Patient Relations

The Intentional Patient
Improving customer service in healthcare


Many healthcare systems invest considerably in providing their patients not only the best health outcomes but also the highest levels of customer service. However, improving customer service in any healthcare system requires a culture that intentionally champions a patient focus.

Clear intentions and strategies at the leadership level within the healthcare system will determine whether a service mindset can exist within an organisation. The engagement of employees and their connection to this mission will determine whether that mindset is actually lived out daily.

A service-centred culture requires alignment in five key areas (figure 1):

- a committed leadership team that champions a philosophy that is aligned with service

- employee commitment to providing outstanding service and quality

- the strategic alignment of the organisation’s plan, policies, and procedures with the goal of being service-focused

- an established process for documenting and disseminating organisational knowledge and efficiencies

- an ongoing commitment to improving performance and using proven tactics

It is difficult to execute any vision for change in a service-oriented industry - even when leaders clearly communicate it to the organisation – without an engaged and motivated workforce. Health systems with a strong service-oriented culture tend to recruit and hire people who fit that culture, and begin sharing the vision during the recruitment phase and through orientation and onboarding.

The healthcare system must implement regular feedback mechanisms in the early stages of a healthcare professional’s tenure. The organisation should “check in” with new hires after approximately 30, 60, and 90 days; using these opportunities to assess whether the recruit is adapting to and thriving in the organisation’s culture. The healthcare system should also continue to provide ongoing training and development, often giving “refresher” courses about the vision and culture every 12 to 18 months. With leadership’s support, these engaged employees become ambassadors for the patient’s priorities.

After proper onboarding, the healthcare system must align its human resource policies to encourage service excellence and hold employees accountable to the standards. Managers must be equipped to drive employee engagement in their departments and be held accountable for action planning and knowledge sharing. Aligning these activities with the hospital’s larger strategic plan and organisation-wide goals is crucial and should be transparent from leadership down to the frontline. One of the greatest challenges within any modern and often multi-location healthcare system is that pockets of excellence are cultivated but best practices are never shared across units. Maintaining open and intentionally structured communication is a means to spread great customer service across an organisation.

As within other service-based industries, consistency is key as a patient may journey across many areas of a hospital over the course of an inpatient stay, series of tests, or throughout a surgery. Receiving fantastic service in one area and mediocre service from another effectively lowers a patient’s perception of the overall experience he or she has had.

Finally, every hospital must have a builtin mechanism for improving performance. Building performance improvement teams and using the Plan, Do, Check, Act (PDCA) method can help ensure performance improvement is an understood and respected part of the culture.

Healthcare systems that are able to effectively achieve a patient-focused service culture take improving the patient experience as seriously as improving financial and clinical outcomes. Gallup’s studies of healthcare systems that have effectively built a strong service culture yield some dominating themes.

Strong and visible leadership that is not only committed to the patient experience, but is able to effectively instil that commitment in the rest of the organisation. There are typically two strong leaders involved in the process – a Managing Director or CEO who sets the vision and a Head of Nursing who helps execute the strategy.

A clear mission, vision, and values and set of behaviour standards that capture the intent of the organisation and create some level of accountability for service among staff members. These are not simply words on a page. Rather, hospitals must reinforce these beliefs and behaviours at orientation, staff meetings, and daily huddles. Ideally, facilities use real patient examples to ensure the mission, vision, and standards resonate throughout the hospital.

Consistency across all messages, so that managers and staff see the patient experience as a strategic objective, as important as other financial and clinical outcomes. It is important that healthcare systems consistently communicate what constitutes the proper patient experience not only in the strategic plan, but also in job descriptions and performance evaluations.

Buy-in from key constituencies, including physicians and the broader patient community. Negative relationships with either group can negatively affect a healthcare systems’ change effort. Physicians are particularly sensitive when they do not feel they have been involved in a significant directional shift. Additionally the general public, full of past or potential patients, can form perceptions about a healthcare systems’ brand based on previous experience – hospitals must be deliberate in their messaging to overcome any lingering problems.

A family atmosphere
in the healthcare system that cuts across unit and even departmental lines. Creating this type of environment often starts by recruiting and hiring the right people – people who fit the kind of culture that provides the best possible patient experience. Leaders and managers then make a point of stressing the sense of family and unity, from orientation forward. The facility instils in employees a sense of common purpose, to the point where they start holding each other accountable.

A defined performance improvement approach
that goes beyond service recovery. Service recovery can add to patient’s perceptions, but the organisation must take proactive measures to identify and address ongoing problems, particularly those that extend beyond the unit level. Healthcare systems often face the challenge of employing so many special teams and committees that each group’s responsibilities and role is not clear. The best performance improvement teams have a defined mandate or charter and clear communication channels, with constant communication on their progress to others.

A proficiency in baseline tactics
such as rounding, using whiteboards for pain management, and establishing “no pass zones”. Gallup finds these efforts necessary for improving the patient experience, but not sufficient. For example, rounding can be even more effective when the information is trended and used as a performance improvement tool. Hospitals can take a more comprehensive approach to discharge planning, as well. Facilities can focus on process or discharge materials without factoring in elements such as wait time or the attention staff pay to the patient between the time they are told they are “discharged” and the time they actually get to leave the hospital.

Improving the patient experience is about changing a hospital’s culture, and this change is the single most powerful and legacy defining step a leader can make to improve the care for a community.

Senior leadership must not only take responsibility to make the patient experience a priority, but also must allocate the necessary time and resources to make this focus a reality. Without this backing and accountability, any efforts to improve the patient experience will be unsuccessful.

The Authors

Christie Fraser is a Senior Consultant – Healthcare and Scott Simmons is a Partner – Healthcare at Gallup.


Gallup has studied human nature and behaviour for more than 75 years. Gallup employs leading scientists in management, economics, psychology, and sociology, and its consultants assist leaders in identifying and monitoring behavioural economic indicators worldwide. Gallup helps organisations boost organic growth by increasing customer engagement and maximizing employee productivity through measurement tools, coursework, and strategic advisory services. Gallup's 2,000 professionals deliver services at client organisations, through the Web, at Gallup University’s campuses, and in more than 40 offices worldwide.

 Date of upload: 26th Jul 2012


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