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Independent of the Affordable Care Act or any upcoming changes in health care, the focus of an ObGyn practice remains paramount: the patient comes first.
The “recipe” for creating patient satisfaction and service excellence is predicated upon the mission of your practice and creating a shared vision with your employees. An action plan that is created and “visited/revisited”on a regular basis will serve to keep all abreast of the latest information to enhance the quality of patient care. It goes without saying, the ObGyn must first “lead by example” and always strive for satisfied patients who will tell their friends about your practice.
Start with the right tools
To organize a practice well, you need the right tools, which ideally include mission and vision statements and an action plan with goals and objectives.
Mission statement
A mission statement can be developed by the ObGyn(s) in your office or in concert with your staff. It should include:
- the “here and now” focus on the current approach to patient care
- why the practice exists (Develop a brief description of your practice, including the desired patient population.)
- the products and services offered and why and how those services are provided.
Here is an example of a mission statement for an ObGyn practice: “Our mission is to provide excellent, exceptional, personalized care for women of all ages in a warm and friendly environment. We incorporate leading-edge technology in our practice and continue to be a leader in obstetrics and gynecology.”
Vision statement
A vision statement should be developed in concert with your staff. It should include:
- the “then and there” focus on the historic perspective of your practice
- the ObGyn(s) and staff vision of the future
- what the ObGyn(s) and staff want to create.
The vision statement should energize and excite your personnel, create a shared and meaningful purpose, inspire passion and interest, and convey the values you want to share in your practice.
Here is an example of a vision statement for an ObGyn practice: “We aim to become the premier obstetrics and gynecology pro-vider to residents of (location) community.”
Action plan: Setting goals
To succeed, an ObGyn practice needs to:
- develop targets and challenges reflecting periodic (quarterly) meetings with staff and new entity development in the practice
- establish benchmarks and measurable parameters (How do you compare with other local practices? Set criteria/metrics to assess your progress.)
- ensure that the objectives support the goals (Develop goals and objectives over a defined period of time.)
- revisit the goals (Have they have been met? Do they need revision?)
Goals and objectives are essential for the continued health of your practice. This is all predicated upon developing a competitive advantage and then maintaining it.
Read about how to make a positive first impression on a new patient.
Is the environment welcoming?
When we examine a practice from the patient’s point of view, a good starting place is with the front desk. Have you looked at your front desk “from the outside in?” In one sense, this is the showcase of your practice.
Related article:
Four pillars of a successful practice: 2. Attract new patients
The first impression: Appointment scheduling
The first impression a patient receives about your practice occurs when she attempts to set up an appointment. Perhaps you might ask someone to call in to schedule an appointment. Is the caller immediately put on hold? Are your personnel courteous on the phone? Can she be seen quickly if she has a problem? How long is the wait for an annual exam? A test run can be very revealing.
Walk in the front door
When a patient walks in the door, does the physical office space radiate a friendly, relaxed atmosphere? Walk through the waiting room, then consultation and exam rooms as if you are a patient seeing it for the first time. Have you created an environment in which patients sense a well-organized office and the esprit de corps of the personnel? Does it look and smell fresh and clean? This all sends a loud and clear positive message about your practice.1–3
Here are some suggestions for making a waiting room more inviting:
- Provide a seating arrangement that is “patient centered.” For example, semi- circular arrangements allow easy viewing of any monitors in the waiting room.
- WiFi is a great addition. Post several signs with the user name and password.
- Offer computers for patients to use to complete registration
- Set up a fish tank. If well-maintained, it can be soothing to many people.
- Display medical information pamphlets, even if they are rarely taken.
- Provide a big screen television that offers information about your practice, including personnel and procedures.
Streaming ads for physician offices are available. One platform, Outcome Health (https://www.outcomehealth.com), provides flat-screen TVs and tablets that show patient education videos.4 Another vendor, Patient Point (http://patientpoint.com), offers waiting room networks, editorials, and other communications designed to support “the goals of improving healthcare.”5 Other available media include channel news and music programming to relax patients.6
Wait times. A patient’s perceived wait time and the actual wait time are often quite different. How long she waits to see the ObGyn is “numero uno” with regard to patient satisfaction and can be a key source of annoyance, irritability, stress, and anger.
Does someone inform waiting patients that the ObGyn is running late? Does staff at the front desk or perhaps your medical assistant inquire, “Can I get you anything? The doctor is running late,” or “Dr. Jones has just finished delivering a baby. He’ll be here in 10 minutes. He’ll see you first.”
Consultation and exam rooms
Suggestions to develop a relaxing environment in your consultation and exam rooms are7:
- decorate the walls with soft, pastel colors
- use “spa aesthetics” to create a colorful atmosphere with appropriate lighting, artwork, and modern furnishings
- present a few magazines neatly and update them periodically
- stock and appropriately maintain the patients rooms with medical supplies
- remember, “Subjects perceive people more positively in beautiful rooms than in ugly rooms.”5
Read about how to keep your patients satisfied and your business stable.
Set the lead example
The need for open and supportive communication between you and your office staff cannot be overly emphasized. An ideal office staff member understands and shares in the vision, is aware of stated goals and objectives, is responsive to patient needs, and wants to create a win-win environment.
