1. Meeting Title Here (on Notes Master)
Patient Loyalty: Making a Difference
Barbara Hotko, RN, MPA
Studer Group Coach
January 12, 2011
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2. Meeting Title Here (on Notes Master)
Today’s Session
Meeting Title Here (on Notes Master)
Patient loyalty – why?
Measure what matters most
Tools for success
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3. Meeting Title Here (on Notes Master)
Patient Loyalty Pays: Treating patients with respect adds up to satisfaction & repeat visits
Meeting Title Here (on Notes Master)
“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
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4. Meeting Title Here (on Notes Master)
Patient Loyalty Pays: Treating patients with respect adds up to satisfaction & repeat visits
Meeting Title Here (on Notes Master)
“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
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5. Meeting Title Here (on Notes Master)
Patient Loyalty Pays: Satisfaction, Loyalty and Profitability are linked
Meeting Title Here (on Notes Master)
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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6. Health Managers Network: Building Patient Loyalty
Are you measuring patient satisfaction?
Yes No

7. Health Managers Network: Building Patient Loyalty
Are you measuring patient turnover?
Yes No

8. Health Managers Network: Building Patient Loyalty
What is the #1 reason patients leave your practice?
Insurance change
Dissatisfaction with provider and/or staff
Geographic location
Disagreement with treatment of care
Wait time (while in office)
Appt. availability

9. Meeting Title Here (on Notes Master)
Patient Loyalty Pays …
Meeting Title Here (on Notes Master)
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
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10. The Cost of Dissatisfaction
Meeting Title Here (on Notes Master)
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
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11. The Cost of Dissatisfaction
Meeting Title Here (on Notes Master)
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 ( Drain and Kaldenberg (1999)
Source: Press-Ganey: Return on Investment: Patient Loyalty Pays, 12-07
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12. Meeting Title Here (on Notes Master)
Patient Loyalty
Meeting Title Here (on Notes Master)
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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13. AHMG surveys patients by clinic and by physician
Meeting Title Here (on Notes Master)
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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14. “What patients want” in rank order
Meeting Title Here (on Notes Master)
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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15. Studer Group Five Fundamentals
Meeting Title Here (on Notes Master)
Safety A
Acknowledge
Decrease Anxiety I
Introduce
Increase Compliance D
Duration E
Explanation
Quality
Patient Loyalty T
Thank You
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16. Advantages of AIDETSM + = Decrease anxiety with increased compliance
Meeting Title Here (on Notes Master)
Decrease anxiety with increased compliance
Improved clinical outcomes and increased patient and physician satisfaction
Decreased
Anxiety
Increased
Compliance + =
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17. Physician and staff AIDET training University Medical Center
Outcome – AIDET
Physician and staff AIDET training
University Medical Center
Physician Practices
Tucson, AZ

18. FPA - Otolaryngology 3rd Qtr 08 4th Qtr 08 1st Qtr 09 2nd Qtr 09
Overall Results Otolaryngology
Percentile Rank
Mean (raw score) 13
Mean
n=30 33
Mean
n=31 35
Mean
n=82 69
Mean 91.9
n=49
Access to Care * 16 40 55
Visit * 34 17 42
Nurse/Assistant * 5 53 48 91
Care Provider * 49 80
Personal Issues * 9 10 30 59
Overall Assessment * 24 46 60 74
* Percentile ranking

19. Meeting Title Here (on Notes Master)
Acknowledge
Meeting Title Here (on Notes Master) A
Acknowledge
Key message: YOU are important
Eye Contact
Make the patient feel that you expected them
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20. Meeting Title Here (on Notes Master)
Introduce
Meeting Title Here (on Notes Master) I
Introduce
First Generation
Next Generation
Your role in the team of care givers
Your experience, skill set, or credentials
Coworkers, physicians, other departments, AHMG
Name
Title
Specialty
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21. Meeting Title Here (on Notes Master)
Manage Up!
Meeting Title Here (on Notes Master)
A Short Bio
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22. 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.” 22

23. Meeting Title Here (on Notes Master)
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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24. Meeting Title Here (on Notes Master)
Duration
Meeting Title Here (on Notes Master) 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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25. Keeping Patients Informed of Duration

26. Meeting Title Here (on Notes Master)
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
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27. Meeting Title Here (on Notes Master)
Explanation
Meeting Title Here (on Notes Master) 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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28. Reality of Explanation
Meeting Title Here (on Notes Master)
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
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29. Meeting Title Here (on Notes Master)
Patient Perspective
Meeting Title Here (on Notes Master)
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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30. Meeting Title Here (on Notes Master)
Thank You
Meeting Title Here (on Notes Master) 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
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31. Meeting Title Here (on Notes Master)
AIDETSM
Meeting Title Here (on Notes Master)
Vanderbilt University Medical Center, Nashville, TN
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32. Meeting Title Here (on Notes Master)
Loyal Patients
Meeting Title Here (on Notes Master)
Loyal Patients will …
Return
Advocate for you in the community
Talk
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33. Creating Patient Loyalty – THE WHY
Meeting Title Here (on Notes Master)
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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34. Practicing Excellence
A guide to implementing specific behaviors that will create a high performance workplace
Written by a physician
Available online at

35. Partner Relations Coordinator
Thank You!
Barbara Hotko
Partner Relations Coordinator
Lauren Holstman