Marketing Research with a Focus on Patient Experiences
April 29th, 2011Earlier today I had the pleasure of describing some of the leading research techniques to the NACCDO/PAN marketing group, this year hosted by UNC Lineberger Comprehensive Cancer Center. Our discussion was focused on ways to elicit feedback from patients, families and referring physicians to guide understanding, delivery, and monitoring of the patient experience.
Below is a recap of key observations, followed by a copy of the presentation.
First, any objective feedback is better than none at all. Incorporating the Voice of the Customer is critical to ensure that scarce marketing and operational resources are put to greatest use. However, the use of marketing research tools is only intended to reduce decision risk, not eliminate it. Strategic prioritization includes a combination of both insights and instincts.
The most important elements of research include well-designed materials (prior experience and expertise in this area helps) and taking action on the results. To ensure action, I recommend engaging implementers as early in the process as possible, not only at the end presentation of results. Rather, they should guide the study materials development and engage in decisions throughout the process. One of the most important questions to ask executives is what they expect to see as an outcome of the process – their response may surprise you and might cause you to re-frame the entire study.
Experience Mapping is a valuable technique to understand patients’ functional AND emotional needs. Functional needs are commonly addressed as efficiency issues – parking, scheduling, discharge, etc… The emotional needs are often overlooked and harder to act upon (but not impossible) – hopefulness, safety, and empowerment are examples. The experience map also provides a framework for action by giving team members a common orientation to what happens before the hospital visit (a part of the process often managed by marketing and community physicians), “inside the walls,” and after discharge (an often neglected piece of the patient’s journey).
Quantitative research can link brand performance to experience management. In fact, marketing’s role to establish expectations as a basis for preference over competitors must be fulfilled or patients will become detractors rather than advocates. Gelb’s brand trust model is used by academic medical centers around the country to establish meaningful differentiators across market segments. Prioritizing these areas of importance and focusing communications and operations is key to building a strong brand.
Finally, accountability comes from measurement. Nevertheless, commonly used satisfaction or performance measurement tools are too late or, at worst, ad hoc. These tools should be viewed as additional “listening posts” for patients and referring physicians to provide feedback in the context of their journey, not an arbitrary date. This approach improves feedback quality and online tools provide a mechanism to for real-time service recovery.
My Job is to Save Your Ass, Not to Kiss It
April 8th, 2011At a recent presentation, an attendee provided an enlightening example of the frequent disconnect between clinical and service excellence. She shared the story of a nursing unit in her hospital (which shall remain nameless) whose nursing staff had put the following on the unit station wall:
“Our job is to save your ass, not to kiss it”
Having visited hundreds of units, this was a new one. While pithy, my main concern is that this attitude is permitted by nursing management. This sign, when taken down, only found a new home in the lounge (at least it’s out of patient view now).
So the struggle between clinical and service excellence continues. Our experience indicates that patients appreciate the positive medical outcome. However, nurses (and other health professionals) cannot always guarantee a positive medical outcome which makes creating loyalty even harder when one chooses to ignore the service delivery component.
Both are needed and can be accomplished rather easily. Instead of just executing the task, explain why you’re doing it (why are you taking out the IV pump – to make the room safer…HCAHPS anyone?).
Finally, management cannot tolerate this type of behavior. It’s not only mean-spirited, but fails to remind healthcare providers why they got into the professional in the first place – to care for others.
Embrace the Role of Strategic Marketing during Healthcare Reform
March 1st, 2011Embrace the Role of Strategic Marketing during Healthcare Reform
Two years after one major political transformation and months after several significant changes brought about by healthcare reform went into effect, marketers and communicators in the healthcare industry are still searching for the best possible solutions to effectively and wisely reach all stakeholders. Although healthcare reform may still seem uncertain, one thing is sure – marketing is critical as successful healthcare organizations navigate healthcare reform.
