“Statistics suggest that when customers complain, business owners and managers ought to get excited about it. The complaining customer represents a huge opportunity for more business.”
Feedback from patients and staff is one of the most effective ways to learn what is working and what may be in need of improvement in one’s practice. The way in which feedback is solicited is key to getting the greatest number of patients to complete surveys and complete them in a way that offers quality information that can be used to improve the practice. In fact, a simple switch from paper-based surveys to the use of online survey tools can significantly increase participation. For example, when switching from paper surveys to online surveys in my practice, we increased the number of surveys we received from one to two per month to an average of 100 to 150 surveys per month due to ease, convenience, and multiple options for where/how patients could fill out the survey (e.g., smart phone, tablet, computer, etc.).
Choosing an Online Survey Option
There are several online survey options to choose from, such as SurveyMonkey, surveygizmo, PatientExperience.net, and kwiksurveys. One of the most important factors to consider when choosing a survey host is whether the website offers HIPAA compliance measures to protect any personal information collected about patients when they complete the surveys. Even if surveys are conducted anonymously, using a HIPAA compliant system is important because often patients share details about their appointment or leave their name and contact information in open comment sections.
SurveyMonkey offers a flexible survey format, customization options, and the ability to embed the survey on a practice’s website or send to patients via email. Results can be filtered and easily exported and shared. Importantly, SurveyMonkey, when upgraded to a Platinum Plan level, offers HIPAA compliant measures, including automatically logging users out of the system after being idle for too long and warning users when they are downloading or sharing information.
Surveygizmo is another survey tool that offers enhanced customization capabilities, including options to personalize and brand the surveys through pre-built formats or fully customizable xhtml/css templates. Results can easily be exported and surveygizmo also offers HIPAA compliant measures when upgraded to an Enterprise level.
PatientExperieince.net is another popular option for many medical practices, but this site does not offer as many customizable options as SurveyMonkey and surveygizmo. Kwiksurveys, although similar to both SurveyMonkey and surveygizmo in many of its offerings, is not recommended for medial practices because it is not HIPAA compliant.
Requesting Feedback from Patients
In addition to offering the right tools to allow patients ease of access to surveys, determining when to ask patients to complete a survey and what to ask are key in obtaining the best results possible.
The ideal time to ask for patient feedback is the next business day following an appointment. Asking too soon does not allow patients enough time to digest what happened at their appointment, but waiting too long will likely result in lower quality feedback and less chance of a patient even completing the survey.
The structure of surveys can also impact both the number of completed surveys a practice will receive as well as the quality of the feedback. Surveys should be short and easy to complete. When emailing patients inviting them to complete the survey, include an introduction that lets patients know that you care about their opinions and concerns and want to hear what they have to say. Be sure to let patients know the survey is short with a note about the number of questions they will be asked to complete. If possible, offer a promise of anonymity, as this can often yield great results.
Survey questions should be constructed to garner feedback that allows a practice to:
• Evaluate all aspects of a patient’s visit from check in to check out.
• Determine if the practice is providing the highest value possible.
• Identify areas of possible improvements.
• Give patients a voice to express their opinions about what’s working as well as any concerns.
The single most important question to ask patients is: “Would you recommend our practice to family or friends?” The goal should be to have 100 percent of patients answer yes to this question. If patients would not recommend their physician to friends or family, their expectations are not being met. When this answer dips below 96 percent, it’s time to stop and evaluate where problems may be occurring and what steps need to be taken to make improvements in the practice. Patient recommendations are the best advertisements for a practice. For example, if a patient has a positive experience at a practice, s/he is likely to tell five people about the experience, and those five people may also share what they heard with even more people. If a patient shares his/her experience on social media, the number of people that hear about his/her positive or negative experience expands exponentially.
Unfortunately, this is also true when patients have a bad experience, and, in fact, research shows people are even more likely to share a bad experience than a good one. In a customer service survey of more than 1000 people conducted by Dimensional Research for Zendesk, 95 percent of respondents who have had a bad experience said they told someone about it, compared to 87 percent who shared a good experience. And respondents who suffered a bad interaction were 50 percent more likely to share it on social media than those who had a good experience (45 percent vs. 30 percent) and 52 percent were more likely to share the negative experience on an online review site like Yelp (35 percent vs. 23 percent).1 Assessing patients’ perceptions about their experiences with the practice and keeping the number of patients who say they would recommend the practice to friends and family high is vital to success.
Other questions to ask in patient surveys include:
• Rate each step of appointment process.
• Are you aware of our Cosmetic / Research Department?
• Have you visited us online?
• Do you currently use our patient portal?
• Do you have any additional comments and/or suggestions?
• Can we use your responses for testimonial purposes?
If patient surveys are not resulting in tangible feedback, consider changing the questions that are being asked—add new ones, take out ones that aren’t serving a purpose, etc.
Learning from Feedback
When reviewing feedback, be prepared for both good and bad reviews. Open, honest—and often anonymous—feedback offers the greatest opportunities for a practice to examine its business and where processes need to be improved. Is the practice offering the highest value to each patient possible? Are there areas for improvement? Be open to feedback—self-awareness and willingness to admit weaknesses can help a practice improve. Good reviews help identify a practice and provider’s strengths and determine the areas of patient experience that are working well. Positive feedback can also boost the morale of staff and encourage the continuation of providing the highest value possible.
Bad reviews are also valuable. Often the most can be learned from negative reviews. For example, if “long wait time” comes up on a number of negative comments, consider what kind of adjustments need to be made to scheduling. Perhaps fewer patients should be seen in a day or spaced out differently. In my practice, we noticed that wait times seemed to garner the largest number of negative reviews. As a result we improved communication with patients when issues came up to let them know how much longer they could expect to have to wait and why we were behind schedule, which has increased patient satisfaction. Other changes we’ve made based on patient feedback include changing the television channel in the waiting room and switching our waiting area furniture. These minor changes have made large strides in terms of patient satisfaction.
Share patient surveys and feedback with staff—this keeps staff engaged in the patient experience. Also, use survey results to determine where marketing efforts should be directed. For example, based on survey results, we noticed that only a small percent of our patients were aware of our clinical research department, so we added a feature on this department to our weekly newsletter and also increased our mentions of this department to our patients in-house. We have since seen a rise in the number of people aware of our research department. Ask patients when they’ve visited you online to help you focus your marketing efforts in different areas.
Share results as testimonials. The practice’s website and social media sites can be updated with testimonials from surveys. These sites should be updated every quarter with new testimonials. In my practice, we also added testimonials to our newsletter just below the “Schedule an Appointment” call to action (CTA). The CTA button has always been on our newsletter, but we never got much follow-through until we added the testimonial.
Surveys: An Essential Tool for Success
Surveys offer physicians a great opportunity to assess patient satisfaction with all aspects of the practice—from check-in to check-out. Feedback offers invaluable opportunities for improvement—good and bad reviews are important and can be used to help a practice grow and expand its brand. Survey results allow a practice to hear directly from patients about what is working and processes that need to be improved. n
Dr. Schlesinger is Director of the Dermatology & Laser Center of Charleston and the Center for Clinical Research in Charleston, SC.