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Making the transformation to a customer-service orientation


With consumers gaining greater control and more choices in their health care, consumer satisfaction is more important than ever. Consumers of healthcare services include patients, family members, third-party payers, governmental agencies, and employer groups.

The degree to which an organization is customer-oriented depends largely on employees’ customer orientation. Yet few healthcare professionals receive adequate education in customer satisfaction. Given current care-delivery models and the emphasis on pay for performance, such education is necessary. This article describes a tool that helps healthcare providers understand the importance of customer satisfaction and outlines ways to improve it.

Is your hospital still waiting on the platform?

Reimbursement changes have forced healthcare organizations to adopt a customer-service philosophy to survive financially. Progressive organizations have already embarked on the transformation to a customer-service orientation; reactive organizations continue to wait on the platform.

Starting with hospital discharges in October 2012, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey will be among the measures used to calculate value-based incentive payments in the new Hospital Value-Based Purchasing program. The first national standard for collecting and publicly reporting information about patients’ experience of care, the HCAHPS survey permits valid comparisons to be made across hospitals locally, regionally, and nationally. The survey asks discharged patients 27 questions about their recent hospital stay, including communication with nurses and doctors, staff responsiveness, hospital cleanliness and quietness, pain management, communication about medications, discharge information, overall rating of the hospital, and whether they would recommend the hospital.

The HCAHPS survey has a threefold purpose:

  • to produce data about patients’ perceptions of care, allowing consumers to make objective and meaningful comparisons of hospitals
  • to create incentives for hospitals to improve quality of care
  • to enhance accountability in health care by increasing transparency of the quality of hospital care.

HCAHPS survey scores will soon determine reimbursement for the care of Medicare and Medicaid
patients. To meet and exceed established HCAHPS targets, healthcare providers must understand the meaning of these targets and use tools and strategies to improve patient satisfaction and perceptions of care. Organizations with a consistent and effective practice of customer-service skills and communication will have a clear score advantage. Research shows a healthcare organization’s quality of care correlates positively with high HCAHPS scores. Similarly, advanced performance outcomes, above-optimal clinical care, and reduced medical errors are linked to a positive patient experience.

Bridging the gap with core competencies

Many colleges and universities include customer-service courses in various degree curricula, but not in medical or allied-health degree programs. Although the definition of customer varies across industries, the skills and tools needed to ensure customer satisfaction are similar in all of them. To improve customer satisfaction, employees must receive education on its importance, along with the tools and skills they’ll need to attain it.

Lehigh Valley Health Network (LVHN), a nonprofit academic organization in northeastern Pennsylvania, provides development activities, sessions, and strategies to its leaders, who serve as role models for organizational behaviors and culture. Senior-level leaders designate structured educational sessions imperative to healthcare leadership success. Through this development, core competencies specific to LVHN have emerged. The universality of these competencies makes them effective in multiple situations. For example, staff can use them to enhance patient satisfaction and leaders can use them to promote staff satisfaction. (See Core competencies for improving customer satisfaction by clicking the PDF icon above.)

The “wheel” of customer satisfaction

I developed a tool in the form of a wheel that gives a working explanation of how to manage patient satisfaction and, indirectly, of the quality of care and customer loyalty to the organization. It can be applied not just in the healthcare industry but in many other service industries and situations. (See Customer satisfaction wheel by clicking the PDF icon above.)

The wheel’s inner circle shows the core competencies and skills needed to enhance customer service. Healthcare employees and organizations should possess these competencies to promote patient satisfaction and a positive perception of care. Use of these competencies can be adapted to the situation: Sometimes, an employee may need to use many competencies simultaneously; at other times, just one may suffice. The more competencies employees have, the stronger the core and the easier it will be to create and sustain customer satisfaction.

Health care as a service industry

Current healthcare trends require organizations to adopt many of the skills and philosophies of the service industry, with customer satisfaction paramount. The quality of relationships between patients and healthcare professionals directly contributes to customer retention and loyalty. Service quality rests on a set of organizational foundation issues that support and promote frontline employee service delivery, including employee training.

Healthcare professionals need to acquire the core competencies that lead to customer satisfaction. This understanding begins with organizational leaders. When used appropriately in an individual situation, these core competencies can enhance customer satisfaction, perceived quality of care, and loyalty while enabling the healthcare organization to receive optimal reimbursement from pay-for-performance plans.

Selected references

Dye CF, Garman AN. Exceptional Leadership: 16 Critical Competencies for Healthcare Executives. Chicago, IL: Health Administration Press; 2006.

Fried BJ, Fottler MD. Human Resources in Healthcare. Managing for Success. 3rd ed. Chicago, IL: Health Administration Press; 2008.

Longest BB, Darr K. Managing Health Services Organizations and Systems. 5th ed. Baltimore, MD: Health Professions Press; 2008.

Lovelock C, Wirtz J, Chew P. Essentials of Services Marketing. Pearson Education; 2008.

Studer Q. Hardwiring Excellence: Purpose, Worthwhile Work, Making a Difference. Gulf Breeze, FL: Fire Starter Publishing; 2004.

Studer Q, Robinson BC, Cook K. The HCAHPS Handbook: Hardwire Your Hospital For Pay-For-Performance Success. Gulf Breeze, FL: Fire Starter Publishing; 2010.

Visit for a complete list of references.

Anne S. Rabert is the director of clinical services in the medical-surgical intensive care unit at Lehigh Valley Health Network in Allentown, Pennsylvania.

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