To deliver a great patient experience, you need to deliver excellence consistently. Every single encounter with your patient makes a difference. To set the scene, I would like to use the words of the great rock musician Bruce Springsteen: ‘Getting an audience is hard. Sustaining an audience is harder. It demands a consistency of thought or purpose and of action over a long period of time.’ This quote obviously relates to producing music and performing, but his emphasis on ‘consistency of thought or purpose and of action over a long period of time’ is equally true for your focus on your patients.
There is plenty of evidence that a long-term sustained focus on any area leads to improvement and that is what you are aiming to achieve in your own practice, clinic or hospital. In your work with patient experience, you started by defining your patient experience strategy, setting out your vision, which forms your guiding map of what you want your practice to be and setting your objectives to achieve in order to have this vision. In last month’s article, we focused on measuring patient experience, discussing the various methods of doing so, including surveys and focus groups, and the importance of capturing and presenting the data in a format that can be easily understood and used.
Identify what patients are telling you.
The next step in the process is to reflect on the findings from the measurement activities to fully understand what your patients are telling you. Identify the highlights and low- lights. You will celebrate the high- lights with your team, as these show the respects in which you are delivering a very positive experience for your patients. The lowlights are where you will need to focus more attention, as these are the identified areas for improvement. Even if all your results are good, I would encourage you to focus on the lowlights. The results may not seem to be disappointing, but there is always room for improvement and focusing on consistent improvement is what you are aiming to achieve. I would suggest choosing three lowlights and create an improvement plan for each of these. The time-scales can vary, but a quarterly plan with monthly review points would allow enough time to deliver and measure improvement, while the monthly reviews will ensure you and your team retain a focus on following up the actions and improving patient experience. The monthly reviews will come around very quickly.
Agree who will take ownership of the improvement plans and who will develop them and manage their progress. I would suggest the overall owner is a senior individual within the team to ensure the right level of focus is given and that actions can be delegated with authority. But you may want to choose a team member to create the actual improvement plans and own the management of the process.
How will your improvement plans be developed?
Every individual who interacts with your patients, from your marketing manager through to the receptionist at the hospital where you operate, is a member of your own patient experience team. But it may not be possible to involve every individual in the development of the improvement plans, although, ideally, you want to involve as many as possible. Involving people at the creation stage is more likely to result in their buy into the process. The best method might be to set up a 30-minute team video call, but, prior to the meeting, circulate the results of your survey, high- light the three lowlights you are going to focus on and ask everyone to come to the meeting prepared to suggest ways to improve. During the meeting, everyone should be encouraged to contribute their thoughts and ideas, and this is more likely to occur in an open culture where individuals know that their input is valued and will be considered seriously. In an open culture, you will receive lots of suggestions and you will need to consolidate on a few actions which you all agree will deliver the best results. For those who are unable to take part in these early discussions, ensure you invest time in communicating your plans with them and giving them the opportunity to contribute. Your improvement plans are basically action plans describing what actions will be taken, by whom and by when. They should be short, very clear and easy to review. Many of you will be familiar with the SMART methodology: Specific, Measurable, Actionable, Realistic, Timescales and this would be a good tool to use. Your success will be measured when you next review your patients using the measurement strategies you implemented previously. If you are running ongoing surveys, you will be able to review the results monthly. If you are running one-off surveys from time to time, your implementation plan should include an action to run a new survey to measure improvement in the key focus areas, ideally quarterly.
Barriers to improvement
There is much research to show that middle managers can be a barrier to the improvement of patient experience, and the reason for this relates to their objectives not being aligned. The leaders and senior members of organisations are committed to improvement and intrinsically believe that it is vital. The front- line staff are engaging with patients every day and they want to deliver the best experience possible. But often middle managers are tasked with making the business more efficient and more profitable and this does not lead to a focus on improving patient experience. To engage middle managers fully, their objectives and key performance indicators need to include goals for improvement in patient experience.
Embedding an improvement culture
If you follow this plan, you will be reviewing the progress of your actions in your improvement plans monthly and measuring for improvement on a regular basis, ideally quarterly. Every three months, you can review your highlights and lowlights and change the focus of the improvement plans, if appropriate. Once each year, you can invest time with your team reviewing your patient experience strategy. Is your vision still relevant? Are your objectives and your measurement criteria still correct or do they need refining?
