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Ensuring patient satisfaction and establishing good practice:

Ensuring patient satisfaction and establishing good practice


Introduction Patients are the foundation of our medical practice It is very obvious that they must be satisfied Do we always succeed?

Some experiences Patients tell the truth :

Some experiences Patients tell the truth

PowerPoint Presentation:

“Quality service? I don’t ask for much from my doctors.” The woman, a business professional in her late 30s, seemed pleased to be asked. “I don’t want to wait endlessly, but I understand it if something comes up in the schedule to cause a delay – just tell me about it! I’m much more forgiving if someone keeps me informed”.

PowerPoint Presentation:

“I like to feel that I have my doctor’s attention during the visit. I don’t expect a half hour of his time, just a sense of concern. My pediatrician is wonderful. He always remembers something personal about my child. When he talks to me, he looks right at me – not at his paper work or forms or does not talk on phone”

PowerPoint Presentation:

“His staff is friendly. They make me feel welcome and not like an interruption in their day. He explains things so they make sense, and he gives me information that I can take home and read. I’m not just a ‘case’ to him.” “Patients don’t care how much you know until they know how much you care” - Sir William Osler

PowerPoint Presentation:

Dynamics of medical practice today Patient as a customer Doctor as a service provider

In the past :

In the past Doctor was God Supreme authority

Medical practice as business activity:

Medical practice as business activity Health care as one of the largest service sector industry Huge capital investments- expected returns Drivers: technology, health regulations, health insurance, CPA, standard of living, influence of media, internet Customer – service provider Customer is the king

Patient satisfaction pays:

Patient satisfaction pays Greater profitability. Improved patient retention and patient loyalty. Increased patient referrals. Improved compliance. Improved productivity. Better staff morale. Patient satisfaction pays Reduced staff turnover. Improved collections. Greater efficiency. Reduced risk of malpractice suit. Personal and professional fulfillment. The process of ensuring patient satisfaction Patient Satisfaction = Clinical Quality + Service Quality TQM (Total Quality Management) A systematic comprehensive process for improving the quality of every activity and interaction in an organization. Patient satisfaction goes even beyond principles of TQM It is about quality service in medical practice. Establishing good practice Synonymous with Ensuring patient satisfaction

“The Quality Diamond” Model of patient satisfaction.:

“The Quality Diamond” Model of patient satisfaction. QUALITY MEDICAL CARE

PowerPoint Presentation:

QUALITY MEDICAL CARE Commitment Customer Expectations Continuity

The Customers : types:

The Customers : types Difficult to deal with : Demanding, annoying, unrealistic, loud and objectionable. Desirable: pleasant, easygoing, intelligent, accommodating and knowledgeable Others: timid, questioning, unprepared, lacking in knowledge and uncertain about what they want or need. Have to handle all

Commitment :

Commitment Emotional and intellectual pledge to a course of action Your commitment to quality services must be 100%. If you are interested in something, you do it when you have time. If you are committed to something, you make time to do it.

Guidelines to ensure commitment to quality:

Guidelines to ensure commitment to quality The physician needs to be a participative leader with conviction. Have a statement of mission and vision for quality services and share it with the staff. Recruit a high performance staff Build a team which is committed to quality services.

Ensure commitment:

Ensure commitment Empower the employees to achieve goals of quality services Ensure staff satisfaction and motivation by various means like good salary, appreciation for good work and imparting a feeling of importance

Ensure commitment:

Ensure commitment Do some medico-social activities in the hospital premises or get involved with similar activities done by other organizations. Have accreditation by some regulatory authority or agency (e.g. ISO).


Expectations (1) Medical (Clinical) expectations: These relate to accurate diagnosis and treatment. This is dependent on the medical core competence. (2) Non-Medical expectations: These relate to physical facilities and functional components of services.

