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Press Start: Lead an Empowered Life as a Clinical Laboratorian

Happy Customers Mean Great Bottom-line

Published October 9, 2010 12:41 PM by Glen McDaniel

Just about every healthcare institution in the US currently conducts some sort of patient satisfaction survey. For hospitals the most respected and widely known is the Press Ganey Survey   but there are several others available, and  hyperbolic claims often ignore  differences in survey instruments.

The federal government is requiring hospitals to participate in, and report their scores on, a survey called Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS).

The HCAHPS is a standardized survey measuring patients' impressions of their hospital stay. The HCAHPS survey contains 18 patient perspectives on care. Patients are asked to rate items that encompass eight key topics: communication with doctors, communication with nurses, responsiveness of hospital staff (including laboratorians), pain management(TAT for labs will impact this item as well), communication about medicines, discharge information, cleanliness of the hospital environment, and quietness of the hospital

This is designed to be an "apples to apples" comparison of hospitals and the data will be made public for consumers to use as part of their decision-making process regarding a hospital of choice. Additionally the federal government which is the largest healthcare payer will be using HCAHPS data to reimburse hospitals. Rather than getting extra reimbursement for good scores, hospitals will be penalized for low scores. Therefore there is a real financial incentive to score well.

So many organizations come up with complicated mission and vision statements. They also adopt lots of quality measures behind the scenes; most transparent to the patient. We sometimes lose sight of why we routinely perform procedures like calibration, maintenance, use of quality control, result verification and the like. They are not merely to avoid law suits or meet CAP standards; but ultimately to provide the best care possible.

But we cannot arbitrarily decide what "best care" is. Patients must have an input since satisfaction is always from the perspective of the customers we serve.

I was in the grocery store yesterday and standing in line I saw a huge sign with the chain's simple mission statement "We have to anticipate and react to the expectations of our current and prospective customers in order to be successful." Isn't that simple, and true??

Patients have a choice. Patients have access to much more information than they used to. They know what options they have. They can easily find out how your lab compares to the guys down the street in terms of patient satisfaction.

Our customers are also varied-everyone who uses our services,  as well as everyone who helps us to provide that service is a customer- and every customer is important.

 Our job is to anticipate and react to the needs, expectations and stated priorities of our customers-doctors, nurses, patients-and employees. How effectively we do this determines how healthy our bottom line will be.



The patient sees phlebotmist and call them lab techs. Even nurses dont know the difference. We need to train phlebotomists to answer simple questions and teach nurses that phlebotomists are like nurses aides or unit secretaries. They are the people that patients and visitors see first but they are not the main professionals, the nurses.

If they knew that difference they would not expect the same knowledge from phlebotomists that they do from CLS and they would not be as disappointed when they dont get answers. Sometimes patients are unhappy because nurses and doctors blame "the lab" (phlebotomists). The patients think the people who stuck them and cant answer their questions or was late drawing their blood is "the lab." We need education to change that.

Jose C October 31, 2010 9:00 PM


I do agree with you in some ways. Organizations will tend to post the most positive survey results and ignore the negative ones.They can also tweak numbers to cast themselves in the most favorable light possible.

Example: "80% of patients say they would recommend ABC Hospital" could mean that they sent out 210 surveys, only 25 were returned and 20 individuals gave  a variety of answers like  "definitely would recommend', "likely to recommend", "would recommend for some services."  The devil is in the details.

Not every single patient is motivated to return a survey, so hospitals must make  the process as easy as possible, while realizing they are missing a subset of patients.

The way surveys are conducted are also important. Hospitals have tried mailing them out, using telephone surveys (these always yield more positive answers), and some have even helped patients fill out surveys before they leave the hospital (this is the most biased of all).

Surveys like Press Ganey ask standardized questions, analyze the returns  for statistical significance and compare hospitals. HCAHPS will be even more objective. All hospitals will use the exact same questions and the scores will be public knowledge and readily available online. That makes it more difficult to spin or manipulate data.

Maria: some inpatient surveys specifically ask patients about the appearance, courtesy, and competence of the person taking their blood. They might ask whether they introduced themselves and explained what they were doing. Of course these questions  target phlebotomists; but they are the lab's face to the patient after all.

Outpatient surveys usually mention the lab by asking about registration, wait times and phlebotomy as well.

Whether inpatient or outpatient if lab-related complaints are handled by laboratory management interacting directly with patients and their families, then the  customer-focused approach of the lab is likely to be recognized.

In some institutions, labs routinely do service recovery whereby a supervisor visits a disgruntled patient to apologize and, if appropriate, might offer  a fruit basket, and check back daily to make sure the patient's impression of the lab has improved, for example.

But to think that the lab has no role in patient satisfaction is to miss the mark totally.

Glen McDaniel October 14, 2010 10:11 PM

What do you get when you employ a used car salesman and a statistician ?

two people who can make rusty numbers look gooooood!

Statistics can be made ...err..  manipulated to say whatever you want them to say.   Naturally an organization is not going to post or advertise their weak points, but they will certainly toot their horn for the sparklingly positive ones they do get to swoon customers into believing what is written on that shiny, verbose placard in the lobby.

Nick Speigler October 14, 2010 10:25 AM

For a long time we used to hear that healthcare is a business. We didnt like that for a long time. We used to think only administrators talked liked that. Now we all agree that healthcare IS a business. However those of us in the lab still dont think that the lab is a business or that we have anything at all to do with patient satisfaction. That is so NOT true.

Maria S MLS October 11, 2010 8:02 PM
Detroit MI

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