Customer Service Orientation for Nursing

Customer Service Every employee has the ability to positively impact the customer’s experience. All employees are expected to do their best to exceed our customer’s expectations every day.

Customer Service Our Goal – 90% How do we reach it? Everyone working together to surpass the expectations of all customers Patients Families and loved ones Physicians Fellow employees Vendors EVERYONE!

Customer Service Up to 60% of dissatisfied patients will not return Dissatisfied customers will tell 8-10 people. 13% will tell 20 people It costs 5X as much to attract a new customer Seven of ten complaining customers will do business with you again if you resolve issue If you resolve a complaint on the spot, 95% will do business again

Customer Service What is our image? How people perceive us is more important than what may or may not be true. We are all a walking and talking advertisement for our employer.

Customer Service Image begins and ends with us Most of us can’t really understand how we appear to others, but we can see the effect we’re having on other people. When we practice warmth, friendliness, honesty, patience, tact, courtesy and promptness, other people respond in positive ways that we can see.

Non-Verbal Expectations Smile. Use direct eye contact when communicating with all patients, visitors, and guests. Ignoring someone or rudeness is never accepted. Acknowledge guests immediately when they enter a unit or department. If you observe someone looking for help, offer assistance, escort them if possible. Never walk by a call light.

Verbal Expectations Always introduce yourself and explain your role. Ask the patient or guest how he or she would like to be addressed. Do not call a patient, guests or co-workers “sweetie” and honey”. In many cultures and among the elderly, these terms can have negative perceptions. Use “please,” “thank you,” “sir or “ma’am” in all conversations Apologize for problems and inconveniences. Try to resolve problems immediately.

Verbal Expectations Patients & family members might not understand medical or technical jargon. Use words they understand and try to keep it simple. Keep patients & family members informed of any and all delays. When exiting a room or completing a task, give the patient or guest your name and role again. If you are returning, tell them when to expect you back. If not, tell them what to expect next so they know why they are waiting.

Overcoming Barriers Keep the customer’s thoughts in mind Take the time to acknowledge - 10 foot rule Be prepared to help other members of your team Avoid the blame-game / criticizing Be careful of how you speak: Tone = 45% of a person’s perception Body Language = 55% of a person’s perception Positive communication with others leads to positive communication FROM others.

Tips for excellent INTERNAL customer service Encourage your co-workers in their efforts. Express praise for a job well done. Ask for others’ ideas. Offer thoughtful suggestions. Provide options and solutions instead of complaints. Stay positive. Listen respectfully to what others say. Resist the urge to gossip.

Tips for excellent INTERNAL customer service Keep lines of communication open. Complete your tasks on time. Do not hesitate to ask questions. Be willing to compromise. Take pride in your achievements. Respect your co-workers and their property. Settle disagreements peacefully.

Measurement Survey questions relate to the eight dimensions of patient-centered care: Emotional Support Physical Comfort Patient Preferences Information and Education Continuity and Transition Involvement of Family and Friends Coordination of Care Access to Care

Public Reporting Customer Service Information to be made available to the public beginning in 2009 While not mandatory, hospitals not in compliance will receive reduced Medicare reimbursement

Hospital Consumer Assessment of Healthcare Providers and Systems Public Reporting Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Provides a standardized instrument and data collection methodology for measuring the patient’s perspective. Enables valid comparisons to be made against all hospitals. Core of set questions to compliment existing data.

HCAHPS Questions COMMUNICATION WITH NURSES During your stay, how often did nurses treat you with courtesy and respect? Never, Sometimes, Usually, ALWAYS During your stay, how often did nurses listen carefully to you? Never, Sometimes, Usually, ALWAYS During your stay how often did nurses explain things in a way that you could understand? Never, Sometimes, Usually, ALWAYS

HCAHPS Questions COMMUNICATION WITH DOCTORS During your stay, how often did doctors treat you with courtesy and respect? Never, Sometimes, Usually, ALWAYS During your stay, how often did doctors listen carefully to you? Never, Sometimes, Usually, ALWAYS During your stay how often did doctors explain things in a way that you could understand? Never, Sometimes, Usually, ALWAYS

HCAHPS Questions COMMUNICATION ABOUT MEDICINES Before giving you any new medications, how often did hospital staff tell you what the medicine was for? Never, Sometimes, Usually, ALWAYS Before giving you any new medications, how often did staff explain medication side effects in a way that you could understand? Never, Sometimes, Usually, ALWAYS

HCAHPS Questions RESPONSIVENESS OF HOSPITAL STAFF During your stay, after you pressed the call button, how often did you get help as soon as you wanted it? How often did you get help going to the bathroom or using the bedpan as soon as you wanted? Never, Sometimes, Usually, ALWAYS

