PE GI Solutions (formly Physicians Endoscopy) first issue of EndoEconomics (now called The PE GI Journal) debuted in fall 2003 with the tagline, “Journal Dedicated to the Economic Issues Impacting GI Practices” (since updated to “A Journal Dedicated to Advancing GI ASCs and Practices”). One column in the inaugural issue stood out in particular, despite being the least economics-focused piece in the entire lineup. It hit at the very foundation of the PE patient-centered business model.
The column-titled “Patient Satisfaction-The Key” and written by attorney James Saxton-offered a plan for developing a service culture and incorporating service excellence strategies.
Fast-forward 15 years, and we at PE are reminded every day that the focus of our business, and that of our partners, is the patient experience. More than 8,000 patients on average visit PE partner centers every week. From the moment patients and their escorts walk in the door through the moment they leave, there are numerous opportunities to obtain feedback on efforts to make them feel like the highest priority. Each patient encounter, whether with a front desk representative, nurse, physician or even other patients, is critical to gauging our performance.
Not all patients who come into our centers are happy to be there. Some can prove difficult. This can be magnified further if staff members allow their personal challenges to influence the way they provide care. Staff and physicians must remember that each patient experience is a reference for the next patient experience.
Saxton wrote: “We must develop a certain service culture that is truly woven into your practice or facility. It is having the confidence that on a rainy Monday morning, even when the weekend did not go well, every individual in your organization is still turning it on to even the most unreasonable patient. It has to do with greetings, body language and demeanor, and it must be a consistent practice throughout your entire organization.”
But many patients viewed as “unreasonable” are being seen because they have experienced a change in their health. “They are seeking treatment or a diagnostic test that may belay fears or deliver devastating news. This is a heavy emotional burden for them, so a degree or anxiety and anxiety-related behavior can be expected,” says Robert Puglisi, PE Vice President of Operations. “Our response should always strive to be positive and focused on quality of care to everyone.”
A Model for Excellence
The groups that excel in this regard are those committed to activities focused on the patient experience, including ongoing physician and staff training, finding new initiatives to promote service offerings and using feedback to drive quality improvement. For South Broward Endoscopy in Cooper City, Florida, engaging patients is top of mind even before they walk in the door.
“We want patients to be informed and serve as active participants in their healthcare,” says Executive Director of Operations Shelly Daduk. “When patients are scheduled for their procedure, they are provided a brochure titled ‘What to Expect.'” This simple initiative helps prepare patients for the experience at the center, hopefully alleviating fears and building comfort.
South Broward Endoscopy also texts reminders to patients about their upcoming procedures and prep instructions. Staff members call patients to review their medical history and medications, review how to take their preps and answer questions. “We have a very friendly and well-educated staff,” Daduk says. “Our front office staff are educated in customer service skills and delivery. On the day of the procedure, patients and escorts are warmly greeted. Staff focus on communicating effectively with patients and practice active listening. They take pride in providing excellent patient care and buy into its importance.”
Harnessing the Power of Data
We want to help our centers make information-driven decisions based on quality data and metrics, cost metrics, center utilization, and physician and staff performance. To that end, we’ve dispatched tools that help our partners compare their performance internally and to the performance of peers and the broader healthcare industry. Puglisi works with partner centers to maximize the value of these tools, one of which is a patient satisfaction survey. “This survey, which is uniform across all PE centers that have chosen to implement it, measures our care to patients from a clinical and operational standpoint,” he says. “It gives us meaningful data to analyze.” On a monthly and quarterly basis, Puglisi, the PE operations team and center administrators receive reports on center performance and compare them to previous findings. “If there is a result lower than anticipated, the center administrator and I will work to pinpoint the issue. Based on what we determine, the administrator will share the information during staff meetings, reviewing what changed, what we think was the cause and what education will be provided to improve performance. The information is also shared with the center’s board of directors,” Puglisi says.
Patient satisfaction survey results help South Broward Endoscopy make positive changes. “Staff is incentivized to achieve exceptional patient satisfaction through a quarterly bonus program,” Daduk says. “Recently, after reviewing patient feedback, we set an internal benchmark and achieved shorter wait times.” In addition to rating a center’s performance, patients can freely share thoughts on their overall experience and ideas for improvements. “We want to know if patients feel they received personalized, quality care or if they were treated like an item on an assembly line,” Puglisi says. “If someone had a bad experience, we want to know about it.
If patients identify themselves on their surveys, we will reach out. The more we can learn, the better we can improve ourselves and their experience.” But measuring and improving patient satisfaction must be more than a monthly or quarterly exercise. Satisfaction rates and perceptions of centers can change quickly. One bad experience can harm a center, especially if the individual takes to public forums to express their displeasure.
As patients leave the facility, the best question we can ask them is, “Now that you’ve been through the experience yourself and know it’s maybe not as bad as you expected, who is the next person you would recommend to our center?” Much of our business is driven by word of mouth. With a large portion of the population skipping colorectal cancer screening, there’s a lot of potential untapped business. The best way to capture the population not coming in is by referral, and you earn referrals by making sure patients are willing to recommend your center. This is an area I think our centers do well. Let’s conclude with a final thought from Saxton that rang true in 2003 and still applies today: “Truly incorporating service excellence strategies into your organization is hard work but is extraordinarily worthwhile.”
I frequently say, “Everything is a learning experience.” When we see something that does not represent the best of us, we must find out how to do it differently or better. For providers, that attitude should carry over to every encounter.
What Truly Matters
People are not typically excited about coming to our business. Right off the bat, we’re fighting an uphill battle to provide an enjoyable experience. That’s why, when someone chooses to come to us, we must make it the best experience we can, taking into consideration his or her preconceived notions.