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Press Start: Lead an Empowered Life as a Clinical Laboratorian

Service Recovery is Part of Quality

Published September 15, 2013 1:50 PM by Glen McDaniel


In healthcare we often talk about quality. In fact we dredge that word up whenever we want to shame someone into doing whatever we want. In healthcare we tend to think of quality as something that somehow improves patient outcome and is often related to some policy, rule or regulation.

We ensure quality control is in range, temperatures are checked and recorded. Blood stream infections, contamination rates and the like are tracked and trended. But these are largely internal measures which are of more importance to us than to the patients. Patients just assume we are competent, qualified (educated, certified, licensed, trained) professionals. To them that's a given. Their idea of quality is related somewhat to outcome, but their daily assessment of quality is based on how they are treated and how we make them feel during daily interactions.

Healthcare is unique in some  ways, but in terms of service and quality it is very similar to industry and every other service organization.

A couple weeks ago, my car was hit and after the inconvenience of negotiating with two insurance companies (the other driver's and mine), I took my car into the shop. I picked up my car a few days later, only to find an error code as  I drove out of the parking lot. When I took the car back, there was no apology just a defensive promise to "take a look at it , because it was fine when WE checked it earlier."  It took them three hours to get a part from the dealer and install it. I had lost about four hours of work before it was all over.

The car was drivable and seemed fine, but I noticed a light out, and a similar error code showed up in less than 24 hours. My calls to the service department went largely addressed. I was given the run around. The front line employees apologized but could do nothing to help. The manager was always unavailable. So, how do you think I feel about that repair shop? What do you think my next interaction with them will be like? A simple "make it right" repair will not be sufficient anymore.

As a laboratory, what do you do when a patient does not receive the service or treatment he/she expects? Many organizations now have Service Recovery policies or even entire programs dedicated to service excellence. Whatever such programs look like, there are a few principles that apply universally-whether dealing with a disgruntled patient or a dissatisfied customer like myself.

Acknowledge responsibility. It's important to acknowledge that you screwed up and that the customer is
justified in feeling angry and in expecting more than they received. This step is not about blaming a specific employee or promising the customer that a certain person will be disciplined or terminated. It's accepting responsibility as an organization that has delivered sub-par quality.

Apologize.  It's human nature that a simple apology very often diffuses tension. Studies have shown that even in malpractice suits, patients and their families are more likely to settle and go easy on organizations that actually
apologize early on. An apology means simply, "We are sorry we did not meet your expectations."

Correct the problem. As much as possible, do the thing right this time around. Some errors cannot be undone. It's impossible to un-ring a bell. But you can still recover somehow by doing something right. Move towards a solution in some way and don't make excuses for the initial poor service.

It sometimes takes the customer or patient to tell you what they consider reasonable "compensation." It is not always what YOU think. One rule of thumb is that recovery almost always involves added value. If you screwed up, merely doing it right the second time, might not be sufficient to compensate for the "hassle factor."

Another rule of thumb: do not make it difficult for the customer to take advantage of whatever it is you are offering. Owning the problem suggests that you do not compound the customer's inconvenience.

Empower front line staff to act. When a patient or customer has been wronged it does not help (in fact it
might be aggravating) if front line staff has to go up several layers of management to start the recovery process. They should apologize as representatives of the organization and must be empowered to at least start the recovery

If the process is complex, non-routine, or requires authorization from a higher up, front line staff should facilitate that
interaction. They should be empowered to contact management  or a decision-maker and make that meeting/call/interaction as expeditiously and seamlessly as possible.

Perception is everything so if a patient feels that they have not been well served, even clinical outcomes are secondary. They don't care about your  QC and your trends or even your clinical competence. During human interactions, problems are a given, but it is always possible to recover if you just follow a few principles.


Press Start: Lead an Empowered Life as a Clinical Laboratorian : Service Recovery is Part of Quality

October 20, 2014 1:15 PM

Very good article. thank you for writing it, We have to follow very strict rules in the military. One of the draw backs is that we are not allowed to do much without authorization. If we could just  give some sort of apology without first having to get permission from a  superior I think I would feel better and the patient would also feel better. Most of us don't see the lab as a service department and  I think that's the main problem.

Mercy T October 12, 2013 5:29 PM

In the past 5 years I have worked at 4 different hospitals and only one of them have  a REAL Service Recovery program. In places I have worked if  someone complains you give them an excuse or you just pass on the informationt to your supervisor and who knows what happens then.

I know at my second lab we had lots of outpatients. The  outpatient area where we did lab draws the space was too small and there were always patients standing around. They waited up to an hour to get registered and get blood drawn. Plus those with GTT were there for 3hours plus. It was awful. Phlebotomists hated working that area because it was stressful and there were lots of complaints.

At one place I worked they used to have some sort of customer service thing . They told us about it orientation, but it stopped because I never saw it in use.  At my current job they do have  a program.  If someone complains about the wait for lab services we give them a ticket so their parking is free when they leave. The receptionist has been trained to apologize if someone waits too long and she actually checks with the phlebotomists to see ow many people before that person. In other words where that person is in line. They then give them an estimate how long their wait is going to be.

If the wait is extra long when someone is checking in the Customer service Rep tells them the wait is approximately 45 minutes for example. We give them the choice of waiting in a lounge down the hall where they have more comfortable chairs, big screen TV and a vending machine.

The CSR will then personally go get them when it's their time to be drawn. They love that instead of  having them stand up in our cramped lab waiting room. Some patients who have been coming here for years say this new procedure works much better for them. They love it!

I am so  impressed that the lab has won  "best patient satisfaction " awards for 5 out of 8 months already this year. It seems like a simple thing, but patients and families appreciate that stuff.

Maria C. September 16, 2013 4:24 PM
Atlanta GA

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