Teaching to the Test
This past weekend, I got to do something I truly enjoy. My tried and true 2007 Avalon was groaning and moaning a bit more than in days past, so I decided it was time to take the dive and go buy a new car. Unlike many people, I actually enjoy the car buying process. I don’t know if it’s the thrill of the hunt, the joy of seeing all of the new bells and whistles, or just the simple pleasure of that “new car smell.” I enjoy it all. After driving the requisite number and style of cars (sports cars, luxury cars, even an SUV), I settled back in to my comfort zone with a brand new shiny Avalon. Just like my 2007 model, this new Avalon still seemed to fit my tastes just fine.
It was getting late in the day and quite honestly, I was ready to get the deal done and get home, but knew I had to be patient and wade through the requisite two trees worth of paperwork. As I began to dive in, my sales person leaned in a bit and said – “You know, I don’t like to sell cars late in the day.” OK, I’ll bite, I thought. “Why is that Frank?” I queried. “My satisfaction scores might be lower” he replied. “People are in a hurry and it doesn’t seem to matter how well I do. We’ll get you out of here; just don’t gig me on my survey – OK?”
In the auto sales and service industry, customer service – or more accurately customer service scores – are king. Every interaction is followed by a phone or email survey and every salesperson and technician is constantly showing you exactly the score they need to have. (Often, only the highest score is considered to be a “passing” score, with all other scores considered to be “failing.”) The incentives for good scores are obviously big and have taken on an almost comic sense of importance.
As we in health care move towards subjective metrics, in the world of patient satisfaction, I can’t help but wonder if we are implementing some of these same behaviors. When we focus too much on short-term, isolated tactics to improve scores, are we really improving the culture in healthcare organizations in a way that genuinely makes patients happy and enhances their overall experience?
I am not saying that patient satisfaction is unimportant, I’m just curious if we are really asking the questions and improving aspects of their experience that mean the most to the patients in terms of their satisfaction. Alternatively, could it be argued that we are simply “teaching to the test” to be sure we capture the maximum amount of revenue associated with patient satisfaction?
All this thinking made me wonder – what questions would I want to see on my own healthcare satisfaction survey? Sure a clean, quiet environment is important, but is that what would make me really satisfied? Here is my first pass at a listing of outcomes that would contribute most to my satisfaction as a patient:
- I know exactly what the services will cost before they are provided. No surprises or hidden fees.
- I know my doctors provide the highest quality care in my area of need, and they have the data to prove it.
- I have access to all of my clinical and financial data all of the time.
- My doctors and caregivers talk to each other. They all know my plan of care and execute it flawlessly in concert with one another.
- I’m healthier now and have been taught how to stay that way.
I don’t know if we will see questions leading to these outcomes on a patient satisfaction survey anytime soon, but as we move toward using patient satisfaction measures more and more, I hope that we in healthcare don’t fall prey to achieving “great scores” that have no real connection at all to patients being truly satisfied.
Mark
I wish I could have said it that well. Having experienced our healthcare system recently it was obvious to me that we don't focus on what is important to our patients; we focus on what some regulatory body has decided is important to them. If we really want to improve the patient experience we need to ask the patient what they want, what they need; then address it.