Few general expectations :

Few general expectations To have clinical core competence. Cure rate does matter Luxurious physical facilities can’t substitute CME Good clinical methods Exude confidence Rational therapy Evidence based practices

Few general expectations:

Few general expectations Honor the appointments. Appointment system should be accurate but flexible. 3. Communicate well with them in day to day language. Medical jargon should be avoided. 4. To listen to their problems patiently and give them enough time. Master the art of listening

Few general expectations:

Few general expectations 5. Show personal concern for the patient. Body language ,greeting , a good first impression of a caring physician, make it visible that we are with them in their worst times too. 6. To explain everything about the illness and treatment. A short detour through the illness - etiology, pathology, clinical features, diagnostic investigations, treatment and prevention

Few general expectations:

Few general expectations 7. Staff which shows care, concern, courtesy and empathy. Patients spend more time with paramedical staff Behaviour and attitude of the staff Ask to go beyond the rules of duty to help Handle personal and telephonic conversations Promptness in all responses Emergency case, admissions

Few general expectations:

Few general expectations 8. Provide reasonably good physical facilities. Both outdoor as well as indoor Approachable location with good parking facility Child friendly environment, cleanliness, facilities for recreation (library, toys, music, TV etc.) Proper place for eating Enough space for various facilities. 9. Impart health education: handouts, video examples.

Few general expectations:

Few general expectations 10 Proper documentation. Good legible prescriptions, a detailed discharge summary, certificates, prompt issue of papers for mediclaim Clear explanation for administration of medicine to ensure compliance. 11.To provide hospital information brochure and to have informative sign boards.

Few general expectations:

Few general expectations 12. To have transparency in financial matters. One of the major causes for dissatisfaction Proper display of routine consultation and indoor charges Should be properly informed about the expected expenditure before any procedure or admission .

Few general expectations:

Few general expectations 13. To use modern technology. Computerization and adaptation to new technology for diagnostic and therapeutic purposes. 14. To have easy flow between various services. Patient should not be wasting time to avail of various services.

Factors affecting expectations:

Factors affecting expectations Nature of medical illness. Past experience in the same set up. Experience at other set up. Financial and social standing. Level of education.

Measuring expectations:

Measuring expectations 1. Direct approach : Simple but effective technique. Can be used by doctor as well as the staff. 2. Questionnaire : This can be designed according to the services provided. Suggestion Box : Outdoor as well as indoor facilities This box should be periodically opened.

Measuring expectations:

Measuring expectations Listening to the staff : Patients often talk more freely with the paramedical staff. Listening to the patient : Their past experiences at other hospitals, a valuable insight into causes of dissatisfaction Analyzing a discharge against medical advise : An opportunity to analyze the short comings in the services and improving upon them.

Meeting expectations - few principles::

Meeting expectations - few principles: 1. Have systems in place to meet general expectations. This involves hospital administration. 2. Be flexible because expectations keep changing. 3. May not be able to meet all expectations, but one must try to manage. Managing expectations means patient listening and then explaining as to why we can not meet those expectations.

Meeting expectations - few principles:

Meeting expectations - few principles Unrealistic expectations may be gently managed through patient education. 5. Take a walk in your patient shoes. Look at the whole set up from patients’ point of view and find out good and bad things about our set up. This helps us to delete the negatives and enhance the positives.

Meeting expectations - few principles:

Meeting expectations - few principles 6.“Delight the customer” is the buzz word .Going beyond the patients’ expectations. Anticipatory guidance or asking the nurse to supervise and train a mother for breast feeding in an OPD visit 7.Master the art of handling difficult patients. Consider them as the people who are testing the quality of your services.

Meeting expectations - few principles:

Meeting expectations - few principles 8. Service Recovery (when things go wrong): Apply the triple A action plan. The steps are Acknowledge, Apologize and Amend. Accept that mistakes do occur, but should make all efforts to prevent them. Analyze the factors leading to mistakes and try to correct them. Differentiate between the wrong act and the doer. Criticize the wrong act and not the doer.


Continuity Loop-closer in the quality diamond model. A method for ensuring continuous, consistent, ever-improving and never ending service quality. All the ways and means of measuring, evaluating and monitoring the progress.


Continuity It ensures that services get better day after day. “Can we do better?” is the guiding question It is about accepting the fact that what you do today may not be appropriate or effective tomorrow. Things do change.


Continuity Benchmarking . Looking beyond to other setups for better services and customer satisfaction. Opens windows of our mind and let in new ideas. Setting standard of service for all aspects Continuity also requires monitoring patient satisfaction. A formal comprehensive process for determining patient satisfaction, may be in form of questionnaire

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