Improving Healthcare Service Quality: Listen to the Patient and Take a Comprehensive Approach

Special Article – Quality Improvement

J Fam Med. 2015; 2(5): 1040.

Improving Healthcare Service Quality: Listen to the Patient and Take a Comprehensive Approach

Nordrum JT¹ and Kennedy DM²*

¹Department of Family Medicine, Instructor in Physical Therapy, Mayo Clinic College of Medicine, and Operations Administrator, Mayo Clinic Arizona, USA

²Department of Administration/Division of Quality Management, Assistant Professor of Healthcare Systems Engineering, Mayo Clinic College of Medicine, Mayo Clinic Arizona, USA

*Corresponding author: Kennedy, DM, Department of Administration/Division of Quality Management Mayo Clinic Arizona, 13400 E. Shea Boulevard, Scottsdale, AZ 85259, USA

Received: November 25, 2015; Accepted: December 14, 2015; Published: December 17, 2015

Abstract

With healthcare reform legislation and the spread of value-based payment models, traditional healthcare quality measures have evolved to include patient perception of the experience of care. Citing concern that many factors outside the organization’s control could arbitrarily influence patient perception, many healthcare leaders have opposed Medicare’s weighting of patient satisfaction data in its value-based purchasing formula. We contend that the patient’s perceptions of various dimensions of service quality are integral to its improvement. The aim of this article is to share Mayo Clinic Arizona’s (MCA) “7-prong” model for service quality improvement, as well as key lessons learned with its implementation in our Family Medicine Department. The model incorporates these service quality principles: (1) multiple data sources to drive improvement; (2) accountability; (3) service consultation and improvement tools; (4) service values and behaviors; (5) education and training; (6) ongoing monitoring and control; and (7) recognition and reward. The model is driven by service-related data and a culture of accountability. A few key lessons, learned over the past several years, are shared to help other healthcare organizations on their service quality improvement journeys.

Keywords: Healthcare quality; Service quality; Patient experience; Quality improvement

Introduction

For decades, healthcare leaders have used industrial methods, such as total quality management, lean, and Six Sigma, to improve process quality and organizational performance. Value-based payment models, which combine clinical and service quality measures to determine medical care reimbursement, have placed more emphasis on improving service quality and the patient experience. This shift has given healthcare leaders an opportunity to re-examine and improve their organizations’ patient-centered focus.

Patient perception of quality of care is subjective. Some healthcare groups have opposed the weighting of patient satisfaction data in Medicare’s value-based purchasing formula, citing regional and patient-related factors that could randomly influence perception [1,2]. Most healthcare and service quality leaders would agree that only a minority of patients (e.g. those with clinical training) have the technical expertise to judge quality of care. The remainder use service dimensions (e.g. interpersonal skills and facility cleanliness) as proxies [3,4]. As customers of service giants such as Amazon, Starbuck’s, and Southwest Airlines, patients know quality service when they experience it. Patients interact closely with front-line staff throughout the organization, giving them a unique perspective on the staff’s empathy, service attitude, and friendliness, as well as the provider’s communication skills and the efficiency of operations. Given their vast customer service experience outside healthcare and their close proximity to the front-line staff, there is no better way to evaluate the impact of service quality on the patient experience than to ask the patient.

A service experience consists of countless points of contact with an organization and its front-line staff. Service breakdowns are inevitable at any of these touch points [5], especially in highly complex systems. Healthcare organizations should monitor patient feedback to anticipate service breakdowns and adopt a comprehensive approach to service quality improvement. The aim of this article is to share Mayo Clinic Arizona’s (MCA) “7-prong” model for service quality improvement, as well as key lessons learned with its implementation in our Family Medicine Department. The model (Figure 1) is driven by service-related data and accountability and has demonstrated efficacy in specialty [6] and primary care [7] settings. The model incorporates seven widely accepted service quality principles: 1-multiple data sources to drive improvement; 2-accountability for service quality; 3-availability of service consultation and improvement tools; 4-service values and service performance standards; 5-service education and training; 6-ongoing monitoring and control of service quality; and 7-recognition and reward.

Citation:Nordrum JT and Kennedy DM. Improving Healthcare Service Quality: Listen to the Patient and Take a Comprehensive Approach. J Fam Med. 2015; 2(5): 1040. ISSN : 2380-0658