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8/14/2019 Experience Mapping for Destination Programs
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Building a Destination Marketing Program from the Inside Out
Service as a Differentiator
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Agenda
Advertising versus Advocacy
Experience Mapping
Our Skin Cancer Program Applications
Questions
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Satisfaction = Profits
Fornell, Mithas, Morgeson III, & Krishnan, Journal of Marketing, 2006
There is a positive
correlation betweencorporate performanceand satisfaction
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Even Starbucks Gets Back to Basics
Closes approximately 600underperforming company-owned stores
with a goal of enabling our
organization to focus itsefforts on locations where wecan more effectively improve
the customer experience.
Howard Schultz, Chairman,
President, CEO (7/1/2008)
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Loyalty and Satisfaction Stem from Experiences
Customer loyalty ismore a result of howcustomers feel about
the overall experiencethey receive from youthan what they
rationally think aboutyour individualproducts and services
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But We Need a Game Plan
Leonard Berry, Ph.D., Texas A&M University,
Professor of Marketing, Gelb Affiliate
Author, Discovering the Soul of Serviceand
Management Lessons from Mayo Clinic
Organizations that simply tweak
design elements or focus on thecustomer experience in isolatedparts of their business will bedisappointed in the results.
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Volume and Experience
To increase patient volume
You need patients and
physicians who becomeadvocates
Because they are
enthusiastic about anexceptional experience
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The Critical Role of Touchpoints
A Touchpoint is theinteraction between anorganization and itscustomers
It is the means by whicha customer realizes thepromise of your brand
And expectations aremanaged
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Touchpoint Types
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Experience Management
What is the current
experience?
How can we make
this experience
exceptional?
How will we deliver a
consistent
experience?
Are we meeting
expectations?
Strategic
Questions
Touchpoint inventory
Staff interviews
Patient interviews
Physician interviews
Operations/ business
processes review
Resources/technology
review
Rollout plan
Customer satisfaction
Touchpoint performance
Employee commitment
Operational performance
improvement
Activities Experience creationworkshop
Implementation planning
Deliverables Touchpoint priority
Day in the Life
Ideal experience map
Touchpoint guidelines
Touchpoint performance
dashboard
Experience dashboard
Organizational excellence
dashboard
Implementation strategy
Understand Design Implement Monitor
Understand
Design
Implement
Monitor
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Benefits of Experience Mapping
Reviews the total experience, including: Expectations prior to the first encounter with the organization
Multiple activities (e.g., parking, check-in, exams, follow-up)
Multiple touchpoints (e.g., materials, conversations, website)
Recognizes changes in attitudes, if any, through each stage
Goes beyond mystery shopping:
By engaging actual patients and their stories, results provide rich insights beyondaudit statistics
Taps into the emotional needs of patients, particularly those with life-changing
events like cancer Increases face validity for staff responsible for making changes
Does not tax medical resources
Includes actual comments (via digital audio files and verbatim comment) toimprove staff empathy
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photo
Skin Cancer Program Patient Experience Map
Key Touchpoints
Primary Experience Stewards
Referring physician Referring
physicians Clerks
Nurses
Nurses
Volunteers/Parkingattendant
Front line staff
members
Physicians
Nurses/Staff Environment
Physician
Nurses Referring
physicians
Ideal Experience Elements
Doctor knows
best
Everything is
smooth
Theyre
expecting me
I feel like their
only patient
Your support
doesnt end
Need Scheduling Arrival Visit End of Visit
photo photo photo photo
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Background
University of Michigan patients access diagnostic, treatment andsurveillance services for Melanoma, Non-Melanoma, and Merkel cellcarcinoma conditions through your world-renowned program
Gelb was retained to derive insights from staff, patient, and referring
physician interviews to lead a process to improve customer empathy todocument the current patient experience, propose a framework fordestination marketing, and provide a set of standards to improve thecustomer journey in other parts of the organization
Our approach examined the customer journey holistically, engaging staff,patients/family members, and referring physicians to:
Define key steps and touchpoints in the patient/physician experience
Assess the performance of those touchpoints
Describe the functional and emotional benefits patients seek
Identify opportunities for alignment and improvement
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Interviews
In-clinic interviews provide visualcues for recall
Interviews with family/support
system reveal unique roles andneeds
By interviewing a large number of
patients, a composite view of thetotal patient experience is attained
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Participants
Over the course of two weeks, Gelb conducted in-depth interviewswith:
50 patients
29 Mohs
12 Melanoma
4 Melanoma & Mohs
4 Merkel cell carcinoma
1 Merkel cell carcinoma and Melanoma
21 referring physicians
54 faculty and staff members who were interviewed individually and in
small groups
These interviews were conducted with the support and assistance ofthe skin cancer program administrative team
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Discussion Areas
Decision criteria
Involvement versus Influence
Expectations
Sources of anxiety
Areas of praise
Experience conclusion
Summary
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Phase Performance Summary
Need
Patients understand that U-M is top-notch, but are intimidated by itssize. More information about the programs services and how its
different from local services could allay fears and reservations.
