Patient Loyalty: Making a Difference

Barbara Hotko, RN, MPA

Studer Group Coach
© 2007 Studer Group January 12, 2011
 Today’s Session

Patient loyalty – why?

Measure what matters most
Tools for success

© 2010 Studer Group

 Patient Loyalty Pays: Treating patients with
respect adds up to satisfaction & repeat visits

“Satisfied patients return for care, and the positive

word of mouth from satisfied patients will bring new
patients into the practice.” (Drain & Kaldenberg 1999, 32).
A better patient rating of information quality and
physician quality was “associated with patients
reporting that they would definitely return” for care.
(Lechtzin, Rubin, White, et al 2002, 1326).

“The compassion with which care is provided appears

to be the most important factor in influencing patient
intentions to recommend/return, regardless of the
setting in which care is provided.” Burroughs, Davies, Cira, Dunagan 1999
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
© 2010 Studer Group
 Patient Loyalty Pays: Treating patients with
respect adds up to satisfaction & repeat visits

“Treatment with respect, the rating of care received,

and the helpfulness of the person at the front desk are
the strongest predictors of patient satisfaction…patient
satisfaction is highly correlated with intent to return
and intent to recommend services.” Hill & Doddato (2002, 108)
“Patient satisfaction will significantly influence the
intent to return and intent to recommend services to
others; thereby serving as a determinant for repeated
clinic visits, new patient visits, and program
marketing.” Hill & Doddato (2002, 108)
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
© 2010 Studer Group
 Patient Loyalty Pays: Satisfaction, Loyalty
and Profitability are linked

Loyalty has been an area of focus both within and

outside of the health care industry for sometime.
The links between customer satisfaction, loyalty,
and profitability have been well established. (Reichheld 1996)
High levels of satisfaction with a service
relationship will override service failures, suppress
shopping for another service provider, and maintain
high compliance. (Forrester & Maute 2001)

Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07

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 Health Managers Network: Building Patient
Loyalty

Are you measuring patient satisfaction?

50% 50%

1. Yes
2. No

1 2

© 2010 Studer Group

 Health Managers Network: Building Patient
Loyalty

Are you measuring patient turnover?

79%

1. Yes
2. No
21%

1 2

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 Health Managers Network: Building Patient
Loyalty

What is the #1 reason patients leave your practice?

1. Insurance change 56%

2. Dissatisfaction with
provider and/or staff
3. Geographic location
4. Disagreement with 22%
treatment of care
5. Wait time (while in 9%
7%
office) 4%
2%

6. Appt. availability
1 2 3 4 5 6

© 2010 Studer Group

 Patient Loyalty Pays …

A “high level of satisfaction will lead to greatly

increased customer loyalty …
And increased customer loyalty is the single most
important driver of long-term financial
performance.” (Jones & Sasser 1995, 88)

Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07

© 2010 Studer Group

 The Cost of Dissatisfaction

The other side of the satisfaction-loyalty link is the link

between dissatisfaction and loss of revenue due to
patients who switch providers or hospitals. Through
the Healthcare Financial Management Association
reports:
• For every one customer who complains, 20 dissatisfied customers do not.
• Of those dissatisfied customers who do not complain, 10% will return but 90% will not.
• Changing a poor customer service image takes 10 years average.
• It costs 10 times as much to attract new customers as it does to keep current ones.
• About 10% of revenue is lost to poor customer service.
• The average “wronged” customer will tell 25 others about the bad experience. Zimowski
(2004)

Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07

© 2010 Studer Group

 The Cost of Dissatisfaction

Patients dissatisfied with physician care and practice are

more likely to leave. (vom Eigen, Delbanco, Phillips, 1998)
Conservative estimate: In a practice with 6,000 patients, if
5% are dissatisfied and leave with members of their
household (assuming 3.5 members per household and 2.5
visits per year, this would be 8.75 visits per household per
year), and the average visit averages $57 in payments, the
cost of dissatisfaction is $149,625. Using the Consumer
Price Index, this would equate to over $180,000 in 2006
dollars (http://www.measuringworth.com/uscompare/). Drain
and Kaldenberg (1999)

Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07

© 2010 Studer Group

 Patient Loyalty

To earn patient loyalty, your staff will need to provide

excellent care for every patient in every encounter.