To bring in-depth industry insight and provide a discussion platform for all healthcare industry stakeholders facing healthcare reform, a Houston AMA Healthcare SIG event was held in February. During this event, challenges and uncertainties of healthcare reform were fully explored and, more importantly, the vital role of strategic marketing was constantly reiterated during presentations. Moderated by Eric Roland, Senior Director of Marketing and Communications at Legacy Community Health Services the panel of speakers included: Alicia Jansen, Associate Vice President of Marketing at M.D Anderson Cancer Center, John McKeever, President of Gelb Consulting Group, INC and Frederic Warner, Public Policy and Government Relations at Memorial Hermann Healthcare Systems.
Complexity and uncertainty seem to be the common themes when people think about healthcare reform but as McKeever shared with the groups, “In the middle of difficulty lies opportunity.” All three speakers emphasized that healthcare reform also presents great opportunities for marketers to bring business value to organizations and help executives recognize what marketing could bring to the table. Therefore, marketers should try to put themselves in executives’ shoes and understand what keeps executives up at night in order to position themselves as strategic partners with them. In order to do so, here are some key strategic marketing points and actions that really resonated with us:
- Strategic marketing requires subjective market data to enhance business decisions
- Strategic marketing involves strategically developing and managing a brand which consequently lays a solid foundation to build business value.
- Strategic marketing requires understanding patients “holistic experience”
- Strategic marketing calls for managing growth
- Strategic marketers should reinforce their value by showcasing and measuring their successes
Even in a rough economy or times of uncertainty, marketers should always strive to transform executives into marketing advocates, a feat possible by following the sage advice of the AMA Houston Healthcare SIG speakers.
Building Accountable Care Organizations
December 22nd, 2010A recent webcast produced by HealthLeaders Media Rounds provided an enlightening conversation regarding Accountable Care Organizations (ACOs). Given the concept is still a fairly new one, the presenters took the time to provide a basic idea of an ACO and how they are working within their organizations to achieve success with this model. It was so helpful to hear how others define this concept and in turn what it looks like in practice!
Leaders from Carilion Clinic, Norton Healthcare and Atlanticare shared their ideas as to how to make an ACO work and operational challenges one might face – as they certainly have faced their share of hurdles. But the speakers from Carilion Clinic began the conversation by explaining an ACO means a different kind of business model for a healthcare facility. As an ACO, this means the facility would be accountable to its patients and community for outcomes, service, and lower costs. To accomplish this, a facility must integrate and manage care more efficiently to lower costs and eliminate unnecessary procedures. As a result, shared savings can be enjoyed by participating physicians, as speakers from Norton Healthcare explained. All the speakers emphasized the importance of dialoguing with your community as to what all participants – patients, physicians, and neighbors within the community – can expect from their healthcare provider and how all can get the most out of it.
To ascertain your readiness to become an ACO, the presenters suggested you ask yourself questions such as How do patients currently go through our system? Addressing this could help you see where you too can streamline your communication among patients, physicians, and your community. For example, in light of this particular idea, Atlanticare felt a good approach was to offer a hotline to community members so they could direct their questions to one central place – an entity of the organization – instead of going into an urgent care facility - not associated with the organization). As a result, they felt this served the community with a valuable and convenient resource, but also streamlined care so that patients who needed assistance were directed to another entity of the organization. Another advantage of this was that the patient’s information is electronically captured and hopefully allowed for fewer issues between treating and referring physicians – a problem we see clients encounter all to often.
One way to investigate how your patients currently navigate your organization is to engage in experience management, about which we’d love to share more information with you. It may also be a useful tool to map the experiences of your internal staff and faculty so as to answer other important questions mentioned by the speakers, such as Who will be integrators of care? Who should organize an ACO? and To whom will savings of benefits accrue?
Increase Loyalty with Experience Dashboard
September 27th, 2010So much attention is paid to attracting patients and influence referring physicians, that it’s easy to overlook retention. As we’ve commented on this blog before, setting initial expectations is key to satisfaction. But loyalty? Yes, and no. Certainly a great experience can yield more loyal patients and physicians; those who will recommend you to others. But many new research studies also suggest that when you have a service recovery issue, and it’s resolved, you actually make increase loyalty over the long-term. Our direct work for institutions like MD Anderson Cancer Center, Texas Children’s Pediatric Associates and Memorial Hermann Healthcare System suggest the same.
