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Customer Service & The Health Care Consumer Experience Created by: Dian Frankson MHA TH-Staff Assistant One SUNY Downstate Medical Center

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  1. 1. Created by: Dian Frankson MHA TH-Staff Assistant One SUNY Downstate Medical Center
  2. 2. Questions to be answered in this course Module 1. Customer service in Health Care What is customer service? Who is the health care customer? Vs. Who is the health Care customer? Who is the customer service representative in a health care organization? What is the Customer service attitude? Module 2. The Health Care Consumer experience What is consumer experience? How can I provide excellent customer service and improve the consumer experience?
  3. 3. Customer service in Health Care Module 1
  4. 4. Customer service has existed for as long as there has been some form of trade between persons.
  5. 5. Customer service is important because it establishes the relationship between consumer and industry provider; it differentiates a company from its competitors. Greys Anatomy Private Practice
  6. 6. In 2022, CMS projects that together, federal, state, and local governments will fund nearly half (49%) of national health care expenditures. -Adam Tatum 2013 (http://cacs.org/pdf/40.pdf)
  7. 7. www. downstate.followmyhealth.com
  8. 8. A Health Care Consumer focused culture Patients who reported that they "Always" received help as soon as they wanted -HCAHPS measure for individual hospitals
  9. 9. Health Care Customer or Health Care Consumer?
  10. 10. Examples of Health care consumers we come across here at SUNY Downstate are: Current Patients Employees Potential Patients CBOs Patient Care Givers Students Patient Proxy & Family Other Hospitals Private Practice
  11. 11. Who is the customer service representative in a Health Care organization? Do you answer phone lines that the public can access? Are you at any point in your day in the same place as? Patients Patient family members, Guardians, or Proxy Other members of your organization Are you required to wear and ID or uniform that identifies your title and employer? If your answer is yes to any of these questions you are a customer service representative for your organization and this course pertains directly to you!
  12. 12. I control The SUNY Downstate Medical center experience
  13. 13. I control The SUNY Downstate Medical center experience Every member of this organization is a patient representative. No matter your grade level or title you have the power to set the tone of every health care consumer encounter. As a patient representative a consumer of health services may : Approach you with question about the organization you represent Make complaints to you about the service provided by another organization representative Make complaints about you
  14. 14. You play an important role in how consumers and regulatory agencies view your organization as a result it is important that you know where to get answers You should be able to direct patients and those involved in their care to: The closest: bathroom, courtesy phone, security post or clinical professional A copy of the patients bills of rights (Learn the facility to help our health services consumers find the services they need) When a patient makes a complaint to you it is your responsibility to: Listen attentively and ensure the complainant that you will find the appropriate representative to respond to their query and get back to them. Unless the patient implicitly expresses that it is against their wishes you should inform the person providing clinical care for the patient of the complaint. Report complaint and details of your involvement to your immediate supervisor. Return to the Health care consumer who issued the complaint and inform him/ her of what you have done to accommodate their query and who will contact them at what time.
  15. 15. There is a difference between a complaint and a grievance - patient complaint mechanism PTBR 3 Complaint a request or concern that is resolved at the time of the complaint by the frontline or supervisory staff Grievance a complaint that is not resolved at the time of the complaint by the frontline or supervisory staff . Complaints alleging abuse/neglect, Medicare billing issues, or where the patient/ family feels they are not receiving safe quality care must be handled as a grievance A written complaint is always considered a grievance all grievances are to be referred to patient relations who will work with clinical staff and leadership to resolve the patients concerns. Check with you department leadership to be sure of your role in reviewing and addressing either a complaint or grievance.
