PATIENT

SATISFACTION,
LOYALITAS AND
CUSTOMER
RELATIONSHIP

Andi Indahwaty Sidin,

5/13/15

Hospital Managamenet Department,

Public Health Faculty, UNHAS

OUTLINE
1. Definition
2. Satisfaction and quality of care
3. Types expectation

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1. Definition
Oliver, 1981

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Bernna,1995

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studied extensively in the fields of

sociology,
psychology,
marketing
healthcare management

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 consumer satisfaction is at the very core

of modern marketing theory and practice
which is based on the notion that
organizations survive and prosper through
meeting the needs of customers

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 The satisfied customer is an

indispensable means of creating a
sustainable advantage in the competitive
environment of the 1990s

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 Consumer satisfaction with healthcare

has, in recent years, gained wide spread
recognition as a measure of quality,
especially since the publication of the
1983
Greater involvement of the consumer in the healthcare
process
The links between satisfaction and patient compliance in
areas such as appointment keeping, intentions to comply
with recommended treatment and medication use.5

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 The marketing literature originally saw

consumer satisfaction as being an
outcome resulting from the consumption
experience:
More recent definitions, however, see
satisfaction as a complex evaluative
process:

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The terms satisfaction and quality assessment are

often used interchangeably and while they have certain
things in common, satisfaction is generally seen to be
the broader concept and one that can be viewed either
at the individual service encounter (transaction) level or
at a more global level, encompassing all experiences
with an organisation.

Perceived quality is just one of a number of antecedent

factors driving satisfaction.

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 there is evidence to suggest that raising

expectations prior to use often results in
increased perceptions about performance
even though the product or service may
have performed poorly. It is satisfaction
mean quality??

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 Disconfirmation theory suggests that when

perceptions of attribute performance differ
only slightly from expectations, there is a
tendency for people to displace their
perceptions toward their expectations
the assimilation effect.

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Types Expectation
desired service

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 A growing number of researchers,

however, are of the opinion that patient
satisfaction and consumer satisfaction are
not one and the same thing,

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 the role that expectations,which are

central to the consumer model, play in
determining satisfaction with healthcare.

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Patient Loyalty: Making a Difference

Brought to you by

Todays Session
Patient loyalty why?
Measure what matters most
Tools for success

Brought to you by

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.
Brought to you by
Burroughs, Davies, Cira, Dunagan 1999

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

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 satisfactionpatient satisfaction is
highly correlated with intent to return and intent
to recommend services.
Patient satisfaction will significantly influence
the intent to return and intent to recommend
Brought
services to others; thereby serving as
a to you by
determinant for repeated clinic visits, new
Hill & Doddato (2002, 108)

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

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.
High levels of satisfaction with a service
relationship will override service failures,
suppress shopping for another service
Brought to you by
provider, and maintain high compliance.
(Reichheld 1996)

(Forrester

& Maute 2001)

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

Health Managers Network:

Building Patient Loyalty
Are you measuring patient satisfaction?

1. Yes
2. No

Brought to you by

Health Managers Network:

Building Patient Loyalty
Are you measuring patient turnover?

1. Yes
2. No
Brought to you by

Health Managers Network:

Building Patient Loyalty
What is the #1 reason patients leave your practice?

1. Insurance
change
2. Dissatisfaction
with provider
and/or staf
3. Geographic
location
4. Disagreement
with treatment

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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)

Brought to you by
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07

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
Brought
to you
by
(2004)

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

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/).
Drainto
andyou
Kaldenberg
Brought
by
(1999)

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

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
Brought to you by

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.
2.
3.
4.
5.
6.

Treats you with dignity and respect

Listens carefully to your health concerns
Easy to talk to
Takes concerns seriously
Willing to spend enough time with you
Truly cares about you and your health

Source: Harris Poll, 2004

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Studer Group Five

Fundamentals
A

Acknowledge

Introduce

Increase
Compliance

Duration

Quality

Explanation

Thank You

Safety
Decrease
Anxiety

Patient Loyalty

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Advantages of AIDET

SM

Decrease anxiety with increased

compliance
Improved clinical
Decreased
Anxiety

Increased
Compliance

outcomes and
increased 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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Acknowledge
A

Acknowledge

Key message: YOU are

important
Eye Contact
Make the patient feel that you
expected them
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Introduce
I
First Generation
Name
Title
Specialty

Introduce
Next Generation
Your role in the team
of care givers
Your experience,
skill set, or
credentials
Coworkers,
physicians, other
Brought
to you by
departments,
AHMG

Manage Up!
A Short Bio

Brought to you by

Examples of Managing Up

Hi, Im Georgette. Ive 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 patients

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

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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 patients story:

Active listening
Clarifying questions
Understanding patients perspective
Explain the treatment plan:
Using language that patients can
understand
Use key words
Use tell, ask, tell approach
Involve patient in decision making

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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)

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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

Brought to you by

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

Brought to you by

AIDET

Vanderbilt University Medical Center,

Nashville, TN

SM

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

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THANK YOU FOR

ATTENTION
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