Patient expectations do evolve over time
The experience of living through 2020 has taught us many things, but one important lesson is that change is inevitable and can be drastic. The growth in telemedicine has been phenomenal and is a good example of how delivery of the patient experience can alter, and very quickly. Not so long ago, our patients would regularly pay their invoices in person by cheque and we would do a weekly bank visit to pay them in, and then BACS transfers became more popular. Nowadays, it is common for patients to receive a text message containing a link to a payment page where they pay by credit card. I believe that online appointment booking will become increasingly popular over coming months and we will make greater use of video in a broader range of applications. While we cannot predict everything that will happen as we adapt to new ways of working, we can ensure we deliver a positive patient experience. This process described here, of continual review, will ensure that the focus on improving patient experience is embedded in your team culture and happy patients will equate to the ongoing success of your practice.
‘You can’t manage what you can’t measure’. This well-known quote by management thinker and ‘the founder of modern management’, Peter Drucker, is a great way to set the scene for this month’s article in our series on patient experience. You cannot know whether you are successful unless success is defined and tracked. To improve patient experience, we need to measure.
What are you measuring? To measure anything requires clear criteria to measure against. Earlier in the series, as part of defining the patient experience strategy, we discussed the importance of setting your vision, which describes what you want your practice/clinic/hospital to be and also your objectives to ensure you achieve this vision.
These will be important, as they will now become the basis for your measurement criteria. As you set out your measurement criteria, it is useful to think ahead about how the findings will be used. It is important to measure the right things that will allow you to track improvements. In the US, there are a set of trademarked surveys called CAHPS surveys, which stands for Consumer Assessment of Healthcare Providers and Systems. These have been created by the US Agency for Healthcare Research and Quality and are designed to report on the aspects of patient experience that are important. They are free to use and may well serve a useful purpose within the UK market too. The measurement criteria you choose will obviously depend on your own vision and objectives, but looking at the questions asked in the CAHPS survey is helpful for inspiration.
As an example, if one of your main objectives is to ensure that patients can book an appointment in a timely manner within your clinic or hospital, you may choose a measure such as the following:
In the last six months, when you needed care right away, how often did you get that care as soon as you needed it?
The patient would be prompted to choose from the following answers:
Another important objective for many healthcare providers is to deliver information in a way that patients can understand and an example measure, seen in the CAHPS survey, might be as follows:
During your recent visit, did your healthcare provider explain things in a way that was easy to understand?
- Yes definitely
- Yes somewhat
This same format of answers applies to other questions asking the patient if the doctor spent enough time with them, listened to them and respected them. While the CAHPS templates will provide you with assistance, it is important that your measurement criteria measure the aspects of your service that are important to you.
How will you capture the information? Having defined your measurement criteria, the next step is to decide how you will survey your patients and capture their responses. You will also need to decide whom you will survey. Will you ask every patient or a subset of your patients?
We all know that responding to surveys can be tedious, so your challenge is to ensure patients are surveyed in a manner that encourages participation. One important factor is to ensure patients are aware why. If they are being asked to take part and how the findings will be used to improve care If they understand the impact their feedback will have, they will be more likely to take part. It is also important to use several different means of engaging with patients, as some ways will appeal to some groups more than others.
Technology solutions: Technology offers us numerous options including email, SMS messages and the use of a computer tablet within the hospital or clinic environment. The beauty of using technology is that it reduces the burden on healthcare staff, but you should not rule out good old-fashioned paper-based surveys, as these may appeal to some patient groups more than technology, but it will, of course, be more time-consuming to collate the responses.