Frequently discuss your expectations with your staff. Expect them to be responsive, courteous, competent, have good communication skills, and be influenced by the appearance of the physical environ-ment. Provide support and educational tools to help them successfully perform their work.
Related article:
Four pillars of a successful practice: 1. Keep your current patients happy
Discover your patients’ vision of customer service
Formal measurement of patient satisfaction began with Professor Irwin Press at the University of Notre Dame. Rod Ganey, a sociologist and statistician, then developed the Press Ganey Patient Satisfaction Survey. These points earlier conveyed by Maslow and Mintz8 addressed the “effects of esthetic surroundings.” Color and art proved to be preferences in an esthetically pleasing environment. Additional historical information has been provided by Siegrist, who addressed “the patient experience.”9 He cites the myth that patients do not fill out satisfaction surveys. Indeed they do. Patient satisfaction is not a personality contest but rather a reflection of the health care provider’s investment of time and effort to offer patient-centered care. Siegrist also notes that the patient’s family plays a key role in how a patient perceives her experience with her health care professional.9
The federal government has been actively involved in assessing patient satisfaction in the hospital setting since 2002. This is reflected in the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. The HCAHPS is a 27-question survey randomly administered to adult inpatients after discharge.10–12
The following metrics are often included in patient satisfaction surveys9,10:
- rating of hospital care from 0 (lowest) to 10 (highest)
- percentage of patients who would recommend a practice to family and friends
- number of patients who say their health care providers always communicate well
- the number of patients who report that the office is always clean and friendly.
Use of search engines focused on health care patient surveys can provide a number of options for clinicians to use in their practice.
Tips on patient satisfaction
Several interesting tips from the busi-ness world can be applied to an ObGyn’s practice14:
- You will only hear from 4% of unhappy customers.
- One dissatisfied customer tells 9.
- 95% of customers with resolved issues will do business with you again.
- If a problem is not addressed, that patient will tell 10 others.
- Resolve the problem and 5 people will know about it.
- It costs 5 times as much effort to gain 1 new customer.
- Loyal customers in 1 area of service are good prospects for other (new) services.
Related article:
Using the Internet in your practice. Part 2: Generating new patients using social media
Tell stories about good, satisfied patients
Sharing the stories of satisfied patients motivates others to consider coming to your practice. To develop these stories, offer a “suggestion box” where patients can leave compliments or comments about their experiences. Ask patients to record their positive reviews (be sure to obtain written consent before recording and publishing). Show the videos on the big-screen TVs in your waiting room and include patient reviews (written, audio, and video) on your website.15
Related article:
Four pillars of a successful practice: 4. Motivate your staff
Reevaluate periodically
Encouraging team spirit makes good business sense. Offer staff members bonuses for coming up with improved processes. Provide educational programs for staff on patient care, technology, etc. If a difficult experience occurs, discuss it openly with staff members without accusing, asking them for suggestions to improve the situation.16
To assess the monetary value of your practice, you need to know what contributes to your profit margin and overhead. What investments are the most profitable? Then monitor each segment of the office practice.
Should you proceed with a purchase? Should you take on a new hire? Let's look at one excellent model from the Boston Consulting Group (FIGURE) that provides insight into "low and high performance" aspects of business or practice.1
In the matrix, Stars use large amounts of cash and are leaders in cash generation. Stars lead to development of a Cash Cow, which are entities that generate profits and cash with low investment prerequisites. Dogs are segments of product and service line(s) that should be carefully reevaluated. A decision must be made to liquidate if the problem cannot be corrected. Question Marks have the worst cash characteristics of all and are associated with high demands and low profit margin(s).1
SWOT analysis
A SWOT analysis is most helpful when assessing a practice in real time. The basic tenets are2:
Strengths:
- prestigious reputation
- technological expertise
Weaknesses:
- antiquated computer system
- lack of experience in specific areas
Opportunities:
- growing market demand for a specific product or procedure
- provision of unique services
Threats:
- changing demographics
- competitive practices
- changes in health care third-party payers.
The American College of Obstetricians and Gynecologists (ACOG) has developed an "ACOG Medical Home Toolkit" to allow ObGyns to assess how significant the changes regarding payers will be to their practice. Sections include the patient/practice partnership support; clinical care information; community resources; care delivery management; performance measurement and improvement; and payment and finance.3 The toolkit is available for download from the ACOG website.
References
- Morrison A, Wensley R. Boxing up or boxed in? A short history of the Boston Consulting Group Share/Growth Matrix. J Market Manag. 1993;7(2):105-129. http://www.tandfonline.com/doi/abs/10.1080/0267257X.1991.9964145.
- Klasko SK, Toub DB. It's not a plan without a business plan. In: Sanfilippo JS, Nolan TE, Whiteside BH, eds. MBA Handbook for Healthcare Professionals. New York, NY: Parthenon Publishing Group; 2002:36-37.
- American Congress of Obstetricians and Gynecologists. ACOG Medical Home Toolkit. https://www.acog.org/About-ACOG/ACOG-Departments/Practice-Management-and-Managed-Care/ACOG-Medical-Home-Toolkit. Accessed August 14, 2017.
