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How to improve loyalty and trust through a powerful patient service-recovery system

Your competition is the last best experience your patient had—anywhere. This realization should inspire the service-recovery efforts of your organization, says program manager and 2022 NRC Health Symposium speaker Katie Lamoreux, MHA, of Sanford Health.   

As the largest rural health system in the United States, Lamoreux says, Sanford Health has found that creating a culture that supports NRC Health’s service-recovery actions has been crucial for its success.  

Service alerts use Natural Language Processing to help healthcare organizations understand customers’ dissatisfaction and work toward ensuring that they return. Service recovery is an important principle for health systems to embrace, because there is no such thing as a “perfect” system—so organizations must prepare for failure.  

Lamoreux shared research that found service recovery works best when: 

  • It is not severe 
  • It is the patient’s first-time experiencing failure 
  • It does not have to happen often 
  • The patient perceives that the organization could not have controlled the situation any better 

The service-recovery paradox1 explains that patients may become more loyal to an organization after a service failure when service recovery is conducted, compared to having an average experience with no service failures. 

Sanford Health’s Story  

“We began a pilot with NRC Health for about a year, and we had 12 clinics across our enterprise using our Real-time Feedback with that pilot,” Lamoreux explains. “At the end of the yearlong pilot, all 12 sites unanimously voted to move forward with NRC. In June of 2020, that led us to transition all our HCAHPS and real-time surveys over to NRC. So, at Sanford, we have it set up so that our directors, managers, and supervisors at the department level are receiving those service alerts.”   

The challenge? Sanford Health wanted to strategically leverage service alerts but did not know how to get leaders on board, as it wasn’t something they had been expected to do in the past.   

Sanford Health opted for a decentralized approach to follow up on service alerts, in order to accommodate:  

  • Patient experience team capacity 
    • Eight team members for 47 hospitals and more than 300 clinics 
  • Access for leaders to ERM and relationships with providers
  • An emphasis on timing 
    • The patient-experience team did not want to be a barrier for timely follow-up 
  • Better visibility for department leadership 

“We needed to build it into our everyday work, our culture, and to utilize these and make this a best practice for us,” Lamoreux says. “We opted for a decentralized approach as a system because we knew that our team of eight could not handle all the service alerts coming in. We also knew that we needed to work on setting a foundation, because there were no prior expectations to follow up on this with our previous vendor. So we needed to coach our leaders through this change. We needed to teach them how, and what were the expectations, to move forward with this.”  

The group focused on the Prosci ADKAR Model of change management to help leaders adopt this change of using service alerts and conducting service recovery:  

  • Awareness (presentations on why vendor changes were needed)  
  • Desire (start with the “why”—sharing personal stories, making the connections)  
  • Knowledge (webinars and presentations on how service recovery works, setting expectations)  
  • Ability (understanding the importance of acknowledging, apologizing, and addressing the issue)  
  • Reinforcement (evaluating the quality-of-service recovery, and assessing ROI)  

In Lamoreux’s presentation, she shared a study with a cohort of 22 leaders who oversaw 56 departments. Executive directors conducted five service-alert audits per month to determine if the workflow was appropriately followed.  

The key finding from this study showed that leader sponsorship matters. It is critical to have executive leaders buy into the idea that service recovery is a strategic tactic for your healthcare organization to retain and gain new patients and increase your net promoter score.

Organizational Assessment Before You Begin    


  • What level of comfort do leaders have today in conducting service recovery? Do they know the fundamentals of crucial conversations?   
  • What change-management model do you want to follow?   
  • Does your executive leadership understand the “why,” and are they willing to support it?  


  • What are the different avenues patients are using to provide feedback (e.g., digital, surveys, phone)?  
  • Are there other support teams that should inform your process (e.g., risk, patient relations)?  
  • What time frame is expected for a follow-up? How is that reinforced?  

Key Takeaways  

  • Service recovery can improve your patient’s trust in your organization, ultimately impacting their loyalty and intent to return   
  • Service recovery is heavily influenced by the culture and mission of your organization   
  • Expectations for service recovery should be clear and easy to complete  
  • Leader sponsorship will make or break your service-recovery efforts—remember to put your mission over metrics  


Save the date for NRC Health’s 29th Annual Symposium in Boston! Get Symposium updates here. 


1Magnini, V.P. et al. (2007) The service recovery paradox: Justifiable theory or smoldering myth?, Journal of Services Marketing. Emerald Group Publishing Limited. Available at: