1. Customer Satisfaction and Service Marketing Preethi Pradhan preethi@aravind.org

2. Who are the customers in a hospital? Patients Family members Referral Doctors SuppliersEmployees Who is the key customer in the hospital?

3. What is patient satisfaction? Patient Satisfaction is minus Patient Satisfaction is hospital services and its perception by the patient minus patient expectations 0 = Patient Satisfied - = Patient Dissatisfied + = Patient Delighted Patient satisfaction measures need to be developed from the patients perspective Patient satisfaction measures need to be developed from the patients perspective Patients are becoming better informed Patients are becoming better informed Involve patients for making improvements Involve patients for making improvements Patient satisfaction is not but Patient satisfaction is not Static but Dynamic

4. Patient Expectations Good Medical Care Good Medical Care Good Nursing Care Good Nursing Care Less Waiting Time Less Waiting Time Excellent Hospitality Excellent Hospitality Personal Attention Personal Attention Courteous Behavior Courteous Behavior Affordable Charges Affordable Charges Cleanliness Cleanliness Good Coordination Good Coordination Cooperation among the Staff Cooperation among the Staff Discipline Discipline Communication & Information Communication & Information Transparency in charges and procedures Transparency in charges and procedures

5. Why customer satisfaction? Health care is generally becoming competitive Health care is generally becoming competitive Providers must not only maintain high clinical standards but also service that satisfies the patients Providers must not only maintain high clinical standards but also service that satisfies the patients To meet the dual challenge, providers must have an understanding of what constitutes both clinical excellence and customer satisfaction To meet the dual challenge, providers must have an understanding of what constitutes both clinical excellence and customer satisfaction

6. What is Service Marketing? Examples: Defense, Postal, Education, health, Religious Services, Hospitals, Airlines, Hotels, Law Firms, Entertainment, etc Examples: Defense, Postal, Education, health, Religious Services, Hospitals, Airlines, Hotels, Law Firms, Entertainment, etc Definition: Activity or benefit that one party can offer to another that is essentially intangible and does not result in the ownership of anything. Its production may or may not be tied to a physical product Definition: Activity or benefit that one party can offer to another that is essentially intangible and does not result in the ownership of anything. Its production may or may not be tied to a physical product

7. Eye Care-Why do we need to do service marketing? Perspective Public Health Public Health Programme Perspective Programme Perspective Sustainability Sustainability

8. Public Health Perspective: Increasing backlog of Blindness Increasing backlog of Blindness Low levels of eye care services – e.g. CSR in the Region varies from 500 to 3,500 Low levels of eye care services – e.g. CSR in the Region varies from 500 to 3,500 Crucial to reduce the blindness rate Crucial to reduce the blindness rate High geographic & gender disparities both in the coverage of service as well as in the quality of eye care. High geographic & gender disparities both in the coverage of service as well as in the quality of eye care. Demographic transition issues Demographic transition issues Commitment to VISION 2020-The Global Initiative Commitment to VISION 2020-The Global Initiative

9. Programme Perspective Rising costs of equipments & other resources Rising costs of equipments & other resources Need to have economies of scale (lower fixed costs) to sustain Need to have economies of scale (lower fixed costs) to sustain Increase resource utilization due to scarcity Increase resource utilization due to scarcity Availability and Affordability of eye services Availability and Affordability of eye services Make eye care programme effective and efficient Make eye care programme effective and efficient New services coming to the forefront New services coming to the forefront

10. Sustainability Perspective Increasing patient awareness and technology acceptance Increasing patient awareness and technology acceptance Government as well as the voluntary sector is under increasing pressure to meet costs. Government as well as the voluntary sector is under increasing pressure to meet costs. International NGOs support for operating expenses have lowered. International NGOs support for operating expenses have lowered. Developing a differential price mechanism and other strategies to become self-sufficient through user fees and attracting paying patients. Developing a differential price mechanism and other strategies to become self-sufficient through user fees and attracting paying patients. Private practitioners have also recognised that goodwill of the community increases their clientele. Private practitioners have also recognised that goodwill of the community increases their clientele.

