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Don't Cut Here! Lower Inpatient Satisfaction Scores an Ominous Sign

 |  By Philip Betbeze  
   May 28, 2010

You remember 2009 right? It was a tough year, economically, and hospitals weren't spared.

Cost savings were the order of the day. Many, many hospitals responded with innovative cost cutting strategies, including asking their employees to identify waste and help save jobs. For some, that tactic wasn't fast enough. Many other hospitals and health systems responded to the economic crisis by laying off workers. Many times, they were able to avoid laying off people in the clinical space in favor of administrative layoffs.

But even those layoffs appear to have taken their toll, as a recent consumer satisfaction survey reveal. According to the American Consumer Satisfaction Index, which measures consumer satisfaction for 10 economic sectors, while many other economic sectors improved their customer satisfaction rates, hospitals were not among them. In fact, between the first quarter of 2009 and the same period in 2010, hospital satisfaction dropped 5%. Only the energy sector provided company in falling customer satisfaction.

Given that sector's recent woes, that's not good company. And it's interesting that inpatient satisfaction recorded the biggest drop. In fact, ambulatory care actually recorded a 1% increase in satisfaction compared to last year.

It's not unusual for customer satisfaction to drop in a recession, but this data point should be a warning sign to senior leaders in healthcare. Why? Because patients are getting wiser toward customer service, and so should you. Customers (otherwise known as patients) will be voting with their feet sooner or later. My bet is on sooner. Yes, you'll be judged by payers on outcomes, but you'll be judged even more harshly by patients on their experience while in your hospital.

What does customer service have to do with a hospital stay? Well, to start with, it signifies a shift in the way hospitals should view their patients. As I mentioned, they are customers, just like in any other business. They deserve to get what they pay for, even if they pay for it indirectly.

The results are puzzling, if only because our own 2010 HealthLeaders Media Industry Survey shows that many CEOs have made patient satisfaction one of the top strategic goals for their organizations in recent years. For example, improving patient satisfaction was the second-highest ranked priority for the next three years in this year's survey, while more than 38% selected it as a top priority this year, compared to 26% in 2009.

Perhaps that means improvements are in the pipeline, and the American Consumer Satisfaction Index will show better results this time in 2011. In the meantime, these are the most recent results, and they're not so good.

In such a broad survey as this, it's difficult to see the trees for the forest, as it were. In other words, some hospitals are assuredly making the important investments in patient satisfaction. But more than a few saw investments in patient satisfaction take a back seat to what were seen as more pressing priorities, like refinancing debt or otherwise cutting costs.

But you can't slash your way to success. Investments in patient satisfaction require more commitment than cash. In fact, relative to other investments hospitals have to make, such as high-tech imaging systems, new patient towers, and new operating suites, patient satisfaction improvement is instead based on clean rooms and hallways, better, hotter food, better service, and more eye contact, among other, seemingly simple fixes.

Those things improve with culture, and as the CEO, there's no more effective person to drive that culture. Are you rounding each day? Do you talk regularly with patients and their families to find out what's dissatisfying them? Do your top lieutenants do these things as well? Can you stop a worker in the hallway and get a good answer for how that person is helping improve patient experience?

If not, some reassessment of priorities may be in order. Your customers are demanding it, and your organization's long-term success depends on it.

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Philip Betbeze is the senior leadership editor at HealthLeaders.

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