But what are they doing differently? They’ve each adopted technology that allowed them to monitor the patient or referring physician experience. Instead of relying on satisfaction reports that take weeks to complete, managers access real-time results via a customer experience dashboard.
We’ve recently put together this demonstration to show how their systems work:
Marketing Execs Among Lowest Paid
August 30th, 2010Those responsible for revenue generation are among the lowest paid healthcare system executives, according to a study by Sullivan, Cotter and Associates, published in Modern Healthcare (http://www.modernhealthcare.com) and available for purchase here (http://bit.ly/9ErrlE). Among marketing executive types (the study references Communications, Marketing, Fund Development, Managed Care, Business Development, but not Physician Relations), the marketing category is the lowest paid, according to the median.
Healthcare system marketing executives need to show results! According to several benchmarking studies we’ve conducted for national healthcare associations, we see this trend emerge as most critical. You might find this informative presentation developed with MD Anderson Cancer Center helpful.
Optimal Healing Environments
August 2nd, 2010One thing I have learned through interviewing patients is that sometimes the “little things” make the biggest difference. Bonuses like receiving valet parking vouchers for their first appointment or listening to a volunteer play a musical instrument in the waiting room add significant value for patients. This is especially true given that most patients can’t initially determine if a healthcare facility is using the newest technology but immediately notice if they feel welcome and cared for.
At the recent Health Forum and American Hospital Association Leadership Summit in San Diego, representatives from Grinnell Regional Medical Center and Samnueli Institute talked about their experiences creating an optimal healing environment for patients as a cost-effective way to improve patient satisfaction and experiences. Here are some examples:
- Physical Environment: A volunteer art advisory committee comprised of members of the community raises money for art work, meditation rooms and other aesthetic elements. They also focus on nature, incorporating a “healing garden” and bird conservatory that patients can watch from the ER waiting room.
- Compassion: Employees are encouraged to show compassion in unique situations, such as caring for a patient’s pet if they have an unexpected and prolonged hospital stay. They also focus on creating a fun environment, through regularly having celebrations or themed dress-up days.
- Patient-Centered Care: New patients answer questions about their background, and a “patient portrait” containing their basic biography is put in their room so care providers can learn more about them and develop personal connections. Also, a patient and family advisory panel, composed of members of the community, helps provide insight and ideas for new initiatives.
- Fitness/Wellness: Fitness facilities are provided on-site and in several locations around the community. Also, a separate building offers a wealth of alternative healing services for patients, such as massages, acupuncture, and stress management.
- “Green” Initiative: Representatives from many departments have come up with ways to “go green” including garage sales, reusable containers, elimination of mercury, purchasing local foods, and energy-saving appliances.
Studies have shown that creating an optimal healing environment can help in pain management, promote long-term healthy living, and ultimately decrease mortality. These are just some examples of ways to promote a healing environment, many of which do not require a large budget. Click here to learn more about understanding your patient’s functional and emotional needs.
Creative Cross-Functional Solutions
August 2nd, 2010I recently attended the Health Forum and American Hospital Association Leadership Summit in San Diego. One theme that I noticed was hospitals improving efficiency by using creative cross-functional solutions. A few specific ideas that I found particularly interesting and inspiring:
- To better support employees, SSM Healthcare – St. Louis developed a HR Consultant role. Instead of waiting for employees to notify HR of problems, the HR Consultant proactively works with departments to determine if they have the tools they need, how they are implementing service improvement plans, and other organizational issues that may be hindering the department. The HR Consultant serves as a partner for improvement and develops relationships with each department coordinator.
- SSM Healthcare – St. Louis also created a new nursing position to solve the problem of the head nurse regularly being away from the clinic for administrative meetings/duties. They created a new position, a clinical support nurse, who is in charge of managing the clinic flow and mentoring struggling nurses. Clinical staff are also able to change a nurse’s name from green to red, which indicates they have noticed them struggling in some way, and the clinical support nurse then works with the particular nurse on any necessary issues.