Bottom line
Ensuring that your patients have an outstanding experience is a smart business strategy. A unified approach that includes team members’ involvement to create a patient-centered environment will provide a quality experience and encourage patients to recommend your ObGyn practice to others.
Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.
- Ulrich RS. Evidence-based environmental design for improving medical outcomes: Paper Delivered at a Conference Entitled Healing by Design: Building for Health Care in the 21st Century. Montreal: McGill University Health Centre; 2000. http://www.brikbase.org/sites/default/files/Evidence%20Based%20Environmental%20Design%20for%20Improving%20Medical.pdf. Accessed August 15, 2017.
- Becker F, Douglass S. The ecology of the patient visit: physical attractiveness, waiting times and perceived quality of care. J Ambul Care Manag. 2008;31(2):128–141.
- Becker F, Sweeney B, Parsons K. Ambulatory facility design and patients’ perceptions of healthcare quality. HERD. 2008;1(4):35–54.
- Outcome Health Website. https://www.outcomehealth.com/. Accessed August 14, 2017.
- Mazer SE. The waiting room: Where suffering begins. Healing Healthcare Systems website. http://www.healinghealth.com/waiting-room-suffering-begins/. Published November 7, 2014. Accessed August 14, 2017.
- Patient Point Programs Website. http://patientpoint.com/. Accessed August 14, 2017.
- Almquist J, Kelly C, Bromberg J, Bryant S, Christianson T, Montori V. Consultation room design and the clinical encounter: the space and interaction randomized trial. Health Environ Res Design. 2009;3(1):41–78.
- Maslow A, Mintz N. Effects of esthetic surroundings: I. Initial effects of three esthetic conditions upon perceiving “energy” and “well-being” in faces. J Psychology. 1956;41(2):247–254.
- Siegrist RB. The patient experience. In: Sanfilippo JS, Bieber E, Javich D, Siegrist R, eds. MBA for Healthcare. New York, NY: Oxford Press;2016:227–236.
- Press I. Patient satisfaction: Understanding and managing the experience of care. 2nd ed. Chicago, IL: Health Administration Press; 2005:66–78.
- Piper L, Tallman E. Hospital consumer assessment of healthcare providers and systems: An ethical leadership dilemma to satisfy patients. Health Care Manag (Frederick). 2016;35(2):151–155.
- Giordano L, Elliott M, Goldstein E, Lehrman W, Spencer P. Development, implementation and public reporting of HCAHPS survey. Med Care Res Rev. 2010;67(1):27–37.
- Jones KE. Helping the health profession help others: Applying business principles to the medical world. University of Tennessee, Knoxville Honors Thesis Projects. http://trace.tennessee.edu/cgi/viewcontent.cgi?article=1560&context=utk_chanhonoproj. Published 2002. Accessed August 14, 2017.
- Baum N. Marketing your practice: ethically, effectively and economically. In: Sanfilippo JS, Nolan TE, Whiteside BH, eds. MBA Handbook for Healthcare Professionals. New York, NY: Parthenon Publishing Group; 2002:123–154.
- Baum NH. Four pillars of a successful practice: 1. Keep your current patients happy. OBG Manag. 2013;25(3):49–56.
- Baum NH. Four pillars of a successful practice: 4. Motivate your staff. OBG Manag. 2013;25(8):29–33.
Dr. Sanfilippo is Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, and Academic Division Director, Reproductive Endocrinology and Infertility, Magee-Women’s Hospital, Pittsburgh, Pennsylvania. Dr. Sanfilippo is a member of the
The author reports no financial relationships relevant to this article.
Dr. Sanfilippo is Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, and Academic Division Director, Reproductive Endocrinology and Infertility, Magee-Women’s Hospital, Pittsburgh, Pennsylvania. Dr. Sanfilippo is a member of the
The author reports no financial relationships relevant to this article.
Dr. Sanfilippo is Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, and Academic Division Director, Reproductive Endocrinology and Infertility, Magee-Women’s Hospital, Pittsburgh, Pennsylvania. Dr. Sanfilippo is a member of the
The author reports no financial relationships relevant to this article.
Independent of the Affordable Care Act or any upcoming changes in health care, the focus of an ObGyn practice remains paramount: the patient comes first.
The “recipe” for creating patient satisfaction and service excellence is predicated upon the mission of your practice and creating a shared vision with your employees. An action plan that is created and “visited/revisited”on a regular basis will serve to keep all abreast of the latest information to enhance the quality of patient care. It goes without saying, the ObGyn must first “lead by example” and always strive for satisfied patients who will tell their friends about your practice.
Start with the right tools
To organize a practice well, you need the right tools, which ideally include mission and vision statements and an action plan with goals and objectives.
Mission statement
A mission statement can be developed by the ObGyn(s) in your office or in concert with your staff. It should include:
- the “here and now” focus on the current approach to patient care
- why the practice exists (Develop a brief description of your practice, including the desired patient population.)
- the products and services offered and why and how those services are provided.
Here is an example of a mission statement for an ObGyn practice: “Our mission is to provide excellent, exceptional, personalized care for women of all ages in a warm and friendly environment. We incorporate leading-edge technology in our practice and continue to be a leader in obstetrics and gynecology.”
