Radiologists are increasingly recognizing their role as direct service providers to patients and seeking to offer an exceptional patient experience as part of high-quality service delivery. Patients’ perceptions of service delivery are derived from the chain of numerous individual real-time encounters that occur throughout their visit. These so-called “moments of truth” define the overall experience and form the lasting impression of the given practice in their mind. Providing excellent service can be difficult to achieve in practice given its intangible nature as well as the heterogeneity and unpredictability of the large number of patients, frontline staff, and environmental circumstances that define the patient experience. Thus, broad commitment and team effort among all members of a radiology practice are required. This article explores important areas to be considered by a radiology practice to ensure positive and meaningful patient experiences. Specific ways in which every member within the practice, including schedulers, receptionists, technologists, nurses, and radiologists, can contribute to achieving high-quality patient service are discussed. Examples of patient-oriented language that may be useful in particular scenarios in radiology practice are given. The role of the practice’s physical facility, including all aspects of its aesthetics and amenities, as well as of Internet services, in shaping the patient experience is also described. Throughout this work, a proactive approach to promoting a service-oriented organizational culture is provided. By improving the patient experience, these strategies may serve to enhance patients’ perceptions of radiology and radiologists.
The Service Encounter
Radiologists are increasingly recognizing their role as more than a consultation service or the “doctor’s doctor,” but rather as direct service providers to patients. As such, radiologists strive not only to achieve technical excellence in imaging interpretation but also to provide an exceptional patient experience. Achieving excellence in service delivery is a critical determinant of patient satisfaction , potentially comprising its primary basis. In addition, patient satisfaction is increasingly being tracked by external stakeholders and impacting levels of reimbursement . Some studies have even shown significant associations between patient satisfaction and adherence to recommendations and clinical outcomes . To this end, a central component of the success, growth, and survival of a radiology practice can be the extent to which its members embrace and excel in quality service delivery.
In the business world, it is recognized that customer perceptions of service quality are largely derived from the chain of numerous individual encounters that occur throughout their experience . These so-called “moments of truth” define the overall experience and form the lasting impression of the organization in the customer’s mind . In radiology, a patient typically interacts with numerous individuals, including a scheduler, receptionist, technologist, nurse, and radiologist. Although each of these interactions is an opportunity to enhance the patient’s experience and prove that the organization can deliver on its promise of excellent service, any single negative encounter has the potential to undermine the combined impact of otherwise positive encounters, leaving an overall negative impression . As it is these real-time human interactions that are most meaningful in the patient’s mind , it is important for a radiology practice to recognize and optimize all potential encounters to enrich patients’ perceptions of service quality.
Providing excellent service may seem like common sense but is in fact difficult to consistently achieve in practice. Unlike a physical product for which production can be centralized and automated, services are inherently intangible and created in the moment through the provider-patient interaction . These moments not only involve a variety of patients in unique scenarios but also a large number of staff with different backgrounds, training, personalities, and motivation, as well as their own personal issues that may influence their work . Such heterogeneity leads to unpredictability and enormous complexity in trying to standardize service quality. This challenge is compounded by the extremely high expectations that patients maintain for health care services, as well as uncertain budgets and limited resources that many practices have available to dedicate to service quality .
In view of these challenges, achieving excellence in service quality requires broad commitment and team effort among all members within a radiology practice. The remainder of this article will explore important areas to be considered by every practice to ensure positive and meaningful patient experiences. Although many of these concepts apply to service industries in general, specific examples of how radiologists may apply the principles in their own practice are provided.
How providers in different roles contribute to positive service encounters
Research has identified a number of dimensions that define perceptions of service quality, which Alderson and Hoe each related to radiology practice . These dimensions include reliability (consistently performing appropriately examinations correctly and providing an accurate interpretation), responsiveness (minimizing wait times for appointments, examination starts, and interpretations), assurance (instilling confidence that patients are receiving the best of care and that the practice is knowledgeable and capable of handling their concerns), and empathy (treating patients compassionately as individuals) . This section describes specific ways in which every member within a radiology practice can strive to attain these attributes and contribute to the overall patient experience.
Schedulers
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Receptionists and Other Front-Office Staff
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Technologists and Nurses
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Radiologists
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Four themes underlying positive service encounters
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Recovery
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Adaptability
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Spontaneity
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Coping
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Additional considerations relating to service encounters
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The “Servicescape”
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Use of the Internet
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Listening to Patients
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“Delighting” the Patient
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Conclusions
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References
1. Ng D., Vail G., Thomas S., et. al.: Applying the Lean principles of the Toyota Production System to reduce wait times in the emergency department. Cjem 2010; 12: pp. 50-57.
