Patient Loyalty: Making a Difference
© 2007 Studer Group
Barbara Hotko, RN, MPA
Studer Group Coach
January 12, 2011
Today’s Session
Patient loyalty – why?
Measure what matters most
Tools for success
© 2010 Studer Group
Patient Loyalty Pays: Treating patients with
respect adds up to satisfaction & repeat visits
“Satisfied patients return for care, and the positive
word of mouth from satisfied patients will bring new
patients into the practice.” (Drain & Kaldenberg 1999, 32).
A better patient rating of information quality and
physician quality was “associated with patients
reporting that they would definitely return” for care.
(Lechtzin, Rubin, White, et al 2002, 1326).
“The compassion with which care is provided appears
to be the most important factor in influencing patient
intentions to recommend/return, regardless of the
setting in which care is provided.” Burroughs, Davies, Cira, Dunagan 1999
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
© 2010 Studer Group
Patient Loyalty Pays: Treating patients with
respect adds up to satisfaction & repeat visits
“Treatment with respect, the rating of care received,
and the helpfulness of the person at the front desk are
the strongest predictors of patient satisfaction…patient
satisfaction is highly correlated with intent to return
and intent to recommend services.” Hill & Doddato (2002, 108)
“Patient satisfaction will significantly influence the
intent to return and intent to recommend services to
others; thereby serving as a determinant for repeated
clinic visits, new patient visits, and program
marketing.” Hill & Doddato (2002, 108)
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
© 2010 Studer Group
Patient Loyalty Pays: Satisfaction, Loyalty
and Profitability are linked
Loyalty has been an area of focus both within and
outside of the health care industry for sometime.
The links between customer satisfaction, loyalty,
and profitability have been well established. (Reichheld 1996)
High levels of satisfaction with a service
relationship will override service failures, suppress
shopping for another service provider, and maintain
high compliance. (Forrester & Maute 2001)
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
© 2010 Studer Group
Health Managers Network: Building Patient
Loyalty
Are you measuring patient satisfaction?
50%
50%
1. Yes
2. No
1
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2
Health Managers Network: Building Patient
Loyalty
Are you measuring patient turnover?
79%
1. Yes
2. No
21%
1
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2
Health Managers Network: Building Patient
Loyalty
What is the #1 reason patients leave your practice?
1. Insurance change
56%
2. Dissatisfaction with
3.
4.
5.
6.
provider and/or staff
Geographic location
Disagreement with
treatment of care
Wait time (while in
office)
Appt. availability
22%
7%
1
© 2010 Studer Group
2
3
9%
4%
4
2%
5
6
Patient Loyalty Pays …
A “high level of satisfaction will lead to greatly
increased customer loyalty …
And increased customer loyalty is the single most
important driver of long-term financial
performance.” (Jones & Sasser 1995, 88)
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
© 2010 Studer Group
The Cost of Dissatisfaction
The other side of the satisfaction-loyalty link is the link
between dissatisfaction and loss of revenue due to
patients who switch providers or hospitals. Through
the Healthcare Financial Management Association
reports:
• For every one customer who complains, 20 dissatisfied customers do not.
• Of those dissatisfied customers who do not complain, 10% will return but 90% will not.
• Changing a poor customer service image takes 10 years average.
• It costs 10 times as much to attract new customers as it does to keep current ones.
• About 10% of revenue is lost to poor customer service.
• The average “wronged” customer will tell 25 others about the bad experience.
(2004)
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
© 2010 Studer Group
Zimowski
The Cost of Dissatisfaction
Patients dissatisfied with physician care and practice are
more likely to leave. (vom Eigen, Delbanco, Phillips, 1998)
Conservative estimate: In a practice with 6,000 patients, if
5% are dissatisfied and leave with members of their
household (assuming 3.5 members per household and 2.5
visits per year, this would be 8.75 visits per household per
year), and the average visit averages $57 in payments, the
cost of dissatisfaction is $149,625. Using the Consumer
Price Index, this would equate to over $180,000 in 2006
dollars (http://www.measuringworth.com/uscompare/). Drain
and Kaldenberg (1999)
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
© 2010 Studer Group
Patient Loyalty
To earn patient loyalty, your staff will need to provide
excellent care for every patient in every encounter.
In order to do so, staff will need:
Actionable Data
Tools
© 2010 Studer Group
AHMG surveys patients by clinic and by
physician
Sample survey questions:
Staff make me feel like I am important and valued
The doctor listened to me and showed respect of
what I had to say
Overall Experience
Recommend to family and friends
© 2010 Studer Group
“What patients want” in rank order
1. Treats you with dignity and respect
2. Listens carefully to your health concerns
3. Easy to talk to
4. Takes concerns seriously
5. Willing to spend enough time with you
6. Truly cares about you and your health
Source: Harris Poll, 2004
© 2010 Studer Group
Studer Group Five Fundamentals
Safety
A
Acknowledge
Decrease
Anxiety
I
Introduce
Increase
Compliance
D
Duration
E
Explanation
T
Thank You
Quality
Patient
Loyalty
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Advantages of AIDET
SM
Decrease anxiety with increased compliance
Decreased
Anxiety
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+
Increased
Compliance
=
Improved
clinical
outcomes and
increased
patient and
physician
satisfaction
Outcome – AIDET
Physician and
staff AIDET
training
University Medical Center
Physician Practices
Tucson, AZ
© 2010 Studer Group
FPA - Otolaryngology
3rd Qtr
08
4th Qtr
08
1st Qtr
09
13
33
35
Mean
83.5
n=30
Mean
88.9
n=31
Mean
89.2
n=82
Mean 91.9
n=49
Access to Care *
16
40
40
55
Visit *
16
34
17
42
Nurse/Assistant *
5
53
48
91
Care Provider *
17
40
49
80
Personal Issues *
9
10
30
59
Overall Assessment *
24
46
60
74
Overall Results Otolaryngology
Percentile Rank
Mean (raw score)
* Percentile ranking
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2nd Qtr
09
69
Acknowledge
A
Acknowledge
Key message: YOU are
important
 Eye Contact
 Make the patient feel that you
expected them
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Introduce
I
First Generation
 Name
 Title
 Specialty
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Introduce
Next Generation
 Your role in the team
of care givers
 Your experience, skill
set, or credentials
 Coworkers,
physicians, other
departments, AHMG
Manage Up!
A Short Bio
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Examples of Managing Up
“Hi, I’m Georgette. I’ve been with Dr. Smith for
over three years and he is excellent. Welcome to
our practice.”
“We have a great staff and we are going to take
very good care of you.”
“Dr. Jones takes the time to answer each
patient’s questions.”
“Good Morning, Mrs. Smith. My name is Ann. I
am a medical assistant and I have been working
in this practice for five year.”
© 2010 Studer Group
The A and I of AIDET for Safety
“Because greetings are one
way to ensure proper
identification of patients, they
may well be considered a
fundamental component of
patient safety”
© 2010 Studer Group
Duration
D
Duration
Key Message: I anticipate your
concerns