Vision statement
A vision statement should be developed in concert with your staff. It should include:
- the “then and there” focus on the historic perspective of your practice
- the ObGyn(s) and staff vision of the future
- what the ObGyn(s) and staff want to create.
The vision statement should energize and excite your personnel, create a shared and meaningful purpose, inspire passion and interest, and convey the values you want to share in your practice.
Here is an example of a vision statement for an ObGyn practice: “We aim to become the premier obstetrics and gynecology pro-vider to residents of (location) community.”
Action plan: Setting goals
To succeed, an ObGyn practice needs to:
- develop targets and challenges reflecting periodic (quarterly) meetings with staff and new entity development in the practice
- establish benchmarks and measurable parameters (How do you compare with other local practices? Set criteria/metrics to assess your progress.)
- ensure that the objectives support the goals (Develop goals and objectives over a defined period of time.)
- revisit the goals (Have they have been met? Do they need revision?)
Goals and objectives are essential for the continued health of your practice. This is all predicated upon developing a competitive advantage and then maintaining it.
Read about how to make a positive first impression on a new patient.
Is the environment welcoming?
When we examine a practice from the patient’s point of view, a good starting place is with the front desk. Have you looked at your front desk “from the outside in?” In one sense, this is the showcase of your practice.
Related article:
Four pillars of a successful practice: 2. Attract new patients
The first impression: Appointment scheduling
The first impression a patient receives about your practice occurs when she attempts to set up an appointment. Perhaps you might ask someone to call in to schedule an appointment. Is the caller immediately put on hold? Are your personnel courteous on the phone? Can she be seen quickly if she has a problem? How long is the wait for an annual exam? A test run can be very revealing.
Walk in the front door
When a patient walks in the door, does the physical office space radiate a friendly, relaxed atmosphere? Walk through the waiting room, then consultation and exam rooms as if you are a patient seeing it for the first time. Have you created an environment in which patients sense a well-organized office and the esprit de corps of the personnel? Does it look and smell fresh and clean? This all sends a loud and clear positive message about your practice.1–3
Here are some suggestions for making a waiting room more inviting:
- Provide a seating arrangement that is “patient centered.” For example, semi- circular arrangements allow easy viewing of any monitors in the waiting room.
- WiFi is a great addition. Post several signs with the user name and password.
- Offer computers for patients to use to complete registration
- Set up a fish tank. If well-maintained, it can be soothing to many people.
- Display medical information pamphlets, even if they are rarely taken.
- Provide a big screen television that offers information about your practice, including personnel and procedures.
Streaming ads for physician offices are available. One platform, Outcome Health (https://www.outcomehealth.com), provides flat-screen TVs and tablets that show patient education videos.4 Another vendor, Patient Point (http://patientpoint.com), offers waiting room networks, editorials, and other communications designed to support “the goals of improving healthcare.”5 Other available media include channel news and music programming to relax patients.6
Wait times. A patient’s perceived wait time and the actual wait time are often quite different. How long she waits to see the ObGyn is “numero uno” with regard to patient satisfaction and can be a key source of annoyance, irritability, stress, and anger.
Does someone inform waiting patients that the ObGyn is running late? Does staff at the front desk or perhaps your medical assistant inquire, “Can I get you anything? The doctor is running late,” or “Dr. Jones has just finished delivering a baby. He’ll be here in 10 minutes. He’ll see you first.”
Consultation and exam rooms
Suggestions to develop a relaxing environment in your consultation and exam rooms are7:
- decorate the walls with soft, pastel colors
- use “spa aesthetics” to create a colorful atmosphere with appropriate lighting, artwork, and modern furnishings
- present a few magazines neatly and update them periodically
- stock and appropriately maintain the patients rooms with medical supplies
- remember, “Subjects perceive people more positively in beautiful rooms than in ugly rooms.”5
Read about how to keep your patients satisfied and your business stable.
Set the lead example
The need for open and supportive communication between you and your office staff cannot be overly emphasized. An ideal office staff member understands and shares in the vision, is aware of stated goals and objectives, is responsive to patient needs, and wants to create a win-win environment.
Frequently discuss your expectations with your staff. Expect them to be responsive, courteous, competent, have good communication skills, and be influenced by the appearance of the physical environ-ment. Provide support and educational tools to help them successfully perform their work.
Related article:
Four pillars of a successful practice: 1. Keep your current patients happy
Discover your patients’ vision of customer service
Formal measurement of patient satisfaction began with Professor Irwin Press at the University of Notre Dame. Rod Ganey, a sociologist and statistician, then developed the Press Ganey Patient Satisfaction Survey. These points earlier conveyed by Maslow and Mintz8 addressed the “effects of esthetic surroundings.” Color and art proved to be preferences in an esthetically pleasing environment. Additional historical information has been provided by Siegrist, who addressed “the patient experience.”9 He cites the myth that patients do not fill out satisfaction surveys. Indeed they do. Patient satisfaction is not a personality contest but rather a reflection of the health care provider’s investment of time and effort to offer patient-centered care. Siegrist also notes that the patient’s family plays a key role in how a patient perceives her experience with her health care professional.9
The federal government has been actively involved in assessing patient satisfaction in the hospital setting since 2002. This is reflected in the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. The HCAHPS is a 27-question survey randomly administered to adult inpatients after discharge.10–12
The following metrics are often included in patient satisfaction surveys9,10:
- rating of hospital care from 0 (lowest) to 10 (highest)
- percentage of patients who would recommend a practice to family and friends
- number of patients who say their health care providers always communicate well
- the number of patients who report that the office is always clean and friendly.
