The University of Arkansas for Medical Sciences (UAMS) recently used an NRC Health patient panel to discover what influence a front-desk staff member has on a patient’s experience.

NRC Health offers health systems a way to maximize the lifetime value of their customers using a survey to target their community to monitor changing perceptions over time. Insights from 2,069 respondents gave UAMS some detailed insights that other health systems can draw from, including these highlights:

• Respondents feel that voice tone (88%), making eye contact (82%), and facial expressions (64%) best demonstrate that front-desk staff are courteous and kind, despite the fact that they’re wearing masks.
• Respondents find it very or extremely important that front-desk staff say, “Hello” (84%) or ask, “Do you have any questions?” (76%) when greeting them upon their arrival at the healthcare facility.
• Nearly half of respondents would most prefer to hear, “Good afternoon—come on up, and we’ll get you checked in for your appointment” from the front-desk staff as a welcoming statement.
• Just over three-fourths of respondents can tell the difference between front-desk staff and screeners when they arrive at the clinic.

UAMS found that this was a struggle for every service line and it needed to be addressed.

When detecting low scores on front-desk staff who they knew to be kind, it became apparent there was work to do.

Opening Eyes to Real and Perceived Issues

UAMS’ NRC Health survey data showed low scores to the question, ‘Was the front desk courteous and helpful?’ But there wasn’t a prompt in the survey comments for patients to tell them what that meant. The staff was being perceived as rude yet the comments weren’t telling them anything.

After some “mystery shopping” undercover work to try to gain an understanding of what UAMS patients were experiencing, the UAMS Patient Experience team knew they needed to write a survey to elicit what concrete behaviors, both positive and negative, would give them specific empirical data on what the patients were experiencing in order to improve in this area.

Having heard from more than 2,000 patients, the team gained tremendous insights from this particular survey. It was across all boards and there was no denying the low scores.  The patients were now able to tell UAMS what happened that made their experience a negative one.

Changing Gears on Survey Questioning

With a survey, if a patient has a bad experience at any point in the clinic, it can affect a lot of scores in a lot of areas. Looking at the NRC Health survey, 94% of UAMS’ patients were either very satisfied or somewhat satisfied. While that gave the team a little bit of relief, it also urged them to dive down into more data. For instance, what occurred that made them unhappy at that time? They were able to go through the debriefing, look at the feedback, and quickly realize that nearly every concern could be corrected with targeted education.

UAMS is paying close attention to its frontline staff as they greet and acknowledge patients. Now that everyone is behind a mask, eye contact and smiling with your eyes becomes more important. Patients can still tell if staff members are paying attention to them, engaged and if they have a pleasant tone. All of these measures are important feedback gained in the survey.

COVID-19 safety precautions also had an impact on performance. Effective communication becomes harder behind Plexiglas while also wearing a mask and being a safe distance from the patient. Raising one’s voice in order to be heard from behind a mask could easily be misinterpreted as being rude.

A key component to a successful survey is the collaboration between NRC and its clients. In this case, NRC listened to UAMS’ needs and goals, and developed and modified questions accordingly. The survey results provided UAMS with a roadmap of how to adjust its training program from a non-verbal communication focus to paying closer attention to “how” staff communicate. The survey allowed UAMS to pinpoint the exact behavior patients found to be the most important.

Monitoring and Measuring Progress

UAMS’ project started on a grassroots level with just a few interested staff members, but as word traveled, other service lines wanted their staff to participate. This led to a full process improvement project where front desk staff participate in a three-course video series. The videos explain the importance of patient experience to their role and provides lessons on basic communications skills including speaking behind a mask and service recovery.  Videos were chosen as the training tool as a way to continually train new staff since these positions experience a high turnover rate.

UAMS plans to do another community survey to the same respondents to determine if they have noticed an improvement. The results will give UAMS the information needed to decide if the training is working or not.

Although the UAMS Patient Experience team monitors NRC Health patient feedback and scores every month, this project provides a new resource to understand patient perceptions and experiences.

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