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©2015 MFMER | slide-1
Service Recovery In Healthcare: Movement From Reactive To Proactive
Sandhya Pruthi, MD, Medical Director for Patient Experience, Mayo ClinicChrissy VerNess, Patient Experience Coordinator, Mayo ClinicSheila Stevens, Patient Experience Coordinator, Mayo Clinic
©2015 MFMER | slide-2
Service Recovery in Healthcare: Movement From Reactive to Proactive
Sandhya Pruthi, MDSheila Stevens, MSW
Christina VerNess, MHAMayo Clinic, Rochester, MN
©2015 MFMER | slide-3
Objectives• Describe the development of a pilot program at Mayo
Clinic (Rochester) to address and resolve patient complaints by frontline staff
• Discuss the importance of addressing service breakdowns at the point of service
• Describe empathic strategies utilized for service delivery and service recovery
©2015 MFMER | slide-4
Let Me Introduce You to My Patient…
©2015 MFMER | slide-5
Patient Experience Definition
An unparalleled patient experience is the result of inspired and dedicated employees demonstrating excellence, compassion and respect by partnering with patients, family and colleagues to continuously
improve the healthcare service experience.
©2015 MFMER | slide-6
MetricsService recovery
Mayo Clinic PX Model
Accountability
Consultation
Recognition & reward
Monitoring & control
Patient Experience
Service values & behaviors
Education & training
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Rights and responsibilities Hospitality
First impressions Professionalism
Other Important Elements
Patient family-
centered care
Respect for diversity Health care literacy
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Patient Experience Team• An identified entity at Mayo Clinic Enterprise• An internal consulting resource trained in the field of
Patient Experience, an emerging field• Sites: Arizona, Florida, Mayo Clinic Health System,
Rochester• Overarching goal – to improve the overall Patient
Experience at every “touch point” of care
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Pilot Overview • Leadership from the following areas requested participation in pilot:
• Urology• Neurology• GIM• Outpatient Pediatrics• Neurosurgery
• Total Trained • Providers – 107• Allied Health - 779
• Educate staff • Service delivery (AIDET)• Service recovery (LEAD)• Online Tracking Tool (Midas)
• Timeline• June 2014 through December 2014
• Patient Experience Champions
©2015 MFMER | slide-10
Evolution of PilotBeginning
• Provider & AHS together• GIM• Outpatient Pediatrics (still need
recovery training)
• Training time 2.5 hours
• 80% didactic - 20% interactive
• Session 1 title – Service Delivery
• Session 2 title – Service Recovery
End• Provider & AHS separate
• Urology• Neurology• Neurologic Surgery
• Training time 1.5 hours(Combined & Revised Curriculum)
• 50% didactic – 50% interactive
• New title – Empathic Communication
©2015 MFMER | slide-11
Service Recovery ProcessPatient communicates concern
staff
Staff able to resolve the concern
Offer apology, thank you, goodwill gesture (if appropriate)
YES
Review algorithm with escalation process
NO
Document in Tracking
Tool/Midas
©2015 MFMER | slide-12
Leadership contact order: (example)• Supervisor• Ops Manager• Administrator
Patient communicates concern
Frontline staff able to resolve?
Preferred method of communication
No
Yes
Decision Tree: Local Level Complaint HandlingQuestions or Concerns – Office of Patient Experience, 507-284-4988
Communicate w/patient: their concern will be
shared with your supervisor for follow-up
Speak to someone right now Call back Letter
Contact appropriate leadership staff
Available? YesTransfer to leadership
for resolution of concern
No
Contact next available leader
Frontline staff documents patient concern and contact
info. and e-mails to supervisor
Offer an apology, parking or food
voucher
Document in MIDAS before the end of
your shiftClose
Leadership able to resolve
Follow-up w/patient, offer an apology, parking or
food voucher
Document in MIDAS
Close
YesNo
OPE - review MIDAS documentation provided
by local level staff
Follow-up w/patient, offer an apology, parking or
food voucherDocument in MIDAS
Close
Leadership Review Process:• Review concern as shared w/ you
by frontline staff• Discuss concern (in-person, e-
mail) w/ provider, administrator or supervisor
• Contact patient or family member w/ resolution after investigation
• Document investigation and follow-up in MIDAS
Types of Concerns:• Access• Wait times• Communication w/ department staff• Scheduling error• Lost or destroyed records• Environment / Cleanliness• Concerns specifically related to your area • Second opinions w/in depart.
