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My cookbook lists these as small distractions, tasty tidbits. Not exactly appetizers. So, let me comment on comments and add a few small thoughts:
1. Quality is satisfying customer needs or desires. There are levels of satisfaction, from merely OK to delightful. I love to fly on Midwest airlines with someone who has never done that. Wow! Satisfy a need before the customer knows he has it. The Sony Walkman is a classic example. (Who asked for a portable tape machine?) Apple does this regularly. (That's why I own their stock.)
2. Satisfaction is the difference between what you expect and what you get. I expect a long wait at the airport. Especially at Dulles. Especially with United. So, I'm not unhappy when it happens. I recently called a Lexus dealer at the midpoint of a long trip, because the fan wasn't working well. He picked up the car in 20 minutes, installed a new fan on time and on budget, and washed the car. Delightful!
3. Before my trip, I took the car to have the front wheels balanced. The tire store did that, on time and on budget. But it didn't solve the problem. It was the rear tires that were out of balance. They did what I asked but didn't do what I needed. Satisfied, yes, but not delighted. Lower expectations.
4. ISO 9001:2000 requires you to determine customer needs and measure how well you're meeting those needs. That's a new concept in healthcare. We tend to take a paternalistic view and assume we know what the patient needs. The IOM definition of quality talks about technical aspects of healthcare--achieving the expected result, improving the patient's health, etc. But for most patients, that's a given. We expect technical excellence. Now, let's talk about starting on time, no pain post op, free parking for my wife when she comes to visit, etc.
5. Communication is a key to satisfaction. The customer must know exactly what you will deliver. Then, they will be happy when you do so. I have been amazed at how long patients will wait for ambulatory surgery if you keep them informed of the progress in the OR. (We set kitchen timers for reminders.) Remember, communication goes both ways. We recently had an unhappy patient who arrived from overseas for a consultation but didn't know where to go. Our office had sent a message but failed to confirm that she received it.
6. To truly delight a customer, you've got to give him something he didn't expect. Last year, I ordered a computer from Apple. They promised delivery in 7 to 10 days, and it arrived on day 11. Not a big deal, but i mentioned it on their post-delivery survey. Someone called! A live human who spoke English. Turns out, the delay was with FEDEX. "But they work for us, and we take responsibilty for their performance." She sent me a credit on my next purchase. Marvelous! I didn't expect a survey. Didn't expect a call. And didn't expect a credit. Nice to see them accept responsibility for their suppliers.
7. In a dying gasp, the Republican administration is calling for "Value-Driven healthcare purchasing. By this, they mean electronic health records, reporting on performance, transarency of pricing, and incentives for quality care. No new ideas, and no money behind it. Fluff.
More on any of this, if there's interest.
Comments
Airline quality is reportedly going down and I can state that the reports are accurate. Flight delays, no food service, no blankets or pillow, $3 for M&Ms on the plane. What concerns me is the quality that we always have assumed to be there and never questioned - the pilot is qualified, the engines have been meticulously maitained to avoid failure. I hope that quality is not also going down.
In healthcare, we need to stop being "patient-centered" and become "customer/consumer-centered. So often the patient has to wait long past the appointed time to be seen by the provider - we fail to realize that that person's time is valuable too - some are self-employed or are paid by commission. Time is truly money for them. If we had to wait an hour for dinner at a restaurant, we most likely would not return yet we do this almost without question in healthcare.
I'm glad to see Medicare/CMS finally saying to hospitals that they will not be paid extra for hospital caused complications (infections, etc.) The shoe is finally on the right foot.
Finally, in a book about hotel service "Chocolates on the pillow", the author discusses customer experience management. He states "This means that the leaders of the organization must learn to examine the customer experience as a totality, understanding the importance of every touchpoint, emphasizing with what clients need and want at each one, empathizing with what clients need and want at each one, and then designing the organizational structure to provide it." We, in healthcare need to do the same.
John Harrison, RN, ASQ-CMQ/OE
Posted by: John Harrison, RN, MHSA | September 21, 2007 11:16 AM