Surveys can be designed to give us data that can be presented in graphs and spreadsheets, which are easy to understand and to monitor trends over time to look for improvement. The most used survey tool in the UK is Survey Monkey, although there are lots of others. Survey Monkey offers a limited free service, but for a reasonable annual subscription, you can access numerous template surveys, some of which are designed for the healthcare sector, including the CAHPS templates described previously. Using technologies such as Survey Monkey to run your surveys also reduces the burden of analysis, as they contain embedded tools to present the data in manageable ways. If you create and run your own survey, you will need to plan for the overhead of collating the data into a useable format. There are also specialist companies focusing on the healthcare industry that provide measurement and analysis of patient experience and cater for all sizes of healthcare businesses, from individual consultants through to large healthcare establishments
Patient interviews: As well as surveys, you could also consider more descriptive patient engagement such as patient interviews and focus groups. The information gained will be harder to present graphically, but will undoubtedly offer some informative knowledge. An interview could even be an informal chat that takes place at the end of a consultation or during a ward round, with each patient being asked a consistent set of three questions and their answers being manually collated. You could also engage your medical PA in the process, asking them to ‘survey’ patients, by phone or email, following their appointment. Like all businesses, healthcare providers receive complaints from patients, and these can provide valuable insights into your patients’ experience and should be included as part of the data collected. At the other end of the spectrum from complaints, I am sure you receive ‘thank you’ letters and compliments from patients regarding the care you have provided. These also provide valuable insights and will highlight the most positive aspects of the patient experience you are delivering.
How will you analyse the data and present it? Once you have run your survey and the data is captured, it needs to be analysed and presented in a meaningful way to ensure it can be used to develop action plans for improvement. You will need to agree who will do the analysis and presentation and continue to do so on a regular basis. If you are using a survey tool, this may not be a significant overhead, but if you plan to run your own survey, the collation of the data will take some time to manage. The output produced should be presented in a manner that is easy to understand by you and the rest of your team. It should be in a format that allows for the measurement of trends over time, so ideally in a spreadsheet or a graph. And the more data that can be collected over time, the more informative the findings will be.
The next stage is to use this valuable information to produce improvement plans enabling you and your team to focus on a small number of areas, usually where you have received lower scores or less positive feedback than you would like to receive. For each of these areas, an action plan should be developed to ensure improvement over time, and this will be the subject of next month’s article. I look forward to answering the following questions next month:
- How will your improvement plans be developed?
- Who will own the improvement plans?
- How will you embed the focus on patient experience in your organisation?
- How to make patient experience a top priority for the long term
One of the most important hires you will ever make is your Medical PA, but in a world where your patient is your highest priority and things generally move at lightning speed, it’s truly difficult to find the time to cultivate your relationship with your secretary who, ideally, would be viewed as your business partner.
Many doctors today work from numerous locations and are bombarded with information and technology; however, many overlook their most valuable asset, namely their private medical secretary services.
Your Medical PA may well be in contact with your patients more regularly than you are. They are an ambassador for your practice and represent you always. Your patient’s opinion of your practice will depend greatly on your care but also on the service that your team provide.
The role of a modern Medical PA is a specialist one but primarily it is about customer service. Your patients will need support to book appointments, arrange prescriptions and follow on treatment. They also need assistance in dealing with insurance companies and other billing matters.
For any doctor looking to grow their practice, the capabilities of their private medical secretary services play a crucial role. The initial patient call or email will be handled by your Medical PA. They will provide information on your behalf and may well play a role in overcoming objections such as your diary availability and the cost of treatment. The modern Medical PA has a key role to play in developing your practice and will support you in doing so. It is important to recognise that there is an element of business development involved and that is a complex area where you will need to work very closely together.
If you accept all this to be true, your next question will naturally be, how do I maximise the relationship and build this important partnership.?
Mutually beneficial relationships, be they personal or professional have communication and open dialogue at their very heart. Taking the time to have meaningful and purposeful interactions is key. This doesn’t necessarily mean you must discuss personal issues but more that you need to make your dialogue beneficial “What do you need from me to [insert your task]?” is a great way to start the flow of information. Listen to your Medical PA’s requests and respond accordingly.
Never presume that your Medical PA automatically knows how you like things to be done, so be sure to take the guesswork out of it; if you don’t like being bombarded with emails, ask for one which rounds up outstanding points/tasks. If you don’t like emails at all be sure to schedule regular time with your Medical PA for a meeting or call to run through your tasks, and avoid changing or moving this time. Provide clear feedback, so that your Medical PA knows how to improve in all respects including how they communicate with you.
Asking your Medical PA how they like to do things will also help you get a broader understanding of how your working practices affect them. Likes and dislikes are what fundamentally help us to connect with each other.
Most Medical PA’s are in this field because they care about patients, are highly skilled organisers and can tackle any task or requests in the most efficient way. It’s quite a leap of faith to trust someone to have such responsibility for your practice but empowering your Medical PA to make key decisions, within agreed boundaries will enable them to be most effective.