Use of search engines focused on health care patient surveys can provide a number of options for clinicians to use in their practice.
Tips on patient satisfaction
Several interesting tips from the busi-ness world can be applied to an ObGyn’s practice14:
- You will only hear from 4% of unhappy customers.
- One dissatisfied customer tells 9.
- 95% of customers with resolved issues will do business with you again.
- If a problem is not addressed, that patient will tell 10 others.
- Resolve the problem and 5 people will know about it.
- It costs 5 times as much effort to gain 1 new customer.
- Loyal customers in 1 area of service are good prospects for other (new) services.
Related article:
Using the Internet in your practice. Part 2: Generating new patients using social media
Tell stories about good, satisfied patients
Sharing the stories of satisfied patients motivates others to consider coming to your practice. To develop these stories, offer a “suggestion box” where patients can leave compliments or comments about their experiences. Ask patients to record their positive reviews (be sure to obtain written consent before recording and publishing). Show the videos on the big-screen TVs in your waiting room and include patient reviews (written, audio, and video) on your website.15
Related article:
Four pillars of a successful practice: 4. Motivate your staff
Reevaluate periodically
Encouraging team spirit makes good business sense. Offer staff members bonuses for coming up with improved processes. Provide educational programs for staff on patient care, technology, etc. If a difficult experience occurs, discuss it openly with staff members without accusing, asking them for suggestions to improve the situation.16
To assess the monetary value of your practice, you need to know what contributes to your profit margin and overhead. What investments are the most profitable? Then monitor each segment of the office practice.
Should you proceed with a purchase? Should you take on a new hire? Let's look at one excellent model from the Boston Consulting Group (FIGURE) that provides insight into "low and high performance" aspects of business or practice.1
In the matrix, Stars use large amounts of cash and are leaders in cash generation. Stars lead to development of a Cash Cow, which are entities that generate profits and cash with low investment prerequisites. Dogs are segments of product and service line(s) that should be carefully reevaluated. A decision must be made to liquidate if the problem cannot be corrected. Question Marks have the worst cash characteristics of all and are associated with high demands and low profit margin(s).1
SWOT analysis
A SWOT analysis is most helpful when assessing a practice in real time. The basic tenets are2:
Strengths:
- prestigious reputation
- technological expertise
Weaknesses:
- antiquated computer system
- lack of experience in specific areas
Opportunities:
- growing market demand for a specific product or procedure
- provision of unique services
Threats:
- changing demographics
- competitive practices
- changes in health care third-party payers.
The American College of Obstetricians and Gynecologists (ACOG) has developed an "ACOG Medical Home Toolkit" to allow ObGyns to assess how significant the changes regarding payers will be to their practice. Sections include the patient/practice partnership support; clinical care information; community resources; care delivery management; performance measurement and improvement; and payment and finance.3 The toolkit is available for download from the ACOG website.
References
- Morrison A, Wensley R. Boxing up or boxed in? A short history of the Boston Consulting Group Share/Growth Matrix. J Market Manag. 1993;7(2):105-129. http://www.tandfonline.com/doi/abs/10.1080/0267257X.1991.9964145.
- Klasko SK, Toub DB. It's not a plan without a business plan. In: Sanfilippo JS, Nolan TE, Whiteside BH, eds. MBA Handbook for Healthcare Professionals. New York, NY: Parthenon Publishing Group; 2002:36-37.
- American Congress of Obstetricians and Gynecologists. ACOG Medical Home Toolkit. https://www.acog.org/About-ACOG/ACOG-Departments/Practice-Management-and-Managed-Care/ACOG-Medical-Home-Toolkit. Accessed August 14, 2017.
Bottom line
Ensuring that your patients have an outstanding experience is a smart business strategy. A unified approach that includes team members’ involvement to create a patient-centered environment will provide a quality experience and encourage patients to recommend your ObGyn practice to others.
Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.
Independent of the Affordable Care Act or any upcoming changes in health care, the focus of an ObGyn practice remains paramount: the patient comes first.
The “recipe” for creating patient satisfaction and service excellence is predicated upon the mission of your practice and creating a shared vision with your employees. An action plan that is created and “visited/revisited”on a regular basis will serve to keep all abreast of the latest information to enhance the quality of patient care. It goes without saying, the ObGyn must first “lead by example” and always strive for satisfied patients who will tell their friends about your practice.
Start with the right tools
To organize a practice well, you need the right tools, which ideally include mission and vision statements and an action plan with goals and objectives.
Mission statement
A mission statement can be developed by the ObGyn(s) in your office or in concert with your staff. It should include:
- the “here and now” focus on the current approach to patient care
- why the practice exists (Develop a brief description of your practice, including the desired patient population.)
- the products and services offered and why and how those services are provided.
Here is an example of a mission statement for an ObGyn practice: “Our mission is to provide excellent, exceptional, personalized care for women of all ages in a warm and friendly environment. We incorporate leading-edge technology in our practice and continue to be a leader in obstetrics and gynecology.”