Scheduling
Patients are highly satisfied with the ease of this process but havedifficulty understanding the need for the consultation. Yet, patients findthe personal attention and organization of this experience reassuring.
Arrival
While the packet helps patients to know what to expect, the wholeprocess of getting to the clinic is still stressful for patients. Their anxietyis high, particularly among older patients. Close parking and friendlygreetings overcome many wayfinding issues.
Visit
The personal attention given by physicians and staff members exceeds
expectations. The timeliness, caring, and expertise of the skin cancerexperience outshine other healthcare experiences.
Follow-up
Education and outcomes provides patients with a sense ofempowerment. The collegial attitude expressed toward referringphysicians leaves patients with confidence in the healthcare system.
The Skin Cancer Program experience is one patients rave aboutSummary
19
High performance Moderate performance Low performance
Summary
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Key referral drivers rooted in reputation, service excellence
Outstanding communication and collaboration regarding their cases
U-M multidisciplinary approach improves quality of care, medical outcomes Consistently positive and efficient patient experiences
Physicians feel differently about other areas, particularly dermatology
Mohs-eligible patients sent to more convenient, but less satisfying local options
Most importantly, referring physicians feel part of the treatment team Patients told their physicians are familiar and made smart a choice in sending
Both parties eager to praise each other
Education is a role U-M fills ably
Dr. Johnsons reputation in medical outcomes, patient focus
Taking the time necessary to answer questions both from physicians andpatients
Physicians are concerned that growth could reduce access andcommunication
Emulate Mayo Clinics efficiency model Improve Web site to promote the program more effectively
Referring physicians are highly satisfied with communication, but areconcerned with consequences of growth
Summary
Summary
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Staff and faculty cite the high standards and patient care, level of service
integration, and positive medical outcomes as critical to success Staff within the skin cancer program feel valued and supported by a strong
leader
Indications that growth must be accompanied by staff and space increases
Some feel that program should be managed under one umbrella
Non-derm staff feel pressure to excel, but dont have resources and control
Separate Mohs/Melanoma clinics inhibit the staffs ability to work as a team
Conflicting priorities and schedules make interdepartmental coordination difficult
A lack of resources limits their ability to meet the demands of the skin cancerprogram
Specific opportunities for improvement
Web site: online forms, secure messaging, condition information, insurance
Improved information transfer with other services (e.g., surgery groups)
More clinical trials
VIP program
Skin cancer staff are proud to be part of a patient-centered program;others respect it, but find staff too demanding
Summary
Summary
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Phase Non-melanoma Melanoma
Need
Patients are worried about quality of life andfacial disfiguration. Nervous, but told by
physician their situation is not life-threatening or
can be treated locally.
Referring physicians often do not provide enoughinformation regarding diagnosis or treatment.
These patients are more likely to have discussed
the situation with someone who has the condition.
Younger patients have the highest levels of anxiety.
Scheduling
Mohs patients may wait longer for their consult
and surgery appointments, but are reassured
their condition is not critical.
Melanoma patients often get appointments
sooner due to the severity.
ArrivalUpon arrival at the Cancer Center patients are greeted warmly; sometimes by the same person they
spoke with over the phone.
Visit
Most finish in the same day. This is a source of
complete satisfaction. Complex cases require
additional services which are skillfully
coordinated.
Visits are coordinated with multiple physicians.
Patients dont see the behind-the-scenes work
required to make their experience a smooth one.
Follow-up
Typically, patients are sent back to their
physicians after their follow-up appointment.
Returning back home quickly endears them to
the program.
Sometimes require more follow-up with other U-M
services. This handoff is often clumsy as no one is
in charge of care. Many also encourage family
members to get screening appointments due to
the genetic link.