Being clear in your priorities will enable your Medical PA to deliver the results you need. Share your objectives with your Medical PA so that you can both work towards achieving them. If you want to increase the number of private clinics you hold each week, ensure your Medical PA knows this. If you promise your patients to provide their results within a certain time, ensure you both agree this is realistic and that your Medical PA shares a commitment to achieve this.
There will be mistakes. It is crucial to handle these with care and respect. Your Medical PA may make a mistake from time to time, for example forgetting to follow up on something. But so will you! How you handle this will set the scene for how you both evolve and learn to ensure continuous improvement. None of us are perfect and we all make mistakes so be accountable for yours which will show your Medical PA that he/she can be open and honest too. Creating an environment of mutual respect will be unendingly beneficial overall. A good Medical PA will offer a solution to any problem and will work with you to ensure a positive resolution.
There will be problems that are outside the control of your Medical PA; for example, a colleague cancels a theatre list, for good reason of course, but this leaves you stranded at short notice. It is your Medical PA who breaks the news to you. Be careful not to shoot the messenger and alienate the one person who can help you find a way out of the chaos. If you make this mistake in the heat of the moment be sure to apologise. This can lead to your Medical PA withholding information to avoid getting shot next time!
The biggest cause of disagreement is often asking your Medical PA to perform tasks that they perceive to be outside their job description. This may vary depending on the background of your Medical PA and the culture they are used to working in but one obvious example is personal tasks. If you expect your secretary to do personal tasks for you then please make sure this is clear from day one. It would help to explain that support with these mundane tasks enables you to be a more effective doctor and is therefore invaluable. Your Medical PA may feel that there is not time to take on these responsibilities and in that case, consider engaging the support of a flexible private PA to assist you.
And finally, show appreciation. Your private medical secretary services will be both highly qualified and committed to the role and does not expect you to show sincere thanks for every task performed, but when your Medical PA goes above and beyond for you, your appreciation will go a long way. I am not suggesting grand gestures of flowers and champagne, although this may be appropriate in some circumstances, but taking the time to say “thank you” for a specific piece of work done well is very powerful.
Working as a partnership will ensure your patients receive the best experience possible from your practice, will generate loyalty from your Medical PA and will ensure you have an enjoyable day to day experience on your private practice.
Top 10 Tips
- Communication is key and it’s a two-way process
- Listen carefully to feedback regarding your patients to help you develop your practice. Your Medical PA talks to your patients more often than you do.
- Be responsive. Remember that your Medical PA is making requests of you to enable him/her to respond to your patients.
- Share your objectives and agree how you can achieve them together
- Discuss and agree how to work together. Don’t assume it’s obvious
- Trust your private medical secretary services to make decisions on your behalf within agreed boundaries of course
- Be accountable for your mistakes and create a culture of trust enabling your secretary to be open and honest
- Don’t shoot the messenger. If you do make this mistake, be sure to apologise
- Discuss and agree boundaries and jointly develop solutions
- Appreciation – say thank you when it is appropriate
Your Medical PA will have an enormous impact on your private practice. The Medical PA role is considered an admin role but I strongly argue that is much more than that and would encourage you to consider your Medical PA as the owner of customer service where the customer is your patient.
The Medical PA role will work alongside you, caring for your patients and ensuring they feel safe and receive good quality care. Many people in the medical industry now talk about the “patient experience” and the service your Medical PA delivers is a significant and important part of your patients experience that impacts on your reputation as a doctor. Your medical PA acts as an ambassador for your practice.
It is imperative that your Medical PA is fully engaged in your vision of your practice, which is your definition of where you want your practice to be. Your Medical PA should also understand your goals and objectives and understand how they contribute to achieving these.
Coming back to patient experience, we can consider your patients journey and break this down into three parts and consider the Medial PA role in each part of the journey:
- Before treatment
- During treatment
- After treatment
Before Treatment – your Medical PA will play a key role in all three parts of your patients’ journey. In stage 1 your Medical PA will handle your patient’s initial enquiry, responding to questions about your practice and starting to build a relationship with a new patient who is often anxious and needs reassurance. This relationship building is key and can determine whether your patient decides to book or not.