Types of Concerns:• Confidentiality Breaches• Amendment Requests• Concern outside the
department• Pt. refuses to speak w/
leadership• Unable to be resolved by local
leadership• Alleged abuse or
inappropriate touch• Second opinions outside dept.
Leadership - document steps taken in MIDAS
Leadership - offer OPE as option; provide OPE
location & phone number
Patient makes contact with OPE
\\mfad.mfroot.org\rchdept\QualOffice\Groups\Patient Experience\Service Recovery\Complaint Flowcharts\MCR
©2015 MFMER | slide-13
©2015 MFMER | slide-14
What do you expect as a patient?
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25
18
8
7
6
3
3
3
2
20 5 10 15 20 25 30
Communication
Access
Shared Decision Making (SDM)
Clinical Quality and provider knowledge and skills
Physical environment
Patient Education
Electronic Medical Record (EMR)
Pain control
Discharge process
Preventive services
Number of Studies
What Patients Say…
Mohammed, et al.
©2015 MFMER | slide-16
AIDETSM = Five Essential Communication Behaviors
I Introduce
D Duration
E Explanation
T Thank You
A Acknowledge Decreased anxiety
Improved health outcomes & satisfaction
+
=Increased compliance
©2007 Studer Group
©2015 MFMER | slide-17
Challenging Communication
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Empathically Redirecting
• Orient with name and sound• Ask permission to jump in• Reflect, validate, summarize• Redirect to mutual goal
©2015 MFMER | slide-19
What is Service Recovery?
Mayo ClinicAn empathic approach
to quickly respond andfairly resolve patient concerns,
in a way thatmakes them feel satisfied
©2015 MFMER | slide-20
Just the Tip of the Ice BergRich information used for improvement opportunities
96% will not complain, leave us and tell 25 others
Only 4% complain
©2015 MFMER | slide-21
Listen Empathize Apologize Do something
©2015 MFMER | slide-22
Service Recovery Paradox Effect
The Service Recovery Index, AboutFace
©2015 MFMER | slide-23
Standardized Service Recovery Tool Kit
• Cafeteria Vouchers• $10 per voucher
• Parking Passes• All day pass
• Message/Note Cards
©2015 MFMER | slide-24
Intended Outcomes
• Enhance patient satisfaction • Identify trends• Develop standardized recovery methods• Improve employee communication• Enhance employee morale• Identify Pt Champions to reinforce message
©2015 MFMER | slide-25
Lessons Learned
• AIDET & LEAD into one session• Identified a need for empathic redirection• Small classroom setting for interaction is crucial• Need leadership buy-in prior to execution• Re-evaluate delivery of provider trainings based on
feedback• Re-visit tracking tool methods
©2015 MFMER | slide-26
Benefits of Patient SatisfactionClinical outcomes • Lowers patient stress• Improves decision-making • Improves patient
compliance
Profitability / financial sustainability• Increase in patient volume• Improved reimbursement rates• Fewer malpractice lawsuit
Brand• Improved patient retention
and referrals
Employee satisfaction• More productive staff• Better morale
©2015 MFMER | slide-27
Back to Sheila’s patient…
©2015 MFMER | slide-28 ©2014 MFMER | 3325622-28
©2015 MFMER | slide-29
Summary• AIDET – Service Delivery• LEAD – Service Recovery• Empathic Communication
• Disconnect between expectations and reality• Service Breakdowns• Noncompliance
Original quote by Maya Angelou
©2015 MFMER | slide-30
References/Resources
Bendall-lyon, Dawn. Powers, Thomas. (2001). The role of complaint management in the service recovery process. : The joint commission.
Doyle, C., Lennox, L. & Bell, D. (2013). A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. British Medical Journal, 3(1)doi:10.1136/bmjopen-2012-001570
Hsu, I, et al. (2012). Providing support to patients in emotional encounters: A new perspective on missed empathic opportunities. Patient Education Counseling. 88(3) 436-442. doi:10.1016/j.pec.2012.06.015.
Mohammed, K., et al. (2014). Creating a patient-centered health care delivery system: A systematic review of health care quality from the patient perspective. American Journal of Medical Quality. doi: 10.1177/1062860614545124
Types of Customer Experience Research. (n.d.). Retrieved December 31, 2014, from http://aboutfacecorp.com/wp-content/uploads/2014/07/Promo-ServiceRecoveryPlan-AboutFace-7-11-14.pdf
©2015 MFMER | slide-31
Next…
Community Dialogue on Improving Patient Experience throughout the Continuum of
Care
4:00-5:00 PMDallas D-H