Study examines the effectiveness of customer service programs in a hospital emergency department. Results show increased patient loyalty and likelihood to recommend as well as rating of overall care.

1. Making a Difference in Perception of Care and Patient Loyalty

2. “For EDs interested in improving patient satisfaction, a person to “round” in
the ED, explaining delays, care-flow issues, and nonmedical processes of
care may have a large impact.”
Robert Locke DO MPH
Pediatric Emergency Medicine, 2011
(Locke and his team conducted a study of Press Ganey surveys that linked defined components of the electronic medical record associated with
each survey respondent's ED visit to ascertain specific objective ED data. The team concluded “Achieving optimal patient/caregiver satisfaction
scores in the pediatric ED is highly dependent on the quality of the interpersonal interaction and communication of ED activities. Wait time and
other throughput variables are less important than perceived quality of the health interaction and interpersonal communication. Patient
satisfaction has advantages greater than market share and should be considered a component of the care-delivery paradigm.”)

3. Strategy
________________________________________________________________
Go beyond satisfaction and measure patient loyalty.
How likely are patients to return and recommend?
Guest Relations Assistant (GRA)
 Non-licensed outsourced staff, employed by Errand Solutions
 Help provide non-medical concierge like services
 Explain delays in care
 Provide food and drink when appropriate, blankets and other comfort
items, reading materials, assistance with home needs (e.g. child or pet care, bill
payment, home maintenance, collecting mail)
 Communication with work, family and friends
 Offer services for patient’s families and guests in addition to the patient
 Serve as liaisons between patients and the health care team

4. Study
________________________________________________________________
• St John Hospital and Medical Center
 ED Volume > 100, 000 visits per year
 May – November, 2012
• Inclusion criteria
 Adult patients in ED with a PCP on staff
 Discharged from the ED
• Participants contacted via telephone within
48 hours of their visit
 Asked 2 Survey Questions
o How would you rate your Overall Care in the Emergency Center?
o How likely is it that you would Recommend this Emergency Center to your friends and family?
(Scale 0 – 10, 10 being Extremely Likely)
• Chi Square Analysis (standard statistical hypothesis test)
Emergency
Department
n=622
Seen by GRA
n=387
Not Seen by GRA
n=235

5. Net Promoter Score (NPS)
________________________________________________________________
NPS = [(Promoter–Detractor )/ Total Surveyed] x 100
• A net promoter score is a quantitative measurement of a customer / patient loyalty
 Alternative to Press Ganey Scoring
 Developed by Fred Reichheld as a loyalty metric and introduced in 2003 in a
Harvard Business Review article
 Known as the “one number you need to grow”; driving good profits and true growth
• Responders divided into three groups
 Promoters scores 9 -10
 Neutral scores 7 - 8
 Detractors scores 0 - 6
Scores
9-10
Scores
0-6
All
Scores
0-10

6. Results
________________________________________________________________
13.2
9.4
77.4
2.6 3.6
93.8
0
10
20
30
40
50
60
70
80
90
100
Detractor Neutral Promoter
Rating of Overall Care
No GRA
GRA
0-6 7-8 9-10
p<0.0001

7. Results
________________________________________________________________
16.2 17.5
66.2
3.6
10.6
85.8
0
10
20
30
40
50
60
70
80
90
100
Detractor Neutral Promoter
Likelihood to Recommend to Family and Friends
No GRA
GRA
0-6 7-8 9-10
p<0.0001

8. 50.2
82.17
0
10
20
30
40
50
60
70
80
90
100
No GRA GRA
Improvement in NPS and Loyalty
________________________________________________________________
63.7%
relative
improvement
.
The use of GRA
improved the
absolute NPS
by 32 points;
a 63.7% relative
improvement
over baseline

9. Study conducted by:
Darrius Guiden MD
Neil Majmundar MD
Charlene Babcock MD
Margarita Pena MD
Robert Takla MD
Lauren Cindrich
Kyle Latouf