Customer Satisfaction: Improving Marketshare, Regulatory Compliance
and Patient Care Part I
Mary Larweck, BSN, MS, CIC,
CPHQ- Consultant, Emerald Quality Services, Mpls, MN
Executive Consultant, Gantz Wiley Research
What do Deming, Juran and Crosby have in common? The principles:
||Focus on the customer,
||Work as a process and
|| Keeping in mind that when the focus
is on the customer, quality begins to happen!
Customer satisfaction has changed over time just as the evolution
of quality improvement: Beginning with marketing data and outcome
measures, moving to benchmarking and utilizing findings to improve
products and services, and ultimately bringing the voice of the
customer to day-to-day operations.
Challenges for business today that impact customer relations include
mergers, acquisitions, changing demographics and the changing workforce….Acquiring
and retaining skilled employees is a key ingredient in an organizations
ability to serve its customers. The average US company loses over
50% of its employees every 4 years (Reicheld, The Loyalty Effect,
1996). In addition, the average US corporation loses 50% of their
customers in 5 years. Keep in mind at least 5 times as much resource
is needed to acquire new customers as it does to retain existing
ones (TARP, 1999).
So why do customers defect? Forum Corporation Research found:
||30% defect because of better
||20% defect due to poor customer contact
||49% defect because the attention they
did receive was perceived as poor quality.
|The example below shows
the strong relationship between satisfaction and retention for a healthcare
organization. While 83% of all patients intend to remain with the
health plan, the retention rate jumps to 90% for those customers who
are very satisfied overall. The retention rate for those who are merely
satisfied are still respectable at 77%. Translating this, however,
there is a difference of 13% in retention. You can also see from the
graph, that when customers are less than satisfied, it is very difficult
to retain their business. Customer research verifies that with few
exceptions satisfaction is a prerequisite for loyalty.
The focus for this article is tying customer satisfaction to the
following three areas:
|| Maintaining/improving marketshare
|| Addressing regulatory compliance
|| Improving patient care services
Customer satisfaction studies need to first define customer expectations,
then affirm and periodically track satisfaction to verify and measure
the impact of improvements/changes. Efforts also need to be focused
on the key market share segments to align efforts and resources strategically.
The right measures are critical for getting the right information.
Your survey should include measures of expected quality (e.g., that
staff responds promptly to calls for assistance), desired quality
(e.g., clear and reassuring/empathetic explanations of tests and procedures)
and excited quality (e.g., staff prepared to anticipate your needs
before they arise). When focusing on marketshare, it is also important
to consider how your customers view you in light of alternatives they
have available. A shift in competitive offerings (e.g., another clinic
that schedules evening appointments) can dramatically impact your
customers' perceptions and satisfaction with your services.
For many of us a new and emerging arena for customer surveys is that
of complying with regulations. ISO now requires demonstration of a
measurement method and a follow-up process for customer input. In
healthcare, NCQA and JCAHO have required such measurement and effective
actions for a decade or longer. For example if an agency had received
a complaint about ER waiting time, customer satisfaction data as well
as admission logs, could be used show overall performance, both in
real time measures and in measures of customer perception/satisfaction.
Customer satisfaction surveys also provide a vehicle for proactively
monitoring regulatory requirements from a patient's viewpoint. Surveys
can be used to identify problems, hazards, assess product quality,
and provide a way to assess "the voice of the customer."` Examples
might include asking questions regarding explanation of tests and
procedures or patient privacy and confidentiality. Effective survey
programs will also include a mechanism where customers can request
follow-up regarding specific issues.
Patient Care and Satisfaction
Customer satisfaction data can be used to identify improvement opportunities
and measure the improvement process, as adjunct to the popular improvement
approach, PDCA (Plan, Do, Check, Act); helping identify the problem
and check the results. Customer satisfaction data can provide both
quantitative (measurement) and qualitative (comment) information.
The ongoing tracking of customer satisfaction is a natural check step
to the process. For example, a customer satisfaction survey identified
communication of possible side effects and what to do about them as
an opportunity for improvement. After updating printed materials and
staff involvement in the development of a standard protocol, the ongoing
tracking study provided a check on the effectiveness of the actions.
Identifying Improvement Areas from your Customer Survey
Whether your objectives are to improve marketshare, comply with regulatory
requirements or improve patient care, surveys can identify a myriad
of possible improvement areas. How does the organization decide on
which opportunities to focus? Three excellent techniques to help prioritize
areas for improvement are Pareto charts, key driver analysis and scatterplots.
Part II of this article will appear
in the January 2003 issue. It is devoted to the use of the
three tools, Pareto chats, key driver analysis and scatterplots
to understand and use customer survey data to prioritize and improve
ASQ Foundations In Quality Learning
Series - Certified Quality Manager Module #4: Customer-Focused Organizations,
ASQ Holmes Corporation, 2001.
Voice of the Customer, GOAL/QPC
Research Committee Research Report #R9501, 1995.
Reichheld, Frederick F., The Loyalty
Effect, HBS Press. 1996.
TARP, Basic Facts of Customer
Complaint Behavior and the Impact of Service on the Bottom Line,
Competitive Advantage, 1999, 1-5.
Bell, R., Krivich, M.J., How to
Use Patient Satisfaction Data to Improve Healthcare Quality, ASQ
Press, Milwaukee, 2000.