For every interaction you have with a patient, either during a consultation or planned surgery, your medical secretary may have more than 6 interactions by phone and by email. When a patient has decided to book an appointment to see you, they have their first human interaction with your practice, and they will most likely email or call your practice to make their initial enquiry. It is at this point of the first interaction that your Medical PA will start to build their relationship with your patient, and this is incredibly important.
Many Hey Doc users are now offering patients the opportunity to book online and for many this is incredibly positive. If your patient books online, their first human interaction will come at the next stage which is the follow-up and confirmation. So, whilst online booking eliminates the first human interaction the way your Medical PA follows up is still incredibly important.
Once your patient has booked their initial appointment, your Medical PA will follow up with booking details including the provision of pricing information to ensure your practice meets its regulatory obligations.
Communication is key throughout the patient journey, but in this initial stage, there is an opportunity for your Medical PA to provide valuable information such as patient information leaflets.
Over recent months the use of video conferencing has grown exponentially, and whilst face to face consultations will always be preferential you may decide to include video as part of your patient care. For example, a new patient who is travelling a long distance to meet you may be reassured by an initial video consultation that is both convenient for them, and provides a great opportunity for you to ensure your patient feels comfortable with you and commits to a face to face consultation. It may also be possible to “meet” patients more quickly by video than in a face to face scenario and therefore deliver a greater patient experience especially for those who need urgent reassurance. Your Medical PA will arrange video calls on your behalf, ensuring both you and your patient have the correct log-in details to ensure the video call goes smoothly.
Your Medical PA will contact your patient prior to their appointment to confirm the date, time and location.
When your patient does come to see you face to face, the physical environment in which you meet will also impact the patient experience. To enhance this, it is important that your PA reconfirms the appointment the day before and ensures the patient has accurate details regarding your location, how to find you and other considerations such as parking. The aim of this communication is to ensure your patient is fully briefed, has clear expectations of what to expect and importantly from your perspective, is very likely to arrive on time.
During treatment: Following your initial consultation, you will have a list of follow up actions, which we refer to as “outcomes” and follow up communications to deliver. It is your Medical PAs role to ensure all the outcomes and communications are handled on your behalf in an accurate, secure and timely manner. This requires enormous attention to detail and the creation of robust processes and systems to ensure mistakes are eliminated. For example, for every test your patient has done, your Medical PA needs to ensure that results are received and communicated to you so you can dictate a letter. The dictation needs to be transcribed and sent in a secure manner to the patient and/ or GP. One missing result letter can be disastrous.
Your Medical PA will handle the management of the outcomes, ensuring your patient is booked for the various tests that you have requested, follow up appointments or surgery, liaising with other clinics and hospitals as needed. Prescriptions must be completed and referrals to other health care professionals managed.
Whatever your treatment plan involves, each step of the process needs to be managed in a way that ensures your patient feels well informed, in control and well cared for. Good communication is key.
Your patients will also need to be billed for the treatment they receive. I know that many Medical PAs also manage billing and credit control (I used to do it myself), but my experience is that doctors are better served by using a professional billing company to fulfill this role for two reasons. Firstly, billing is a complex process requiring excellent knowledge of insurance company codes. It also requires a different skill set to that of a Medical PA. Managing credit control is a skill and chasing patients and insurance companies for overdue invoices and shortfalls is both challenging and time-consuming. In my opinion, the Medical PA role is to provide your patients with a service such that they feel safe and secure in your care. It is very difficult for your Medical PA to maintain that relationship when they need to have discussions with patients about overdue invoices, insurance company shortfalls etc. These discussions are best handled by your billing company.
Depending on the location of your practice you may also need to order your own medical supplies and your Medical PA will handle this. All your suppliers will need to be paid and again your Medical PA can handle this although you may be wise to engage a professional bookkeeper. Good bookkeeping ensures you have a robust handle on your finances throughout the year. Your bookkeeper will be able to provide you with monthly management accounts so you can assess the performance of your practice. Heydoc integrates with Xero which is a brilliant finance management system and well worth considering. Managing your bookkeeping well throughout the year will also ensure that the production of your accounts at year-end is relatively easy and quick and should also save you money on your annual bill from your accountant.
