The fertile ground for ideas
How organizational health forms the fertile ground for tangible improvement in satisfaction scores
Step 1. Make improvement a cyclical process
It is well-known that satisfaction surveys have now acquired a fundamental role in healthcare. However, it is not always self-evident that the scope of this role grows in tandem. Whereas in the past, assessment mainly served as accountability to stakeholders or was simply an obligation, there is now a shift from assessment as a goal to assessment as a means. Although understandable, the once common perspective of “measurement equals knowledge” is no longer sufficient. From the perspective of Deming’s PDCA (Plan Do Check Act) improvement cycle, organizations with a “measurement equals knowledge” policy remain stuck at the first two steps. Only 10% of healthcare organizations complete the entire PDCA cycle.
With a relatively high score on execution (do) compared to other sectors, the need to go through a complete improvement cycle is not immediately clear. With a focus on execution, there may be a lot happening, but without insight, there is no direction, and the improvement process remains reactive. The problem should not be sought in a specific step but in the importance of a robust improvement cycle where each step plays a role. To make satisfaction a core process with cyclical improvement, proactive action is essential. This provides space, direction, and peace of mind. Therefore, ensure that no step is overlooked, and a rhythm of improvement is established. This methodically builds resistance against acting out of necessity—the first step towards a thriving organization!
Step 2. Lead according to the “First Things First” principle
In the book “The 7 Habits of Highly Effective People,” Stephen R. Covey writes, “The key is not to prioritize what’s on your schedule, but to schedule your priorities.” Within this lies the core message of “First Things First,” an essential element of effective leadership. For forming an improvement plan, proactively determining priorities is not only crucial but also the first step.
For example, what is the first step in starting a satisfaction survey? Don’t start by sending a questionnaire to the entire patient population, but rather let the desired number of realized improvements guide you. From this starting point, a simple calculation emerges. By examining previously measured results, you can identify improvement ratios: X realized improvements require Y identified improvement opportunities, for which Z patient responses are needed. For instance, with ratios of 10%, you would need 20 improvement opportunities and 200 patient responses for 2 realized improvements. Once this is clear, you complete the improvement cycle by determining a realistic time frame.
An important reason why organizations get stuck on the notion that measuring equals knowing can be captured in an apparent truism; when everything has priority, nothing has priority. Trying to improve on too many fronts at once is a pitfall in which focused improvement gets lost under piles of improvement points. By first mapping out priorities, you prevent satisfaction surveys from becoming too overwhelming. Within a short improvement cycle, focus on one or a few improvement themes. This way, you don’t lose sight of the main objective. In fact, when working proactively on satisfaction scores, room is created for consistent long-term planning.
With the realization that “Nothing is particularly hard if you divide it into small jobs,” Henry Ford built an empire. So, it’s as true as can be. Choose to improve with clear customer or employee themes as a guiding thread. Manageable responsibility within improvement teams leads to targeted improvement. And equally important, tangible improvement among employees. In short, by transitioning to leadership with control, the “first things first” principle is also the second step towards a thriving organization.
Step 3. Connect grounded KPIs to the improvement cycle
A solid KPI (Key Performance Indicator) structure provides reliable insight into the long-term goals and achieved improvements across all core processes of an organization. Reports on core processes such as finance are periodically provided on a weekly, monthly, and yearly basis. Purely numerical core processes are inherently measurable, making them excellent candidates for effective KPIs. A KPI pitfall arises when core processes have a higher purpose than just numbers. When the satisfaction score becomes the sole KPI target, the main objective is lost sight of.
First and foremost, this encourages score manipulation. The negative effects of this are evident, as the score loses its value as an indicator of growth. Furthermore, this KPI only provides a snapshot and may not be equally relevant to everyone. While an operational manager prefers tangible improvements, the satisfaction score is crucial for the management. It is important that both the management and the board understand the purpose behind KPIs. Of course, a growth trend can be observed in snapshots, but the why is missing.
Measuring the growth trend is key in this process. The growth trend is directly dependent on the improvement ratios within an improvement cycle; more conversion between input, identification, and realized improvements leads to more improvements per cycle. Therefore, connect KPIs to the ratios of the improvement themes. This way, it becomes clear how different teams are performing for each theme, and management can be guided based on grounded indicators. More results after each completed cycle!
Step 4. Working towards higher scores is one thing, but also put your scores to work
What do improvement teams see from satisfaction surveys? The crucial question of the check phase in the PDCA improvement cycle. It’s a step where opportunities can easily be overlooked. In addition to providing crucial input, satisfaction surveys also offer an opportunity to create engagement, the ingredient for experience and decisiveness. Cyclical improvement implies that striving for perfection, the point on the horizon, is not a finish line but an ongoing pursuit. It also means that progress can only be valued when it is clear how far it brings us towards the point on the horizon. Providing feedback on results and priorities is therefore crucial, but this alone does not create the desired experience.
To reap the benefits of satisfaction surveys, effective communication is essential. When teams have different improvement themes, not all information is relevant. Therefore, provide relevant feedback for each theme. Additionally, themes that score well should not be seen as low-priority items to check off, but rather as insights into the progress already achieved. Thus, give scores context by showing where your organization stands. Communicating with numbers is certainly possible, but remember that results supported by a brief patient or employee story, for example, will resonate more with employees.
Last but not least, create space to celebrate successes. With all the ingredients for organizational health in place, successes will quickly follow. Is the newsletter not yet full, or could the website use some fresh content? Great! This is the perfect opportunity to let employees share their successes. When progress is felt, scores will continuously contribute to the determination of employees. And the higher the determination, the more improvement will be achieved.
In conclusion, a very brief summary.
Genuine insight, clear direction, and real experience are the key to tangible improvement in satisfaction scores!