- Baylor Health Care System implemented the Naylor Model, in which an advance practice nurse helps high-risk patients by streamlining hospital care and transiting them to home care. They visit patients within 24-48 hours of hospital admission, then provide up to 8 home visits. Baylor Health Care has seen a decrease in mortality rates after implementing this model.
- University Hospitals recognized a problem in their ICU, as nurses were in charge of several patients, but had to leave those patients to assist in “code blue” emergency situations. They created a new nursing position, an advanced nurse who is in charge of proactively rotating throughout the ICU to identify patients who are likely to be in “code blue” emergency situations. The result of this proactive care has been fewer “code blue” situations, as well as decreased resource restraints and better patient care when they do occur.
- Barnes Jewish Hospital piloted using mid-level providers, under the attending physician, to focus on transitioning patients from one stage of their journey to the next. This mid-level provider serves as the “glue” that pulls all of the pieces together, even after discharge. Not only has this improved patient care, but referring physician satisfaction has improved because they have a single point of contact to obtain updates on their patients. Additionally, new nurses perceive this newly formed position as a goal in their career path.
All of these organizations first developed a strategy and vision for improving their hospital, and noted that sticking with this strategy was the foundation that enabled these changes. By thinking outside of the box, these leaders used cross-functional improvements to help clinical staff and ultimately improve patient outcomes. To learn more about developing a strategic plan to make improvements in your organization, click here
More, more, more
July 26th, 2010The June issue of Hospitals and Health Networks, brought to light an all too familiar issue, the shortage of physicians, but author Bill Santamour’s explanation was particularly gripping.
To share some highlights – according to Santamour, medical school graduates are on the rise, which is definitely good news for the issue at hand, but residency slots unfortunately are not keeping up with the increase of graduates. Only a one percent annual increase of residency slots has been noted. “And,” as Santamour points out, “with 32 million formerly insured Americans soon to receive health care coverage, the demand for doctors, particularly primary care physicians, will intensify.” As a nation, we need 45,000 additional primary care doctors by 2020, according to the Association of American Medical Colleges.
One bright spot? Texas is one of the leading states in terms of the number of total medical school graduates in 2009!
We’d love to continue the conversation with you about the challenges healthcare organizations are facing and will face in the future. If you’re interested in joining us, take a look at one of our articles, Marketing in the Era of Health Reform. We look forward to hearing what you have to say!
Disney Offers Prescriptions for Experience Management
June 7th, 2010In Fred Lee’s excellent book on translating Disney best practices to hospitals and healthcare systems, I found some insights that align with much of what we talk about in experience mapping, as well as some new ideas. Lee’s use of specific examples from nursing staff to housekeepers make this book a must read. I highly recommend it for those challenged with translating strategy into employee behaviors.
Some take-aways:
-Redefining the competition to the patient’s point of reference, not healthcare. As in experience mapping, there’s a clear need to understand patient expectations which are often not founded in their healthcare experiences. Many patients do not have direct experience with conditions like cancer, heart disease, and delivering babies.
-Mandates don’t work. Almost every organization with which we’ve worked has well documented service standards. The challenge remains that staff find it difficult to translate those items into behaviors. As Lee points out, concrete guidelines and the freedom to perform against them are what’s needed. In experience mapping, we call these the ideal emotion (e.g., I feel empowered). There are a multitude of actions one could take to meet this expectation, but managers must be willing to allow employees to become part of the solution.
-Focus on dissatisfaction. If word-of-mouth advocacy is your best advertising (and studies suggest that negative experiences are huge detractors), then the organizational culture should be set up to address the issues of those who share negative feedback. Our experience dashboards have been doing this for healthcare organizations for years – the most important aspect – identifying dissatisfied patients immediately and putting them in a queue for service recovery. In fact, one of our clients has mandated that managers have 24 hours to contact patients who express dissatisfaction to resolve the issue. The result: a significant increase in volume, advocacy and even percentile rankings using national benchmarks. Fred Lee would be proud.
I want to thank Mark Stinson, a pioneer in the area of process-led design, to share this book with me. Mark’s group helps translate patient expectations we uncover through experience mapping into facility and process design.