2. Billing K., Newland H., Selva D.: Improving patient satisfaction through information provision. Clinical & experimental ophthalmology 2007; 35: pp. 439-447.
3. Halac M., Aliyev A., Yilmaz S., et. al.: Delayed imaging of the pelvis with diluted and filled bladder: a simple and efficient method in FDG PET/CT imaging of bladder carcinoma. Clinical nuclear medicine 2012; 37: pp. 778-780.
4. Locke R., Stefano M., Koster A., et. al.: Optimizing patient/caregiver satisfaction through quality of communication in the pediatric emergency department. Pediatric emergency care 2011; 27: pp. 1016-1021.
5. Boss E.F., Thompson R.E.: Patient satisfaction in otolaryngology: can academic institutions compete?. The Laryngoscope 2012; 122: pp. 1000-1009.
6. Shirley E.D., Sanders J.O.: Patient satisfaction: implications and predictors of success. The Journal of bone and joint surgery American volume 2013; 95: pp. e69.
7. Hospital value-based purchasing: biggest bonuses and penalties. CMS percentage change in reimbursement based on process performance and patient satisfaction. Modern healthcare 2013; 43: pp. 34.
8. Dyck B.A., Zywiel M.G., Mahomed A., et. al.: Associations between patient expectations of joint arthroplasty surgery and pre- and post-operative clinical status. Expert review of medical devices 2014; 11: pp. 403-415.
9. Borders T.F., Warner R.D., Sutkin G.: Satisfaction with health care and cancer screening practices among women in a largely rural region of West Texas. Preventive medicine 2003; 36: pp. 652-658.
10. Narayan K.M., Gregg E.W., Fagot-Campagna A., et. al.: Relationship between quality of diabetes care and patient satisfaction. Journal of the National Medical Association 2003; 95: pp. 64-70.
11. Steven I.D., Thomas S.A., Eckerman E., et. al.: The provision of preventive care by general practitioners measured by patient completed questionnaires. Journal of quality in clinical practice 1999; 19: pp. 195-201.
12. Weingarten S.R., Stone E., Green A., et. al.: A study of patient satisfaction and adherence to preventive care practice guidelines. The American journal of medicine 1995; 99: pp. 590-596.
13. Verhoef P.C., AG , de Hoog A.N.: Service processes as a sequence of events [Internet].2002 Nov.Erasmus Research Institute of Management (ERIM) Report No.: ERS-2002-105-MKT. Available from http://hdl.handle.net/1765/256
14. Zeithaml V., Bitner M., Gremler D.: Services marketing: integrating customer focus across the firm.ed2013.McGraw-Hill
15. Carlzon J.: Moments of truth: HarperBusiness.1989.
16. Dzama T.: Service encounters in the fast food industry-case of Midlands Province. International Journal Of Marketing, Financial Services & Management Research 2013; 2: pp. 171-192.
17. Flipo J.: On the intangibility of services. The Service Industries Journal 1988; 8: pp. 286-293.
18. Kelley S., Donnelly J., Skinner S.: Customer participation in service production and delivery. Journal of Retailing 1990; 66: pp. 315-335.
19. Moeller S.: Characteristics of services—a new approach uncovers their value. Journal of Services Marketing 2010; 24: pp. 359-368.
20. Brady D.: Why service stinks.2000 October 20.BusinessWeekpp. 118-128.
21. Alderson P.O.: Customer service and satisfaction in radiology. AJR American journal of roentgenology 2000; 175: pp. 319-323.
22. Hoe J.W.: Service delivery and service quality in radiology. Journal of the American College of Radiology : JACR 2007; 4: pp. 643-651.
23. Parasuraman Z., Zeithaml V., Berry L.: SERVQUAL: a multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing 1988; 64: pp. 12-37.
24. How Marriott makes a great first impression. The Service Edge 1993; 6:5
25. Betterncourt L., Gwinner K.: Customer orientation: effects on customer service perceptions and outcome behaviors. Journal of Service Research 2001; 3: pp. 241-251.
26. Hogan J., Hogan R., Busch C.: How to measure service orientation. Journal of Applied Psychology 1984; 69: pp. 167-173.
27. Brown T., Mowen J., Donavan T., et. al.: The customer orientation of service workers: personality trait effects on self- and supervisor performance ratings. Journal of Marketing Research 2002; 39: pp. 110-119.