HCAHPS Questions DISCHARGE INFORMATION During your hospital stay, did hospital staff talk to you about whether or not you would have the help you needed when you left the hospital? YES NO During your hospital stay, did you get information in writing about what symptoms or health problems to look out for after you left the hospital? YES No

HCAHPS Questions PAIN MANAGEMENT During your hospital stay, how often was your pain well-controlled? Never, Sometimes, Usually, ALWAYS During your hospital stay, how often did hospital staff do everything they could to help you with your pain? Never, Sometimes, Usually, ALWAYS

HCAHPS Questions CLEALINESS During your hospital stay, how often were your room and bathroom kept clean? Never, Sometimes, Usually, ALWAYS QUIETNESS During your hospital stay, how often was the area around your room quiet at night? Never, Sometimes, Usually, ALWAYS

HCAHPS Questions RATING OF THE HOSPITAL Using any number from 0 to 10 where 0 is the worst hospital possible and 10 is the best hospital possible, what number would you use to rate this hospital? 0-8, 9-10 Would you recommend this hospital to your family and friends? Definitely no, Probably no, Probably yes, Definitely yes

Emergency Department Rating RATING OF THE HOSPITAL Overall, how would you rate the care you received in the Emergency Room? Poor, Fair, Good, Very Good, Excellent Would you recommend this emergency room to family and friends? Yes definitely, Yes probably, No

Outpatient Rating RATING OF THE HOSPITAL Overall, how would you rate this visit? Poor, Fair, Good, Very Good, Excellent Would you recommend this outpatient service to your family and friends? Yes definitely, Yes probably, No

Impact of the Electronic Medical Record (EMR) on Patient Satisfaction EMR Benefits Improved provider access to patient data No wasting time looking for chart 2 or more persons can review chart at same time Pt’s chart can be opened on any hospital computer Patient Perceptions Patient may perceive a reduction in time delay to see physician and obtaining test results

Impact of EMRs on Patient Satisfaction EMR Benefits Improved continuity of care between healthcare providers Patient Perceptions Patients may experience higher levels of confidence and trust in their healthcare providers Patients may perceive that their healthcare providers understood their condition completely Patients may perceive that their healthcare providers work well together

Impact of EMRs on Patient Satisfaction EMR Benefits Increased patient safety Reduction in medication errors Better medical decision making Patient Perceptions Patients may rate our effort to provide safe care at a higher level

Impact of EMRs on Patient Satisfaction EMR Benefits Improved quality of healthcare Patient Perceptions Patients will be more likely to rate their overall satisfaction with a higher score Patients will be more likely to recommend the facility to family and friends

Impact of EMRs on Patient Satisfaction EMR Potential Pitfalls Privacy issues The data is only as good as the individual entering it Patient Perceptions Patients may experience anxieties or fears concerning who may have access to their medical information

Impact of EMRs on Patient Satisfaction EMR Potential Pitfalls May encourage a focus on performing tasks (data entry) rather than on service Patient Perceptions Patients may perceive that their healthcare providers are not listening carefully to them

Avoiding the Pitfalls Entering the Patient’s Room Knock Smile Introduce yourself Explain your role and the purpose of the computer on wheels Explain what you are going to do i.e. nursing assessment, enter orders, update medication list…

Avoiding the Pitfalls Entering the Patient’s Room Never refer to a computer on wheels as a “C.O.W.” Patients may perceive that you are calling them a “Cow” Reference the computer on wheels as a “W.O.W.” or wireless on wheels.

Avoiding the Pitfalls Place the computer as close to the patient as possible Sit rather than stand The computer on wheels should not obstruct your direct line of vision with the patient Maintain eye contact with the patient. Look at the computer screen only when necessary Talk to your patient and not the computer

Avoiding the Pitfalls When updating a patient’s medical history, avoid reading to the patient, rather ask the patient to provide his medical history Never assume that the information already present in the database is correct. Always clarify with the patient/others as needed. Always use positive communication with patients Unacceptable: “Mr Smith, it says here that you have HIV, Hepatitis C, and a history of drug abuse. Do you have anything else to add?” Acceptable: “Mr Smith, would you share your medical history with me so that I can update your medical information? Is there anything else that you’d like to share?”

Avoiding the Pitfalls Reassure the patient that his medical information is protected and that providers will only have access to the information they need to perform their role While using the computer on wheels, make sure that no one is standing behind you and reading the patient’s information If you must walk away from the computer, always log off. Never leave patient information displayed on the computer screen if you are not present Always log off when you are finished utilizing the “W.O.W”

Conclusion Personal interaction is the most important function in a high TECH environment. No matter how good a computer is, it cannot replace the compassion and caring of a human.

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