Point well-stated Tony!

Research by Fred Reichheld indicates a strong correlation between an organization's Net Promoter Score and business growth. Ultimately, consumers of healthcare are no different from any other type of consumer: they simply want the best value for their money. That's why it's crucial to carefully monitor and perform well on all measures of customer evaluation. This holds true whether you are an auto body repair shop, a restaurant, a home improvement store, or a hospital.

First, as a newcomer to this site, thanks for providing a place to discuss these important ideas.

No doubt, providing a "5" experience is what our patients deserve. Increasingly, as hospitals as well as service providers across industries raise their performance levels, it's also what patients (who are called consumers by these other industries) expect. But giving a 5 experience “sometimes” isn't the hard part. The body shop in your blog probably did get the fuel level right for most of their customers that day. If everything else went as smoothly for them, they probably got a lot of 5's that day.

But they didn't have a culture coupled with processes that combined to create a hardwired culture, a high reliability organization that consistently, predictably, reliably produces great outcomes. One of the most interesting trends to follow will be how hospitals respond to the advent of the new HCAPHS scoring, which asks whether a patient "always" saw certain behaviors occur during their experience with the hospital. Through HCAHPS we will finally have a way of assessing how hardwired these "5" experiences are. Since everyone will be assessed using the same questions and methodology, the results will be comparable. And CMS plans to share the results online just like they are beginning to share quality data.

So how will consumers respond? Will this be the tipping point of transparent information that finally gives consumers enough meaningful information to change the way they decide where to seek care? Will this collective experience of patients trump the advice of their friend who had a good experience? Clinical quality has proven difficult to translate to consumers; it’s tricky to present in a way that maintains the integrity of the data while making it easy to understand. But we all know what a “5” experience feels like, whether we’re talking about the body shop or the hospital experience. Of course, patients still don’t have quite the freedom to choose providers that car owners have in selecting the place to get their car fixed, but that’s getting a little easier to do all the time as our payment systems change. It will be an interesting trend to follow.

There’s so much good that happens everyday in our industry. And having more transparent, comparable data on our performance will only help show us where we need to improve. Where the rubber hits the road is using evidence-based tactics to improve performance. As an industry we’ve spent a lot of resources to identify those clinical best practices. Now we need to apply the same rigor to identify and implement the evidence-based leadership techniques that drive performance across the organization.

By the way, since auto repair shops are famously aggressive in getting customers to fill out satisfaction surveys it’s great that you’ll have a chance to show them how to improve. Now let’s see how they respond to your feedback!

both of you bring up great points. part of the issue is a cultural one. "Hardwiring" a culture that minimizes these service deviations is key, but so is recovering with grace.

If I remember correctly those that rank you 5 out of 5 are 6 times more likely to refer others to you than a 3 or 4 out of 5.

Absolutely. A great point. Even at six sigma levels there are by definition defects, so focus on prevention and be ready for the inevitable need to do service recovery. I liken this to the great patient safety model of the "error troika" to describe how to design safe systems . . . systems should be designed to avoid errors; if the error isn't avoided, the system should be able to "trap" it as it is unfolding; and if the trap doesn't work the system needs to be able to mitigate the harm that the error might cause. So, for great service, let's design a system that produces "5" experiences as reliability as is possible; identifies the less than 5 experiences as they happen so that we can course correct; and service recovery for the inevitable cases that escape even the most perfect systems.

Thanks for the blog - I enjoy surfing and seeing what people are up to - keep up the hard work ~ Grabby