28. Gremler D., Gwinner K.: Rapport-building behaviors used by retail employees. Journal of Retailing 2008; 84: pp. 308-324.
29. Salopek J.: Improvisation: not just funny business. Training and Development 2004; 58: pp. 116-118.
30. Reiner B.I., Knight N., Siegel E.L.: Radiology reporting, past, present, and future: the radiologist’s perspective. Journal of the American College of Radiology : JACR 2007; 4: pp. 313-319.
31. Bruno M.A., Petscavage-Thomas J.M., Mohr M.J., et. al.: The “Open Letter”: radiologists’ reports in the era of patient web portals. Journal of the American College of Radiology : JACR 2014;
32. Lavery H.J., Droller M.J.: Do Gleason patterns 3 and 4 prostate cancer represent separate disease states?. J Urol 2012; 188: pp. 1667-1675.
33. Rosenkrantz A.B., Mason D., Kunzler N.M., et. al.: The radiologist as direct public educator: impact of sessions demystifying select cancer screening examinations. Journal of the American College of Radiology: JACR 2014; 10: pp. 979-983.
34. Bitner M., Booms B., Mohr L.: Critical service encounters: the employee’s viewpoint. Journal of Marketing 1994; 58: pp. 95-106.
35. Akhtar A., Sadrul Huda S., Dilshad S.: Critical service encounters: employee’s viewpoint a study on transport services in Dhaka city. Current Research Journal of Social Sciences 2009; 1: pp. 16-22.
36. Sherry J.: Servicescapes: the concept of place in contemporary markets.1998.NTC Business Books
37. Bitner M.: Servicescapes: the impact of physical surroundings on customers and employees. Journal of Marketing 1992; 56: pp. 57-71.
38. Bitner M.: Evaluating service encounters: the effects of physical surroundings and employee responses. Journal of Marketing 1990; 54: pp. 69-82.
39. Bruggen E., Foubert B., Gremler D.: Extreme makeover: short- and long- term effects of a remodeled servicescape. Journal of Marketing 2011; 75: pp. 71-87.
40. Herrington J., Capella L.: Practical Applications of Music in Service Settings. Journal of Services Marketing 1994; 8: pp. 50-65.
41. Spangenberg E., Crowley A., Henderson P.: Improving the store environment: do olfactory cues affect evaluations and behaviors?. Journal of Marketing 1996; 60: pp. 67-80.
42. Massad N., Heckman R., Crowston K.: Customer satisfaction with electronic service encounters. International Journal of Electronic Commerce 2006; 10: pp. 73-104.
43. Zeithaml V., Parasuraman A., Malhotra A.: Service quality delivery through web sites: a critical review of extant knowledge. Journal of the Academy of Marketing Science 2002; 30: pp. 362-375.
44. Holloway B., Beatty S.: Satisfiers and dissatisfiers in the online environment. Journal of Service Research 2008; 10: pp. 347-364.
45. Downey K., Riches S.F., Morgan V.A., et. al.: Relationship between imaging biomarkers of stage I cervical cancer and poor-prognosis histologic features: quantitative histogram analysis of diffusion-weighted MR images. AJR Am J Roentgenol 2013; 200: pp. 314-320.
46. Sharma S., Kilian R., Leung F.H.: Health 2.0-lessons learned: social networking with patients for health promotion. Journal of primary care & community health 2014; 5: pp. 208-210.
47. Goldstein K., Briggs M., Oleynik V., et. al.: Using digital media to promote kidney disease education. Advances in chronic kidney disease 2013; 20: pp. 364-369.
48. Dizon D.S., Graham D., Thompson M.A., et. al.: Practical guidance: the use of social media in oncology practice. Journal of oncology practice/American Society of Clinical Oncology 2012; 8: pp. e114-e124.
49. Zeithaml V., Parasuraman A., Berry L.: Delivering quality service: balancing customer perceptions and expectations.1990.Free Press
50. Lexa F.J.: 300,000,000 customers: patient perspectives on service and quality. Journal of the American College of Radiology : JACR 2006; 3: pp. 346-350.
51. Gross T.: Positively outrageous service: Business Plus.1994.
52. Rust R., Oliver R.: Should we delight the customer?. Journal of the Academy of Marketing Science 2000; 28: pp. 86-94.
53. Menezes M., Serbin J.: Xerox Corporation: The Customer Satisfaction Program, case no. 591-055.1991.Harvard Business School