The Hospital for Joint Diseases (HJD) is one of the major hospitals in New York City addressing orthopedic issues. With a staff of nearly 1,500 health care and other professionals, HJD operates in the highly competitive New York health care arena. One of the arenas in which health care has become especially competitive is in customer service. Not only is this about increasing market share, but the nation’s health care agency changed its reimbursement policy so that hospitals that have lower patient satisfaction ratings get reduced reimbursements on Medicare patients. So the urgency to increase customer care is of major strategic importance.

In order to enhance its customer service reputation and patient satisfaction ratings, the CEO and Chief Medical Officer (CMO) decided to conduct a major customer service initiative and engaged me as the primary consultant to guide this effort. The effort involved several stages:

1. Initial visioning retreat: At an initial half-day session, I led the top 50 leaders and people of influence in HJD through a day-long session to clarify the impetus and urgency behind the initiative and to establish a vision for what HJD customer service would become. We also clarified the strategy that we would use to transform the culture to raise the customer service ratings.

2. Design Advisory Team: In recognition of the critical need for ongoing leadership, I led HJD in establishing a team of credible and committed leaders called the Design Advisory Team (DAT); I met with this team regularly to plan each of the various stages of the intervention, assess and progress, and implement outcomes.

3. Systemic improvements: We then created a number of groups, each led by a manager and including a range of employees, to review each element of the hospital (such as operating rooms, patient floors, cafeteria, etc.) and identify improvements in the physical plant, systems, procedures, and policies to make them more patient friendly; I trained the leaders of these groups in how to be effective facilitators and then guided the groups over a period of several months as they prepared their recommendations, and then worked with the DAT to finalize the recommendations for implementation.

4. Staff training: Once there was a vision in place and the systemic improvements had been identified it was now time to equip all staff with the skills they needed to act as customer service exemplars. Therefore, I designed a comprehensive curriculum of customer service training that encompassed basic principles, skills for interacting with customers, teamwork skills, and self-care skills*. I arranged for this program to be delivered to every single one of HJD’s 1,500 physicians, nurses, other healthcare team members, and administrators. The evaluations of the training were outstanding.

The program became institutionalized, so as new employees came into HJD they received the training soon after their employment began. And patient satisfaction ratings—crucial for raising Medicare reimbursement ratings—showed a significant increase as the program took hold.

This is perhaps the most comprehensive customer service curriculum created for health care. The program was based on a similar program I created for Westchester Hospital, which contributed to their achieving 99th percentile customer service status.

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