Vision statement
A vision statement should be developed in concert with your staff. It should include:
- the “then and there” focus on the historic perspective of your practice
- the ObGyn(s) and staff vision of the future
- what the ObGyn(s) and staff want to create.
The vision statement should energize and excite your personnel, create a shared and meaningful purpose, inspire passion and interest, and convey the values you want to share in your practice.
Here is an example of a vision statement for an ObGyn practice: “We aim to become the premier obstetrics and gynecology pro-vider to residents of (location) community.”
Action plan: Setting goals
To succeed, an ObGyn practice needs to:
- develop targets and challenges reflecting periodic (quarterly) meetings with staff and new entity development in the practice
- establish benchmarks and measurable parameters (How do you compare with other local practices? Set criteria/metrics to assess your progress.)
- ensure that the objectives support the goals (Develop goals and objectives over a defined period of time.)
- revisit the goals (Have they have been met? Do they need revision?)
Goals and objectives are essential for the continued health of your practice. This is all predicated upon developing a competitive advantage and then maintaining it.
Read about how to make a positive first impression on a new patient.
Is the environment welcoming?
When we examine a practice from the patient’s point of view, a good starting place is with the front desk. Have you looked at your front desk “from the outside in?” In one sense, this is the showcase of your practice.
Related article:
Four pillars of a successful practice: 2. Attract new patients
The first impression: Appointment scheduling
The first impression a patient receives about your practice occurs when she attempts to set up an appointment. Perhaps you might ask someone to call in to schedule an appointment. Is the caller immediately put on hold? Are your personnel courteous on the phone? Can she be seen quickly if she has a problem? How long is the wait for an annual exam? A test run can be very revealing.
Walk in the front door
When a patient walks in the door, does the physical office space radiate a friendly, relaxed atmosphere? Walk through the waiting room, then consultation and exam rooms as if you are a patient seeing it for the first time. Have you created an environment in which patients sense a well-organized office and the esprit de corps of the personnel? Does it look and smell fresh and clean? This all sends a loud and clear positive message about your practice.1–3
Here are some suggestions for making a waiting room more inviting:
- Provide a seating arrangement that is “patient centered.” For example, semi- circular arrangements allow easy viewing of any monitors in the waiting room.
- WiFi is a great addition. Post several signs with the user name and password.
- Offer computers for patients to use to complete registration
- Set up a fish tank. If well-maintained, it can be soothing to many people.
- Display medical information pamphlets, even if they are rarely taken.
- Provide a big screen television that offers information about your practice, including personnel and procedures.
Streaming ads for physician offices are available. One platform, Outcome Health (https://www.outcomehealth.com), provides flat-screen TVs and tablets that show patient education videos.4 Another vendor, Patient Point (http://patientpoint.com), offers waiting room networks, editorials, and other communications designed to support “the goals of improving healthcare.”5 Other available media include channel news and music programming to relax patients.6
Wait times. A patient’s perceived wait time and the actual wait time are often quite different. How long she waits to see the ObGyn is “numero uno” with regard to patient satisfaction and can be a key source of annoyance, irritability, stress, and anger.
Does someone inform waiting patients that the ObGyn is running late? Does staff at the front desk or perhaps your medical assistant inquire, “Can I get you anything? The doctor is running late,” or “Dr. Jones has just finished delivering a baby. He’ll be here in 10 minutes. He’ll see you first.”
Consultation and exam rooms
Suggestions to develop a relaxing environment in your consultation and exam rooms are7:
- decorate the walls with soft, pastel colors
- use “spa aesthetics” to create a colorful atmosphere with appropriate lighting, artwork, and modern furnishings
- present a few magazines neatly and update them periodically
- stock and appropriately maintain the patients rooms with medical supplies
- remember, “Subjects perceive people more positively in beautiful rooms than in ugly rooms.”5
Read about how to keep your patients satisfied and your business stable.
Set the lead example
The need for open and supportive communication between you and your office staff cannot be overly emphasized. An ideal office staff member understands and shares in the vision, is aware of stated goals and objectives, is responsive to patient needs, and wants to create a win-win environment.
Frequently discuss your expectations with your staff. Expect them to be responsive, courteous, competent, have good communication skills, and be influenced by the appearance of the physical environ-ment. Provide support and educational tools to help them successfully perform their work.
Related article:
Four pillars of a successful practice: 1. Keep your current patients happy
Discover your patients’ vision of customer service
Formal measurement of patient satisfaction began with Professor Irwin Press at the University of Notre Dame. Rod Ganey, a sociologist and statistician, then developed the Press Ganey Patient Satisfaction Survey. These points earlier conveyed by Maslow and Mintz8 addressed the “effects of esthetic surroundings.” Color and art proved to be preferences in an esthetically pleasing environment. Additional historical information has been provided by Siegrist, who addressed “the patient experience.”9 He cites the myth that patients do not fill out satisfaction surveys. Indeed they do. Patient satisfaction is not a personality contest but rather a reflection of the health care provider’s investment of time and effort to offer patient-centered care. Siegrist also notes that the patient’s family plays a key role in how a patient perceives her experience with her health care professional.9
The federal government has been actively involved in assessing patient satisfaction in the hospital setting since 2002. This is reflected in the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. The HCAHPS is a 27-question survey randomly administered to adult inpatients after discharge.10–12
The following metrics are often included in patient satisfaction surveys9,10:
- rating of hospital care from 0 (lowest) to 10 (highest)
- percentage of patients who would recommend a practice to family and friends
- number of patients who say their health care providers always communicate well
- the number of patients who report that the office is always clean and friendly.