After treatment: In most cases, patients will attend a follow-up appointment with you which is normally face to face. Your Medical PA will ensure that all follow-up appointments are booked in a timely manner. After the follow-up appointment, your patient may be discharged from your care or you may require a longer-term follow-up, for example, an annual check-up. Your Medical PA will set a “recall” task for your patient which will notify your Medical PA, at the right time, to contact your patient and arrange that check-up. This may also be the time when your Medical PA encourages your patient to leave a review on the platform of your choice, e.g. Google Reviews, Doctify, I want great care etc.
I encourage all doctors to view all patients as long-term patients as they may need further treatment in the future, or they may have friends and family who have a need for your services. For these reasons, I would encourage you to consider your patient experience to be long term and to look for opportunities for continued care.
You may choose to send a regular newsletter to keep your patients informed on the services you provide and potentially new treatments that are available. You might also include articles regarding preventative health. In your patients mind you are already a trusted expert and so your continued communication is likely to be welcomed. Your Medical PA can assist with this but may need help from a marketing specialist too.
In summary, I recommend choosing your Medical PA with care, recognising that your Medical PA will represent your practice and have a significant impact on your reputation as a doctor.
There are of course functional skills that your Medical PA needs to show competency in, for example, audio typing, but the most significant impact your Medical PA will have is on the many on which your patients are looked after and cared for. The skills to deliver this are developed through training but are also dependent on attitude and being aligned with your vision for your practice.
You know that patients research their doctor online before committing to make an initial appointment, as well as conducting additional checks on websites such as Doctify and Google reviews.
Patients are hugely impacted by your “online reputation”. Your online reputation needs to be well managed, ensuring that when your current or potential patients Google your name, all the content they read is positive and informative, with a clear visual representation that creates a standout impression, validating their decision to book to see you and instilling confidence in the potential relationship.
Why is a visual identity important in the form of a logo and unique colour palette?
Because it grabs attention, makes a strong first impression, and is the foundation of your brand identity. A professional logo and colour palette is memorable, communicates personality and will separate you from your competition. And ultimately it is expected by your audience.
A logo can often be the first impression of your practice to your patients – for example via your website. But your logo needs support to be able to deliver your message and to give you a clear standout from your competitors.
Colours, tones and fonts are all determined by the message you are trying to tell, and your logo sets the stage for this story. These elements along with your logo will translate onto all your branding materials including letterheads, business cards and your website.
Dare to be different with your logo, because your logo tells patients why your business is unique. In other words, your logo is the forum to both convey your values and show patients why you are not like your competitors – you are better. And, finally, your logo is the first thing that your audience will look for when they see any communications from your practice. It should be front and centre of all your communications, providing consistency and it provides an opportunity to make sure your practice stays in the minds of your audience.
Enhancing your reputation, growing your practice
Contact Hannah Smith, our Designated Medical
Client Relationship Manager
E: Hannah@Designatedgroup.com T: 020 7952 1437
Maintaining close engagement from a distance
Virtual events have been around in various guises for a number of years now but, to a lot of people, this will still feel very new and possibly overwhelming. So how, and why, should you embrace the world of virtual events?
Connect with your teams
Working from home has huge benefits but can leave teams feeling disconnected. Sometimes you can’t beat a face to face conversation, whether it’s a one-to-one chat, or joining in with a larger group. Invite everyone for an online coffee (or a glass of wine!) or offer something more structured such as a quiz night or a town hall. The options are endless. Remind your teams that you are there to support them in these strange and challenging times.
Maintain contact with your clients
If your clients cannot come to you, reach out – virtually – to them. Webinars, online product launch events, even client social events. Everything from a technical product demo to a murder mystery can all be created online. Videoconferencing packages such as Zoom, Microsoft Teams, Google Hangouts etc can be used to create simple communication events. If you’re looking to go bigger then there are plenty of agencies ready and waiting with the latest technology to take your events online for you.
Continue with planned marketing activities
If you haven’t already embraced social media fully, now is the time to do it. Take advantage of the online universe and reach your audience via the likes of Twitter, Facebook, Instagram and LinkedIn. The beauty of virtual events is that they can be hosted from anywhere – and are far cheaper than hiring a venue!
Whether you’re already a pro at all of this, or a complete beginner, Designated are here to help. Contact us on 020 7952 1460 or at email@example.com to see how we can help you create fantastic virtual events and stay connected.