How long will the registration
process take?
How long will the test, procedure,
or appointment actually take?
How long will it take to get the
results?
Goal: Keeping Patients Informed
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Keeping Patients Informed of Duration
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Explanation
E
Explanation
Listen to the patient’s story:
 Active listening
 Clarifying questions
 Understanding patient’s perspective
Explain the treatment plan:
 Using language that patients can
understand
 Use “key words”
 Use “tell, ask, tell” approach
 Involve patient in decision making
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Explanation
E
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Explanation

Why are we doing this?

What will happen and what you should
expect?

What questions do you have? (about
medications, instructions for follow up
care)
Reality of Explanation
During a 20 minute encounter
Physicians self-report spending 9 minutes “providing
information”
REALITY: Physicians spent 1.5 minutes
The key driver for patient
satisfaction
The quality and clarity of
information that patients
receive from physicians
© 2010 Studer Group
Patient Perspective
72% of patients unable to list medications they
take
58% of patients unable to recite their own
diagnosis
Mayo Clinic Proceedings, 2005
© 2010 Studer Group
Thank You
T
Thank You
Key message: I appreciate the opportunity
to care for you
Closing Key Words
 Thank you for choosing us
 Thank you for your patience today
 Thank you for coming in today, I
know we can help
© 2010 Studer Group
AIDETSM
Vanderbilt University Medical Center,
Nashville, TN
© 2010 Studer Group
Loyal Patients
Loyal Patients will …
Return
Advocate for you in the community
Talk
© 2010 Studer Group
Creating Patient Loyalty – THE WHY
Improves patient compliance
Improves clinical outcomes
Improves patient satisfaction
Increases growth and market share
Reduces malpractice risk
Improves physician satisfaction
Improves clinical efficiency
© 2010 Studer Group
Practicing Excellence
A guide to
implementing specific
behaviors that will
create a high
performance
workplace
Written by a physician
Available online at
www.studergroup.com
© 2010 Studer Group
Thank You!
Barbara Hotko
bhotko@studergroup.com
Partner Relations Coordinator
Lauren Holstman
850-343-1057
www.studergroup.com
© 2010 Studer Group