  16. 16. Healthcare Consumer Initates conern with POS Health Care represetiative Is concern a complaint ? Complaint resolved at POS Patient relations informed of complaint for follow up email sent to department head about complaint Complaint not able to be resolved at POS Is concern a grievence? Healthcare Consumer greivence report is written and sent to Pateint Relations Dept Within 12 hours of reciept of complaint PR will 1. visit with in-patient complainant or call out-paitient complainant to physically acknowledge geivence 2. Patient Relations Dept. will generate and post an receipt of greivence letter to patient Pateint Relations Department will contact Department head about HCC greivence Patient Realtions Departmet will issue formal report with COPC and Director of service area where incedent occured COPC resolution process begins Patient realtions will contact patient in wrtiitng to inform pateint of steps taken to adress initial concern and COPC's involvement in the resolution of the greivence
  17. 17. Contact information for reporting and event
  18. 18. Patients have the right to Call NYSDOH directly at 1-800-804-5447 Call The Joint Commission at 1-800-994-6610 If they are not satisfied with the hospitals actions Call IPRO at 1-888-880-9976 If they are a Medicaid patient who feels they are being discharged too soon from the hospital without fear of reprisal
  19. 19. M1A. The Customer service attitude You never get a second chance to make a good first impression. -unknown Ted Lecturer Jan Gunnarson on making people feel welcome Consider the four customer service senses: What does the customer see? What does the customer hear? What does the customer smell ? What does the customer feel? Attitude is everything Huggies ad
  20. 20. What a customer service attitude looks like For Dummies Answer the phone with a greeting before identifying yourself or your company. Doing so starts the conversation out on the right foot. Become more aware of your facial expression when a customer approaches you. A smile works much better than a grimace. Customers often judge your mood on how you look when they approach you. Don't take it personally when a customer complains. Think of a complaint for what it is, an opportunity to get valuable feedback from your customers. You listen better if you don't feel threatened. Always offer options when you can't give customers exactly what they want. Your customers can live with a no if it is softened by alternative recommendations. Before transferring a customer to another extension (if you must), ensure that the service provider is available before completing the transfer. A dead end transfer creates a negative impression. (For Dummies A Wiley Brand) Always act with Empathy, Professionalism, and Service
  21. 21. Module 1. Customer service in Health REVIEW A Health care customer is any person or organization that purchase services from a HCO A Health care consumer is any person or organization who utilizes the services of a HCO Every member of SUNY Downstate Medical Center regardless of title or grade is a representative of SUNY Downstate Medical Center, and may act as a customer service representative to the health care consumer. The customer service attitude is a culture of I can, it means being prepared to address the needs of the health care consumer, affiliates, vendors, and other organization members with a friendly energy and a compassionate outlook. When a patient approaches you with a query or concern you are the health career representative in control of this patient encounter. If the patient issues a complaint with you that you cannot resolve bump it up! Health care consumer complaint Flow chart QUIZ Answer Video
  22. 22. END OF MODULE 1
  23. 23. The Health care Consume Experience Module 2
  24. 24. What is the experience of a Health Care Consumer ? Why do consumers engage the health care system? What does excellent health care look like to you? What do you expect from your health care provider?