Patient handoffs are biggest difference, but not a source of dissatisfactionSummary
22
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A Framework for Action
Interactions are categorized
using the experience map
Each step/touchpoint hasexperience stewards who are
responsible for delivery
With an experience map,every steward can see the
relationship of their actions tothe rest of the journey
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CompetitionFacility Physicians Driving
Distance
NCI
designation
Airfare
(non-stop)
2007 US News
Ranking
(cancer)
University of Michigan 23 0 Miles CCC N/A 21
Beaumont Hospital No program listed
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Non-melanoma Market Profile
Overview: These patients are concerned about their cancer, but, with education,realize its not life-threatening. Motivated by convenience, timely appointments, andpositive cosmetic and medical outcomes
Descriptors:
More commonly older patients (>50 years old)
Depend on dermatologist for medical direction
Anxiety driven by uncertainty, cosmetic outcomes
Size:
Non-melanoma new cases/year 1,000,000 (NCI, US)
Competition:
Procedure available through multiple resources in community
6 active clinical trials within 200 miles of Ann Arbor
Mainly dermatology practices, a primary referral source for the entire program
19 ACMS certified Mohs surgeons in MI (ACMS website)
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Melanoma Market Profile
Overview: Anxious patients with a potentially life-threatening cancer diagnosis.Having a team approach is critical for accurate diagnosis and effective treatment.Early detection is the key to a cure.
Size:
Merkel cell 1,200 new cases per year (NCI)
Melanoma 60,000 new cases per year (NCI)
Descriptors:
Less than 5% are self-referred
Multidisciplinary very important
Many arrive at U-M without diagnosis
Anxiety driven by life-threatening nature of condition
Competition:
Numerous multidisciplinary programs within 250 miles
23 active clinical trials within 200 miles of Ann Arbor
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Messaging
Overcome perceptions as too big and bureaucratic
Leverage positive reputation and service excellence
Fight your disease, not red tape
FasterOrganized around patient to completeMohs treatment in one week;Appointments within a week forMelanoma with multi-disciplinary team
BetterLargest multidisciplinary team in the countryThis team of experts gives you the best chance for favorable medical outcomesBest trained: only two year fellowship in the countryReturns to your community physicianMedically-trained care coordinatorsNCI Comprehensive Cancer Center designation
99% success rate (Mohs) this is available for all doing Mohs
CheaperDetroit Metro airport: international hubTransportation ease
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Tactics Consumers
U-M Differencepatient stories
In one week, at one placeall my questions answered, treatment by a team of nationally-
recognized specialists, cancer eradicated or quality of life improved
Imagery
No buildings
Patient after pictures only (cant be scary)
Doctors/staff behind patients, busy executives
Improve online physician profiles
Care philosophy
Motivations why I care about patients
Showcase expertise
Figurehead: Dr. Tim the authority in skin cancer
U-M Indices: Sponsored Skin Cancer or UV Index
Set standards for early detection programs for melanoma
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Tactics - Referring Physicians
Build wider team of referring physicians in key markets
Destination program will not interfere with patient relationships and encourage return
Provides support of multidisciplinary teamsecond opinion (e.g., pathology)
U-M maintains contact when following their case
Branded physician tools
Skin self-exam
Patient education materials
U-M website for downloads
Skin Cancer Knowledge Transfer CME online or hosted on-site (make sure DOs can receive credit)
Conferences national/international venues, focus on melanoma
Newsletter - information about the latest technology, other physicians in program
Use these forums to build reputation of other program faculty (skin cancer, medical oncology,
plastic surgery, pathology, etc)
Include international outreach education
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The Patient-Centered Culture
MotivationX
Ability=
Behavior
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A case for change must be made to physician administrators
By focusing on the patient , the skin cancer program has successfully:
Decreased/minimized staff turnover
Improved staff empowerment and satisfaction
More service line revenue = better office space and amenities
Improve program-specific donations (e.g. Hannah Fisher fund-raising)
Potential claims:
Increase access to clinical trials (our searches dont support this)
Improved patient satisfaction (must separate this from dermatology) Improved faculty recruitment (not sure if youre losing to community, too)
Motivation
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Current enablers in the Skin Cancer program:
Mantra with a focus on the patient, not on the physician
Strong leadership
Scheduling templates
Direct access between front office and physicians
Interchangeable faculty and staff
Role players, not generalists (e.g., bench scientists versus clinicians)
Team driven innovation, physician driven implementation
Use of first names puts everyone (and their input) on the same level
Opportunities for improvement in Skin Cancer program:
Training of those not directly in the unit (support services like call center)
Not just near misses but patient moments
Monitoring system for patient experience
Tutorials on software tools Scheduling templates for other areas
Better use of online media photos from community physicians, website scheduling, etc
No voice mail in other departments; home phone numbers physicians?
