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How accurate are patient satisfaction surveys?
'Continual monitoring' brings best results
When it comes to quality assurance in the customer service arena, those patient satisfaction surveys that have become ubiquitous in health care may not be providing accurate feedback, suggests Michael Friedberg, FACHE, CHAM, a manager with Besler Consulting in Princeton, NJ.
"My feeling is that patient satisfaction surveys are potentially flawed," he says. "Many hospitals taint the process by preparing patients in advance of their receipt of the survey."
When he asked a recent gathering of health care professionals if they had a similarly negative opinion of such surveys, three-quarters of the hands went up, Friedberg adds. "I'm not convinced [patient satisfaction surveys] are an accurate representation of the service provided in patient access."
Among the more effective means of accessing managers and directors to measure customer service, he says, are to look at complaints to hospital administration and to create standard telephone scripts and then check to see if they are being used properly.
Since access is a 24/7 operation, that means calling late at night and early in the morning, Friedberg adds. "Many [access departments] have one or two access people on duty from 6 at night to 6 in the morning. If nobody is in charge, they can pretty much do what they want. You need to figure out a way to continually monitor them."
During his early years as a corporate director of access, Friedberg was also a new father. "When I gave the baby a bottle at 3 a.m., I also called all three hospitals. [Staff] used to hate that.
"Mystery shoppers also work very well for this," Friedberg adds. He recounts an example from his own experience in which a mystery shopper, pretending to be an existing patient, presented to his emergency department registration area.
"We expect our staff to re-interview [existing patients], especially in the emergency department," Friedberg says. "The mystery shopper reported that the registration representative did not speak to him during the process, except to ask his name, Social Security number, and date of birth."
The registrar then proceeded to hit the "enter" key all the way through the registration, asked the patient to sign in three places without any explanation, and then sent him on his way, he continues. "If a supervisor, manager, or director was in the area, [employees] would never show this behavior.
"Due to the 24/7 nature of patient access," Friedberg adds, "I would have to say that you must assume some of this is happening — especially on the third and first shifts, that is, 3 p.m. to 11 p.m. and 11 p.m. to 7 a.m. — but it is hard to prove."