  25. 25. Barriers to care Transportation Barriers Financial Barriers Education and awareness barriers Language Identification and Documentation Disability Inadequate provider availability due to reimbursement rates OTHER EXTERNAL STRESSORS THAT AFFECT THE PATIENT EXPERIENCE Child care Abuse Sexual Identity Criminal implications
  26. 26. Customer service Tools for reducing barriers to care Transportation Barriers Courtesy transportation services (free metro cards) Having Transit maps on hand, MTA Trip Planner, or any smart phone transportation AP Having print information about Hospital van services Financial Barriers & Identification and Documentation Referral to financial services Department Having referrals about insurance options and contact information readily available Building relationship with insurance consultants and maintaining an updated phone log of accepted insurance provider information Education and awareness barriers Patient Navigators Taking the time to orally explain information in simple and relatable terms Make appointment reminders through various communication formats Providing culturally sensitive patient education literature Language Use telephone translation devices Have an updated translator log Providing culturally sensitive patient education literature Multi lingual, Large print, and brail signage Disability Wheel Chair ramps Being courteous Patient and considerate towards wheelchair users Having large print and brail signage & pamphlets
  27. 27. Customer service Tools for improving the patient experience Scripted telephone etiquette (Try to answer calls by second ring) Flexible appointment times Appointment Reminder Pre visit questionnaires What you should bring to your appointment? (List) Staff Huddles
  28. 28. The Visit experience Facilitating a positive Patient experience in the:
  29. 29. Front Office Appearance Orderliness of wait area, reception area, and restrooms Professional and approachable attire of staff Scripted front desk greeting and sign in sheet Comfortable seating Aesthetic Trappings i.e. Stock area with magazines and health education materials. Play pleasant music in the background at a low volume. Display a health education program on the TV (if available). Offer a cup of water or have a water dispenser available
  30. 30. Front Office Etiquette Be prepared Eye contact with a warm smile Speak in a audible but uniform tone Call Patients, Care givers, and HCO professionals by last name Have a pen available Never address grievances in front of your patients Do not eat , listen to music ( with ear buds or without), internet shop, manage social networking, or have personal conversations in patient care areas Do not make assumptions about client preferences, ask!!! Acknowledge if there is a wait longer than 15 minutes and apologize to the patient
  31. 31. 3 phrases that hurt the patient experience and how you can correct them 1. I dont know Thats a great question let me find out for you! 2. I cant do that MR/MS I would be happy to help you with that lets see what I can do! 3. Its Hospital policy Mr/Ms we generally do not because it is not beneficial to your health care needs. What we can do for you is
  32. 32. Examination area Greet the patient with a smile and ask how he/she is Direct the patient to a clean room in an organized manner Tell the patient the general range of time before seeing a practitioner Provide health education materials to read while waiting in the exam room
  33. 33. Closing the patient visit Remind patient of any necessary tests or exams he/she should get Schedule any necessary follow-up appointments, if you come across any conflict scheduling urgent appointments be respectful of the health care consumers time and set a time frame within which you will contact them with the appointment information. Ask the patient to fill out a brief, anonymous, survey about the visit to get feedback on your service performance Give the patient a smile and nice farewell
  34. 34. The challenging patient visit How to treat a difficult patient experience Whatever the emotional state of the patient, it is important to understand his/her needs The patient is not upset at you. Dont take it personally! Listen Allow the patient to speak and state his/her concerns without interrupting Ask questions to help you understand his/her needs Demonstrate active listening skills Commiserate Put yourself in the patients shoes (How would you feel if the same thing happened to you?) Treat the patient the way you want to be treated Make an apology Be sincere and specific with your apology Avoid over-explaining the mistake Acknowledge the patients stress without playing the blame game I.e. I am sorry that this was your experience, and I acknowledge how this has affected your experience with us. Please allow me to look into this. Do something Do whatever possible to correct/resolve the problem/issue Follow through until the issue is resolved Deliver on promises. If you cant deliver it, dont promise it.
  35. 35. THE HEALTH CARE CONSUME EXPERIENCE Drivers of Patient loyalty
  36. 36. Drivers of Patient loyalty Data-Mining Patient Experience Navigation of the health care process Conflict resolution / Loyalty recovery Clinical quality
  37. 37. Module 2. The Health Care Consumer experience REVIEW Barriers to care are the experiences and physical difficulties that prevent a health care consumer from seeking medical attention. Being prepared by having available information and securing networks of service relationships that make it easier for the health care consumer to access your organization will reduce barriers to care Investing in translation equipment, making physical modifications for the physically disabled, and being culturally competent will make your organization the health care provider of choice in the community it serves Using scripted communication and maintaining a professional image is the best way to initiate the patient experience Being respectful of the health care consumers schedule, culture, and vulnerability is important when creating the patient experience Communicate Communicate . . . . Communicate
  38. 38. THANK YOU!