Monitoring mechanisms (e.g., calls to Cancer Answer Line, referring physician satisfaction)
Succession planning the next Tim
Ability
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Consistent communication and support from senior leadership
The mantra
Reinforces clarity of purpose
Research does not come at the expense of the patient
Patient focus relentless and genuine Linking performance to pre-defined objectives
Holistic design of an exceptional functional and emotional patient experience
Empowerment
Collaborative problem solving Anticipating patient needs
Mutual respect
Community physicians are colleagues Dont knock the doc
Phone call post-op from physician/nurse to patients Consideration of ideas from those who are experience stewards
Behaviors
Adapted from APQC Best
Practice Benchmarking
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Interviews indicate that the current experience for melanoma patients is comparableto non-melanoma, but it seems to take more resources to manage
Satisfaction score differences between Mohs and Melanoma not statistically significant (small
sample sizes, but our interviews indicate the same)
The non-dermatology staff who serve melanoma and Mohs patients are caught in the
middle Arent dedicated to serve only skin cancer patients
Do not receive the same type of training regarding skin cancer conditions
Administrators may place restrictions on what can be changed
Cannot draw from a large pool of resources
Not included in Skin Cancer staff meetings
Nevertheless, expectations from the skin cancer program staff are high
Therefore, there needs to be a new collaborative mechanism established betweenskin cancer and others
First Stop: Melanoma
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Participants were divided into three groups:
Administration
Physicians and Nurses
Frontline Staff
Each group will be asked to identify opportunities toimprove the ideal patient experience
Creating Solutions
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Operational Output
As a result of the kick off meeting November 7, 2008 three groups,physicians, nurses, administrators, and front end staff each
highlighted barriers and developed solutions for issues.
Three distinct committees are being formed with subcommitteesattached to each:
The Steering Committee: A high level administrative committee. The purpose ofthis committee is to have a high level view of what the operational, clinical andbusiness barriers are to the programs and create steps to remove the barriersand ensure success.
The Clinical Enterprise Refinement Group: Comprised of several key physiciansand clinicians, will work to resolve the clinical issues pertaining to the program.
Business Enterprise Facilitation Group: Comprised of business service team.Will meet quarterly and oversee the business issues which relate to the program.
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Meeting the Demand
Creating a phone decision tree for all calls
Perfect the registration process to include a flag forthese patients in all systems which include registration,scheduling and billing and cash collections
Ensuring that a system is in place to monitor each andevery patient for quality assurance, lessons learned, andupgrades needed to the program
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Promotion
Consumer - print and radio ads attached
Purpose of this and search advertising efforts is to drivequalified(diagnosed) patients to our landing pageshttp://www.umskincancer.org/
Referring Physicians - sent dedicated Colleagues inCare newsletter, with personal letter attached from Dr.Johnson.
http://www.umskincancer.org/http://www.umskincancer.org/8/14/2019 Experience Mapping for Destination Programs
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Results Q4 2008
Acquired 33 new patients
Conversion rate of 33% from phone inquiry to patient
Close to 60% of inquiries from outside of Michigan
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Making this Work for You
UMHS as a large, academic medical center, has all the same challenges of
decentralization, doctor/administrator personalities, and strategy/budgetcoordination as you do
We have larger plans for destination programs, and purposely choose thisone as a pilot to demonstrate to the nay-sayers that this can work
We're not creating new "centers of excellence" and all the organizationhurdles that presents, rather we're capitalizing on ones that already exist byadding the factor of customer service
This process output allows individuals to see the relationship of their actionsto the rest of the journey -- get out of our internally-created boxes
Need a physician champion like Dr. Tim Johnson
Thorough internal communications are key
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Questions
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John McKeever, [email protected]
800-846-4051 x22
Gelb Consulting Group, Inc.
1011 Highway 6 South, Suite 120Houston, TX 77077
281-759-3600
www.gelbconsulting.com