Quality Progress - May 2017 - 19

flow, implementing service performance standards
and ensuring that staff performs to standards-
directly affect patient satisfaction. The gaps model
was adapted for operations managers by restating
the four organizational service gaps as questions that
influence the total patient experience:
+ Gap one-Do we understand patient expectations
of MCA? If not, why? What is the effect on clinical
operations and the patient experience?
+ Gap two-Do we design processes and develop
service standards to meet patients' expectations
of MCA? If not, why? What is the effect on clinical
operations and the patient experience?
+ Gap three-Do we hire, educate and train the
right people to deliver service that meets MCA
patient-defined standards? If not, why? What is
the effect on clinical operations and the patient
experience?
+ Gap four-Do marketing communications appropriately set patient expectations for MCA's service
delivery? If not, why? What is the impact on clinical
operations and the patient experience?
+ Gap five (the "patient experience" gap)-Do
we consistently provide a healthcare
experience that meets MCA's patient
expectations? If not, why? What is the
effect on the patient's perception of the
organization?

Gaps one and four are related to marketing
research, and advertising and communications,
respectively. Gap two (process design and service
standards development) and Gap three (hiring service-minded people and ensuring service is delivered
as designed) are more closely aligned with operations
management.
By categorizing service deficiencies as either
related to external marketing or internal operations,
we preserve the model's original intent: to distinguish
between factors inside and outside the organization.
Figure 1 illustrates the gaps model, adapted for
healthcare service consultation to help managers
see the four organizational gaps as potential service
deficiencies in their departments. It also shows them
how these deficiencies can contribute to a patient
experience that falls short of patient expectations.

Satisfaction and the patient
experience gap

MCA uses a national vendor to conduct ongoing surveys of patient satisfaction. Patients are asked to rate
service quality related to physicians and mid-level
providers (physician assistants and nurse practitioners), allied health staff (nurses, technicians and
nonclinical staff ), the facility, overall quality and the
likelihood of recommending MCA to others on a fivepoint scale (excellent, very good, good, fair or poor).

Hiring service-minded people and providing ongoing
education and training to ensure service is delivered
as intended is a method for closing gap three, the
service-delivery gap.
MCA's operations managers monitor patient
satisfaction and manage to the best-possible score
(excellent) on the survey rating scale. In Figure 1, the
customer gap (the middle circle) was restated as
the difference between the 90th percentile patient
satisfaction target, which reflects leadership's understanding of patients' expectations that MCA will be
among the best, and patient satisfaction ratings of
the service experience.
If a department's patient satisfaction scores are
below target, categorizing the service deficiencies
by gap-such as people, process or marketing
(Figure 1's four corners)-can help manager and staff
identify the likely causes of patient dissatisfaction.
Feedback on the clarity and simplicity of this tool
was positive.

qualityprogress.com ❘ May 2017

QP 19


http://www.qualityprogress.com

Table of Contents for the Digital Edition of Quality Progress - May 2017

Seen and Heard
Expert Answers
Progress Report
Mr. Pareto Head
Field Notes
Mind the Gaps
Solid Footing
Are These the Same?
New Tricks for an Old Tool
Innovation Imperative
Experience More
Career Coach
Statistics Spotlight
Standard Issues
Marketplace
Footnotes
Back to Basics
Quality Progress - May 2017 - intro
Quality Progress - May 2017 - cover1
Quality Progress - May 2017 - cover2
Quality Progress - May 2017 - 1
Quality Progress - May 2017 - 2
Quality Progress - May 2017 - 3
Quality Progress - May 2017 - 4
Quality Progress - May 2017 - 5
Quality Progress - May 2017 - Seen and Heard
Quality Progress - May 2017 - Expert Answers
Quality Progress - May 2017 - Progress Report
Quality Progress - May 2017 - Mr. Pareto Head
Quality Progress - May 2017 - 10
Quality Progress - May 2017 - 11
Quality Progress - May 2017 - Field Notes
Quality Progress - May 2017 - 13
Quality Progress - May 2017 - 14
Quality Progress - May 2017 - 15
Quality Progress - May 2017 - Mind the Gaps
Quality Progress - May 2017 - 17
Quality Progress - May 2017 - 18
Quality Progress - May 2017 - 19
Quality Progress - May 2017 - 20
Quality Progress - May 2017 - 21
Quality Progress - May 2017 - 22
Quality Progress - May 2017 - 23
Quality Progress - May 2017 - Solid Footing
Quality Progress - May 2017 - 25
Quality Progress - May 2017 - 26
Quality Progress - May 2017 - 27
Quality Progress - May 2017 - 28
Quality Progress - May 2017 - 29
Quality Progress - May 2017 - Are These the Same?
Quality Progress - May 2017 - 31
Quality Progress - May 2017 - 32
Quality Progress - May 2017 - 33
Quality Progress - May 2017 - 34
Quality Progress - May 2017 - 35
Quality Progress - May 2017 - New Tricks for an Old Tool
Quality Progress - May 2017 - 37
Quality Progress - May 2017 - 38
Quality Progress - May 2017 - 39
Quality Progress - May 2017 - 40
Quality Progress - May 2017 - 41
Quality Progress - May 2017 - 42
Quality Progress - May 2017 - 43
Quality Progress - May 2017 - Innovation Imperative
Quality Progress - May 2017 - 45
Quality Progress - May 2017 - 46
Quality Progress - May 2017 - Career Coach
Quality Progress - May 2017 - 48
Quality Progress - May 2017 - 49
Quality Progress - May 2017 - Statistics Spotlight
Quality Progress - May 2017 - 51
Quality Progress - May 2017 - 52
Quality Progress - May 2017 - 53
Quality Progress - May 2017 - Standard Issues
Quality Progress - May 2017 - 55
Quality Progress - May 2017 - 56
Quality Progress - May 2017 - 57
Quality Progress - May 2017 - Marketplace
Quality Progress - May 2017 - 59
Quality Progress - May 2017 - Footnotes
Quality Progress - May 2017 - 61
Quality Progress - May 2017 - 62
Quality Progress - May 2017 - 63
Quality Progress - May 2017 - Back to Basics
Quality Progress - May 2017 - cover3
Quality Progress - May 2017 - cover4
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