11. Services Unique characteristic - 1 INTANGIBILITY Customer is unable to experience theproduct prior to purchase

12. Services Unique characteristic - 2 PERISHABILITY PERISHABILITY Cant be stored

13. Services Unique characteristic - 3 INSEPERABILITY Production & consumption happen at the same place and cannot be separated

14. Services Unique characteristic - 4 VARIABILITY Difficulty in establishing consistency in quality Difficulty in establishing consistency in quality across Providers or within providersacross Providers or within providers across Timeacross Time across Delivery Centersacross Delivery Centers

15. Challenges in Service Marketing Giving a feel for the product Giving a feel for the product Managing Demand Fluctuations Managing Demand Fluctuations Maintaining Quality Maintaining Quality Cost Containment Cost Containment Attitudinal block in using proven marketing principles in service marketing Attitudinal block in using proven marketing principles in service marketing

16. Factors that promote Demand - Availability Perspective Services are available for longer or convenient hours Services are available for longer or convenient hours Patients are provided information through Brochures, Publicity, etc on services available Patients are provided information through Brochures, Publicity, etc on services available Services are reliable and offered promptly Services are reliable and offered promptly Required equipment are available Required equipment are available Patient friendly Systems & Procedures Patient friendly Systems & Procedures

17. Factors that promote Demand - Accessibility Perspective Good public transportation Good public transportation Centrally located Centrally located Outreach Programs to reach out to the Rural People Outreach Programs to reach out to the Rural People

18. Factors that promote Demand - Affordability Perspective Standard pricing structure Standard pricing structure Charges affordable by most of the people in the Community Charges affordable by most of the people in the Community Transparency in Patient Fees – no hidden charges Transparency in Patient Fees – no hidden charges Simple procedure for getting free/subsidized care Simple procedure for getting free/subsidized care

19. Factors that increase Demand - Promotion Avenues Structured approach with designated staff Structured approach with designated staff Good Rapport with Community Good Rapport with Community Publicity through different media Publicity through different media Promotion at Outreach activities Promotion at Outreach activities Meetings/seminars for other doctors Meetings/seminars for other doctors Developing a referral network Developing a referral network Promotion through satisfied patients Promotion through satisfied patients Industrial tie-up for routine examination of their employees Industrial tie-up for routine examination of their employees

20. Factors that affect Demand - Attitude Perspective Reasons for Low Demand: Sophisticated technology will automatically trigger demand Sophisticated technology will automatically trigger demand Belief that patients, if need eye care, will definitely come to us Belief that patients, if need eye care, will definitely come to us Providing Service as per Providers Convenience Providing Service as per Providers Convenience Systems & Procedures are not patient friendly Systems & Procedures are not patient friendly Gap between Patients Expectations & Providers Perception Gap between Patients Expectations & Providers Perception Lack of patient orientation Lack of patient orientation

21. Factors that promote Demand - Quality Perspective Skilled Doctor & other staff Skilled Doctor & other staff Standard Clinical Protocol Standard Clinical Protocol Good Administrative System & Procedures Good Administrative System & Procedures Courtesy & Politeness Courtesy & Politeness Proper Explanation Proper Explanation Clean environment and comforts meeting or exceeding expectations Clean environment and comforts meeting or exceeding expectations Systems to monitor clinical outcomes & Patient satisfaction Systems to monitor clinical outcomes & Patient satisfaction

22. Factors that promote Demand - to the Rural areas & the poor Reasons for Low Demand: No one to Escort No one to Escort Fear of Surgery Fear of Surgery Ignorance Ignorance No desire for surgery No desire for surgery No time for Surgery No time for Surgery No money for surgery No money for surgery Promoting Demand: Counseling to build confidence that Staff will take care Counseling to build confidence that Staff will take care Health education Health education Explain benefits Explain benefits Free Transport/Food Free Transport/Food Free/subsidized Surgery Free/subsidized Surgery