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Show descriptions on the bill were provided in layman's terms, and specific tests and specialties which would be billed separately were identified on the bill. "Feedback from patients following implementation of these changes has been positive. The focus group input achieved the desired result of enhanced customer service" (Bernstein, et al., 1989). 4. Coordination is another area which needs to be addressed in making systems more customer-friendly. The diverse number of individual services provided within a hospital should be coordinated to better serve the patient. Meal service and room cleaning should be scheduled so as not to disturb or upset patients. The scheduling of specific tests and diagnostic procedures should be coordinated with individual departments to assist the patient in avoiding lengthy waiting times. Patients should be made aware of test schedules, and schedules should be adhered to. Patients are often brought to a radiology department for x-rays during the course of their hospital stay. They are frequently forced to endure the embarrassment and powerlessness of waiting alone in a cold hallway lying on a gurney under a thin sheet. They often wait for long periods of time without any explanation by staff. Procedures should be scheduled in coordination with expected waiting times, allowing patients to wait in their rooms instead of in hallways. 5. Finally, hospital complaint procedures need to be available and accessible to patients and staff. Whether or a not a hospital is actually responsible for causing a specific complaint is not the issue. The issue is the customer's perception of the hospital's response to a specific complaint (Leebov, 1988). Customers are more likely to continue doing business with an organization if they perceive that their complaints are being acknowledged. When complaints are resolved, and resolved quickly, then as many as 95 percent of customers who have registered a complaint will continue to do business with the organization (Albrecht & Zemke, 1985). Addressing these aspects of a customer-friendly system can help transform the patient's immediate environment, but management can also shape the overall healthcare climate through changes in the corporate culture. TOM and COI: The New Corporate Culture The most recent trend in the transformation of corporate culture focuses on quality. American corporations have adopted an orientation known as Total Quality Management (TQM) or, as it is sometimes referred to, Continuous Quality Improvement (CQI). TQM and CQI involve "the integration of quality and management methods, practices, concepts, and beliefs into the culture of an organization to bring about continuous improvement" (Anderson & Daigh, 1991). Hospitals have turned to this theory with the hope of improving patient care and increasing customer satisfaction. (This use of "customer" refers more broadly to all internal and external individuals or organizations which interact with the hospital or utilize its services.) Healthcare organizations have not, however, independently initiated TQM or CQI. The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), in its 1989 Accreditation Manual for Hospitals, established standards for Quality Assurance (QA) and specified a process by which the quality of care was to be monitored and evaluated. This process, known as the Ten-Step Process, has since been modified based upon the CQI orientation. The basic Ten-Step Process for Monitoring and Evaluating Quality is: 1. Assign responsibility. 2. Delineate scope of care and service. 3. Identify important aspects of care and service. 4. Identify indicators. 5. Establish thresholds for evaluation. Utah's Health: An Annual Review 1993 81 |
