feel like I am important and valued
The doctor listened to me and showed respect of what I had to say
Overall Experience
Recommend to family and friends
© 2010 Studer Group
“What patients want” in rank order
1. Treats you with dignity and respect
2. Listens carefully to your health concerns
3. Easy to talk to
4. Takes concerns seriously
5. Willing to spend enough time with you
6. Truly cares about you and your health
Source: Harris Poll, 2004
© 2010 Studer Group
Studer Group Five Fundamentals
A
I
D
E
T
Acknowledge
Introduce
Duration
Explanation
Thank You
Safety
Decrease Anxiety
Quality
Patient Loyalty
Increase Compliance
© 2010 Studer Group
Improved clinical
outcomes and increased
patient and physician
satisfaction
Advantages of AIDETSM
DecreasedAnxiety
IncreasedCompliance+ =
Decrease anxiety with increased compliance
© 2010 Studer Group
Physician and staff AIDET
training
Outcome – AIDET
University Medical Center
Physician Practices
Tucson, AZ
© 2010 Studer Group
FPA - Otolaryngology
* Percentile ranking
3rd Qtr 08
4th Qtr 08
1st Qtr 09
2nd Qtr 09
Overall Results OtolaryngologyPercentile RankMean (raw score)
13Mean 83.5
n=30
33 Mean 88.9
n=31
35Mean 89.2
n=82
69Mean 91.9
n=49
Access to Care * 16 40 40 55
Visit * 16 34 17 42
Nurse/Assistant * 5 53 48 91
Care Provider * 17 40 49 80
Personal Issues * 9 10 30 59
Overall Assessment * 24 46 60 74
© 2010 Studer Group
Acknowledge
A Acknowledge
Key message: YOU are important
Eye Contact Make the patient feel that you
expected them
© 2010 Studer Group
Introduce
First Generation
Name Title Specialty
Next Generation
Your role in the team of care givers
Your experience, skill set, or credentials
Coworkers, physicians, other departments, AHMG
I Introduce
© 2010 Studer Group
Manage Up!
A Short Bio
© 2010 Studer Group
“Hi, I’m Georgette. I’ve been with Dr. Smith for over three years and he is excellent. Welcome to our practice.”
“We have a great staff and we are going to take very good care of you.”
“Dr. Jones takes the time to answer each patient’s questions.”
“Good Morning, Mrs. Smith. My name is Ann. I am a medical assistant and I have been working in this practice for five year.”
Examples of Managing Up
© 2010 Studer Group
“Because greetings are one way to ensure proper
identification of patients, they may well be considered a
fundamental component of patient safety”
The A and I of AIDET for Safety
© 2010 Studer Group
Duration
D Duration
Key Message: I anticipate your concerns
How long will the registration process take?
How long will the test, procedure, or appointment actually take?
How long will it take to get the results?
Goal: Keeping Patients Informed
© 2010 Studer Group
Keeping Patients Informed of Duration
© 2010 Studer Group
Explanation
E Explanation
Listen to the patient’s story: Active listening Clarifying questions Understanding patient’s perspective
Explain the treatment plan: Using language that patients can
understand Use “key words” Use “tell, ask, tell” approach Involve patient in decision making
© 2010 Studer Group
Explanation
E Explanation
Why are we doing this?
What will happen and what you should expect?
What questions do you have? (about medications, instructions for follow up care)
© 2010 Studer Group
Reality of Explanation
During a 20 minute encounter
Physicians self-report spending 9 minutes “providing information”
REALITY: Physicians spent 1.5 minutes
The key driver for patient
satisfaction
The quality and clarity of
information that patients
receive from physicians
© 2010 Studer Group
Patient Perspective
72% of patients unable to list medications they take
58% of patients unable to recite their own diagnosis
Mayo Clinic Proceedings, 2005
© 2010 Studer Group
Thank You
T Thank You
Key message: I appreciate the opportunity to care for you
Closing Key Words Thank you for choosing us Thank you for your patience today Thank you for coming in today, I know we can help
© 2010 Studer Group
AIDETSM
Vanderbilt University Medical Center, Nashville, TN
© 2010 Studer Group
Loyal Patients
Loyal Patients will …
Return
Advocate for you in the community
Talk
© 2010 Studer Group
Creating Patient Loyalty – THE WHY
Improves patient compliance
Improves clinical outcomes
Improves patient satisfaction
Increases growth and market share
Reduces malpractice risk
Improves physician satisfaction
Improves clinical efficiency
© 2010 Studer Group
Practicing Excellence
A guide to implementing specific behaviors that will create a high performance workplace
Written by a physician
Available online at www.studergroup.com
© 2010 Studer Group
Thank You!Barbara Hotko
Partner Relations CoordinatorLauren Holstman
850-343-1057
www.studergroup.com