Patient Loyalty: Making a Difference

1. Patient Loyalty: Making a Difference Barbara Hotko, RN, MPA Studer Group Coach January 12, 2011

2. Today’s Session • Patient loyalty – why? • Measure what matters most • Tools for success

3. 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

4. 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

5. 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

6. Health Managers Network: Building Patient Loyalty Are you measuring patient satisfaction? • Yes • No

7. Health Managers Network: Building Patient Loyalty Are you measuring patient turnover? • Yes • No

8. Health Managers Network: Building Patient Loyalty What is the #1 reason patients leave your practice? • Insurance change • Dissatisfaction with provider and/or staff • Geographic location • Disagreement with treatment of care • Wait time (while in office) • Appt. availability

9. 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

10. 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

11. 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

12. 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

13. 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

14. “What patients want” in rank order Treats you with dignity and respect Listens carefully to your health concerns Easy to talk to Takes concerns seriously Willing to spend enough time with you Truly cares about you and your health Source: Harris Poll, 2004

15. Studer Group Five Fundamentals A Acknowledge Safety Decrease Anxiety I Introduce Increase Compliance D Duration E Explanation Quality Patient Loyalty T Thank You

16. Advantages of AIDETSM Decrease anxiety with increased compliance Improved clinical outcomes and increased patient and physician satisfaction Decreased Anxiety Increased Compliance + =

17. Outcome – AIDET Physician and staff AIDET training University Medical Center Physician Practices Tucson, AZ

18. FPA - Otolaryngology * Percentile ranking

19. Acknowledge A Acknowledge Key message: YOU are important • Eye Contact • Make the patient feel that you expected them

20. Introduce I Introduce First Generation Next Generation • Your role in the team of care givers • Your experience, skill set, or credentials • Coworkers, physicians, other departments, AHMG • Name • Title • Specialty

21. Manage Up! A Short Bio

22. “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

23. The A and I of AIDET for Safety “Because greetings are one way to ensure proper identification of patients, they may well be considered a fundamental component of patient safety”

24. 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

25. Keeping Patients Informed of Duration

26. 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

27. 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)

28. 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

29. Patient Perspective • 72% of patients unable to list medications they take • 58% of patients unable to recite their own diagnosis Mayo Clinic Proceedings, 2005

30. 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

31. AIDETSM Vanderbilt University Medical Center, Nashville, TN

32. Loyal Patients Loyal Patients will … • Return • Advocate for you in the community • Talk

33. 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

34. A guide to implementing specific behaviors that will create a high performance workplace Written by a physician Practicing Excellence Available online at www.studergroup.com

35. Thank You! Barbara Hotko bhotko@studergroup.com Partner Relations Coordinator Lauren Holstman 850-343-1057 www.studergroup.com