In order to do so, staff will need:

Actionable Data
Tools

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 AHMG surveys patients by clinic and by
physician

Sample survey questions:

Staff make me feel like I am important and valued
The doctor listened to me and showed respect of
what I had to say
Overall Experience
Recommend to family and friends

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 “What patients want” in rank order

1. Treats you with dignity and respect

2. Listens carefully to your health concerns

3. Easy to talk to

4. Takes concerns seriously

5. Willing to spend enough time with you

6. Truly cares about you and your health

Source: Harris Poll, 2004

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 Studer Group Five Fundamentals

Safety A Acknowledge
Decrease
Anxiety I Introduce

Increase D Duration
Compliance

Quality E Explanation

Patient T Thank You

Loyalty

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 Advantages of AIDET SM

Decrease anxiety with increased compliance

Improved
clinical
outcomes and
Decreased Increased increased
Anxiety
+ Compliance
= patient and
physician
satisfaction

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 Outcome – AIDET

Physician and
staff AIDET
training

University Medical Center

Physician Practices
Tucson, AZ

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 FPA - Otolaryngology

3rd Qtr 4th Qtr 1st Qtr 2nd Qtr

08 08 09 09
Overall Results Otolaryngology 13 33 35
69
Percentile Rank Mean Mean Mean
Mean 91.9
Mean (raw score) 83.5 88.9 89.2
n=49
n=30 n=31 n=82
Access to Care * 16 40 40 55
Visit * 16 34 17 42
Nurse/Assistant * 5 53 48 91
Care Provider * 17 40 49 80
Personal Issues * 9 10 30 59
Overall Assessment * 24 46 60 74
* Percentile ranking

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 Acknowledge

A Acknowledge

Key message: YOU are

important

 Eye Contact
 Make the patient feel that you
expected them

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 Introduce

I Introduce

First Generation Next Generation

 Name  Your role in the team

 Title of care givers
 Your experience, skill
 Specialty set, or credentials
 Coworkers,
physicians, other
departments, AHMG

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 Manage Up!

A Short Bio

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 Examples of Managing Up

“Hi, I’m Georgette. I’ve been with Dr. Smith for

over three years and he is excellent. Welcome to
our practice.”
“We have a great staff and we are going to take
very good care of you.”
“Dr. Jones takes the time to answer each
patient’s questions.”
“Good Morning, Mrs. Smith. My name is Ann. I
am a medical assistant and I have been working
in this practice for five year.”
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 The A and I of AIDET for Safety

“Because greetings are one

way to ensure proper
identification of patients, they
may well be considered a
fundamental component of
patient safety”

© 2010 Studer Group

 Duration

D Duration
Key Message: I anticipate your
concerns

 How long will the registration

process take?
 How long will the test, procedure,
or appointment actually take?
 How long will it take to get the
results?

Goal: Keeping Patients Informed

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 Keeping Patients Informed of Duration

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 Explanation

E Explanation
Listen to the patient’s story:
 Active listening
 Clarifying questions
 Understanding patient’s perspective

Explain the treatment plan:

 Using language that patients can
understand
 Use “key words”
 Use “tell, ask, tell” approach
 Involve patient in decision making

© 2010 Studer Group

 Explanation

E Explanation

 Why are we doing this?

 What will happen and what you should
expect?
 What questions do you have? (about
medications, instructions for follow up
care)

© 2010 Studer Group

 Reality of Explanation

During a 20 minute encounter

Physicians self-report spending 9 minutes “providing
information”
REALITY: Physicians spent 1.5 minutes
The key driver for patient
satisfaction
The quality and clarity of
information that patients
receive from physicians

© 2010 Studer Group

 Patient Perspective

72% of patients unable to list medications they

take
58% of patients unable to recite their own
diagnosis

Mayo Clinic Proceedings, 2005

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 Thank You

T Thank You
Key message: I appreciate the opportunity
to care for you

Closing Key Words

 Thank you for choosing us
 Thank you for your patience today
 Thank you for coming in today, I
know we can help

© 2010 Studer Group

 AIDETSM

Vanderbilt University Medical Center,

Nashville, TN

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 Loyal Patients

Loyal Patients will …

Return
Advocate for you in the community
Talk

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 Creating Patient Loyalty – THE WHY

Improves patient compliance

Improves clinical outcomes
Improves patient satisfaction
Increases growth and market share
Reduces malpractice risk
Improves physician satisfaction
Improves clinical efficiency

© 2010 Studer Group

 Practicing Excellence

A guide to
implementing specific
behaviors that will
create a high
performance
workplace
Written by a physician

Available online at
www.studergroup.com

© 2010 Studer Group

 Thank You!
Barbara Hotko
[email protected]

Partner Relations Coordinator

Lauren Holstman
850-343-1057

www.studergroup.com
© 2010 Studer Group