Use of search engines focused on health care patient surveys can provide a number of options for clinicians to use in their practice.
Tips on patient satisfaction
Several interesting tips from the busi-ness world can be applied to an ObGyn’s practice14:
- You will only hear from 4% of unhappy customers.
- One dissatisfied customer tells 9.
- 95% of customers with resolved issues will do business with you again.
- If a problem is not addressed, that patient will tell 10 others.
- Resolve the problem and 5 people will know about it.
- It costs 5 times as much effort to gain 1 new customer.
- Loyal customers in 1 area of service are good prospects for other (new) services.
Related article:
Using the Internet in your practice. Part 2: Generating new patients using social media
Tell stories about good, satisfied patients
Sharing the stories of satisfied patients motivates others to consider coming to your practice. To develop these stories, offer a “suggestion box” where patients can leave compliments or comments about their experiences. Ask patients to record their positive reviews (be sure to obtain written consent before recording and publishing). Show the videos on the big-screen TVs in your waiting room and include patient reviews (written, audio, and video) on your website.15
Related article:
Four pillars of a successful practice: 4. Motivate your staff
Reevaluate periodically
Encouraging team spirit makes good business sense. Offer staff members bonuses for coming up with improved processes. Provide educational programs for staff on patient care, technology, etc. If a difficult experience occurs, discuss it openly with staff members without accusing, asking them for suggestions to improve the situation.16
To assess the monetary value of your practice, you need to know what contributes to your profit margin and overhead. What investments are the most profitable? Then monitor each segment of the office practice.
Should you proceed with a purchase? Should you take on a new hire? Let's look at one excellent model from the Boston Consulting Group (FIGURE) that provides insight into "low and high performance" aspects of business or practice.1
In the matrix, Stars use large amounts of cash and are leaders in cash generation. Stars lead to development of a Cash Cow, which are entities that generate profits and cash with low investment prerequisites. Dogs are segments of product and service line(s) that should be carefully reevaluated. A decision must be made to liquidate if the problem cannot be corrected. Question Marks have the worst cash characteristics of all and are associated with high demands and low profit margin(s).1
SWOT analysis
A SWOT analysis is most helpful when assessing a practice in real time. The basic tenets are2:
Strengths:
- prestigious reputation
- technological expertise
Weaknesses:
- antiquated computer system
- lack of experience in specific areas
Opportunities:
- growing market demand for a specific product or procedure
- provision of unique services
Threats:
- changing demographics
- competitive practices
- changes in health care third-party payers.
The American College of Obstetricians and Gynecologists (ACOG) has developed an "ACOG Medical Home Toolkit" to allow ObGyns to assess how significant the changes regarding payers will be to their practice. Sections include the patient/practice partnership support; clinical care information; community resources; care delivery management; performance measurement and improvement; and payment and finance.3 The toolkit is available for download from the ACOG website.
References
- Morrison A, Wensley R. Boxing up or boxed in? A short history of the Boston Consulting Group Share/Growth Matrix. J Market Manag. 1993;7(2):105-129. http://www.tandfonline.com/doi/abs/10.1080/0267257X.1991.9964145.
- Klasko SK, Toub DB. It's not a plan without a business plan. In: Sanfilippo JS, Nolan TE, Whiteside BH, eds. MBA Handbook for Healthcare Professionals. New York, NY: Parthenon Publishing Group; 2002:36-37.
- American Congress of Obstetricians and Gynecologists. ACOG Medical Home Toolkit. https://www.acog.org/About-ACOG/ACOG-Departments/Practice-Management-and-Managed-Care/ACOG-Medical-Home-Toolkit. Accessed August 14, 2017.
Bottom line
Ensuring that your patients have an outstanding experience is a smart business strategy. A unified approach that includes team members’ involvement to create a patient-centered environment will provide a quality experience and encourage patients to recommend your ObGyn practice to others.
Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.
- Ulrich RS. Evidence-based environmental design for improving medical outcomes: Paper Delivered at a Conference Entitled Healing by Design: Building for Health Care in the 21st Century. Montreal: McGill University Health Centre; 2000. http://www.brikbase.org/sites/default/files/Evidence%20Based%20Environmental%20Design%20for%20Improving%20Medical.pdf. Accessed August 15, 2017.
- Becker F, Douglass S. The ecology of the patient visit: physical attractiveness, waiting times and perceived quality of care. J Ambul Care Manag. 2008;31(2):128–141.
- Becker F, Sweeney B, Parsons K. Ambulatory facility design and patients’ perceptions of healthcare quality. HERD. 2008;1(4):35–54.
- Outcome Health Website. https://www.outcomehealth.com/. Accessed August 14, 2017.
- Mazer SE. The waiting room: Where suffering begins. Healing Healthcare Systems website. http://www.healinghealth.com/waiting-room-suffering-begins/. Published November 7, 2014. Accessed August 14, 2017.
- Patient Point Programs Website. http://patientpoint.com/. Accessed August 14, 2017.
- Almquist J, Kelly C, Bromberg J, Bryant S, Christianson T, Montori V. Consultation room design and the clinical encounter: the space and interaction randomized trial. Health Environ Res Design. 2009;3(1):41–78.
- Maslow A, Mintz N. Effects of esthetic surroundings: I. Initial effects of three esthetic conditions upon perceiving “energy” and “well-being” in faces. J Psychology. 1956;41(2):247–254.
- Siegrist RB. The patient experience. In: Sanfilippo JS, Bieber E, Javich D, Siegrist R, eds. MBA for Healthcare. New York, NY: Oxford Press;2016:227–236.
- Press I. Patient satisfaction: Understanding and managing the experience of care. 2nd ed. Chicago, IL: Health Administration Press; 2005:66–78.
- Piper L, Tallman E. Hospital consumer assessment of healthcare providers and systems: An ethical leadership dilemma to satisfy patients. Health Care Manag (Frederick). 2016;35(2):151–155.
- Giordano L, Elliott M, Goldstein E, Lehrman W, Spencer P. Development, implementation and public reporting of HCAHPS survey. Med Care Res Rev. 2010;67(1):27–37.
- Jones KE. Helping the health profession help others: Applying business principles to the medical world. University of Tennessee, Knoxville Honors Thesis Projects. http://trace.tennessee.edu/cgi/viewcontent.cgi?article=1560&context=utk_chanhonoproj. Published 2002. Accessed August 14, 2017.
- Baum N. Marketing your practice: ethically, effectively and economically. In: Sanfilippo JS, Nolan TE, Whiteside BH, eds. MBA Handbook for Healthcare Professionals. New York, NY: Parthenon Publishing Group; 2002:123–154.
- Baum NH. Four pillars of a successful practice: 1. Keep your current patients happy. OBG Manag. 2013;25(3):49–56.
- Baum NH. Four pillars of a successful practice: 4. Motivate your staff. OBG Manag. 2013;25(8):29–33.
- Ulrich RS. Evidence-based environmental design for improving medical outcomes: Paper Delivered at a Conference Entitled Healing by Design: Building for Health Care in the 21st Century. Montreal: McGill University Health Centre; 2000. http://www.brikbase.org/sites/default/files/Evidence%20Based%20Environmental%20Design%20for%20Improving%20Medical.pdf. Accessed August 15, 2017.
- Becker F, Douglass S. The ecology of the patient visit: physical attractiveness, waiting times and perceived quality of care. J Ambul Care Manag. 2008;31(2):128–141.
- Becker F, Sweeney B, Parsons K. Ambulatory facility design and patients’ perceptions of healthcare quality. HERD. 2008;1(4):35–54.
- Outcome Health Website. https://www.outcomehealth.com/. Accessed August 14, 2017.
- Mazer SE. The waiting room: Where suffering begins. Healing Healthcare Systems website. http://www.healinghealth.com/waiting-room-suffering-begins/. Published November 7, 2014. Accessed August 14, 2017.
- Patient Point Programs Website. http://patientpoint.com/. Accessed August 14, 2017.
- Almquist J, Kelly C, Bromberg J, Bryant S, Christianson T, Montori V. Consultation room design and the clinical encounter: the space and interaction randomized trial. Health Environ Res Design. 2009;3(1):41–78.
- Maslow A, Mintz N. Effects of esthetic surroundings: I. Initial effects of three esthetic conditions upon perceiving “energy” and “well-being” in faces. J Psychology. 1956;41(2):247–254.
- Siegrist RB. The patient experience. In: Sanfilippo JS, Bieber E, Javich D, Siegrist R, eds. MBA for Healthcare. New York, NY: Oxford Press;2016:227–236.
- Press I. Patient satisfaction: Understanding and managing the experience of care. 2nd ed. Chicago, IL: Health Administration Press; 2005:66–78.
- Piper L, Tallman E. Hospital consumer assessment of healthcare providers and systems: An ethical leadership dilemma to satisfy patients. Health Care Manag (Frederick). 2016;35(2):151–155.
- Giordano L, Elliott M, Goldstein E, Lehrman W, Spencer P. Development, implementation and public reporting of HCAHPS survey. Med Care Res Rev. 2010;67(1):27–37.
- Jones KE. Helping the health profession help others: Applying business principles to the medical world. University of Tennessee, Knoxville Honors Thesis Projects. http://trace.tennessee.edu/cgi/viewcontent.cgi?article=1560&context=utk_chanhonoproj. Published 2002. Accessed August 14, 2017.
- Baum N. Marketing your practice: ethically, effectively and economically. In: Sanfilippo JS, Nolan TE, Whiteside BH, eds. MBA Handbook for Healthcare Professionals. New York, NY: Parthenon Publishing Group; 2002:123–154.
- Baum NH. Four pillars of a successful practice: 1. Keep your current patients happy. OBG Manag. 2013;25(3):49–56.
- Baum NH. Four pillars of a successful practice: 4. Motivate your staff. OBG Manag. 2013;25(8):29–33.
