Quality Progress - May 2017 - 21

Closing gap one

expectations and are under the service marketer's
control, and people and process capabilities, which
are under the operations manager's control-the two
functional areas should work together.
MCA's marketing director regularly attends
meetings of clinical operations leaders to better
understand frontline physician and staff challenges
and ensure accurate advertising messages.
An experience that falls short of expectations is
a function of service gaps in an organization. When
an organization closes the four preceding gaps, the
result is closure of gap five (the customer gap), a better experience and improved overall satisfaction.

Closing gap two

Service consultation in MCA's internal medicine
department began with reviewing complaint, patient
satisfaction and telephone data with physicians and
allied health staff. The gaps model was used to focus
the discussion on service-quality deficiencies that
likely contributed to patient dissatisfaction.
The staff identified these causes:
+ Gap one-Patients expect the best at Mayo Clinic.
They expect appointments to be available when
needed, physicians to be unhurried, a thorough
medical examination to be conducted and test
results to be promptly reported.
+ Gap two-Processes for scheduling and canceling
appointments and for reporting test results were
not designed with patient expectations in mind.
+ Gap three-Patient satisfaction ratings and
verbatim comments indicated variable service
performance, specifically related to physicians'
courtesy and caring and front-desk staff friendliness. Service performance standards for the
frontline staff had not been established.
+ Gap four-A facilitated discussion of messages
in MCA's advertisements and other promotional
materials helped staff understand how marketing
activities were likely to influence the patient expectations, noted in gap one.

MCA's ongoing market research has consistently
shown that patients have extraordinarily high
expectations of the Mayo brand. MCA's operations
managers understand patient expectations and try to
manage them proactively, beginning with scheduling
of the first appointment.
Staff ask questions up front to truly understand
a patient's needs and expectations. Education is
provided to patients when it is necessary to reset
unrealistic expectations and close this gap. At MCA,
patient dissatisfaction is often related to processes
and standards that do not meet patient expectations,
which is the focus of gap two.

Even healthcare organizations that conduct regular
market research to understand patients' expectations
of their brands do not consistently design processes
and set service standards to meet them. MCA's marketing director presents quarterly brand-monitor survey
results at meetings of executive and clinical leaders to
help them understand evolving patient expectations.
MCA's operations managers and business process
analysts receive lean Six Sigma training and incorporate the voice of the customer into process design
and improvement.14 They also incorporate the voice of
the frontline staff-employees with rich insights into
patient expectations, process bottlenecks and workarounds-and likely causes of patient dissatisfaction.

Closing gap three

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
are involved in the hiring process, from reviewing the
candidate pool to selecting the final candidate.
Multidisciplinary interview panels use behavioral
interviewing techniques to select candidates most
likely to fit in MCA's service culture. The service lead
works with staff to develop role-specific service performance standards, which help a manager communicate
service-delivery expectations and evaluate the staff's
service performance against consistent criteria.

Closing gaps four and five

Another key gap researchers identified was that service marketers do not always understand the frontline
challenges to delivering quality service. To prevent
discrepancies between external advertising and
communication promises-which help shape patient

Improving service in internal medicine

Results

Targeted interventions to close the gaps and improve
service quality included:
+ Discussing patient satisfaction ratings, patient
comments, and opportunities for improvement at
monthly department meetings.
+ Providing service-quality education to staff.
+ Partnering with staff to develop job-specific service
performance standards aligned with MCA's service
values-solutions focused, empathetic, reliable,

qualityprogress.com ❘ May 2017

QP 21


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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