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Surveying patients & staff for strategic planning

By Rebecca Anwar, Ph.D.

Physicians concerned about their future and the turmoil of the managed care movement want to take concrete steps to strengthen their position. They recognize the importance of developing a sound strategic plan as a pro-active strategy to control their destiny. Unfortunately, one of the most important steps to determining your position and identifying your strengths and weaknesses is overlooked. It is asking your patients and staff what they think! These are the people who know you and your practice better than anyone else.

Before embarking on the long, somewhat tedious and costly road of developing a written strategic plan, find out what your patients and your staff think of both the practice and you. This will provide important information about changes that can be made before a formal strategic plan is considered. For example, you may discover that the biggest gripe is uncomfortable seating in the reception room or that the thermostat is set too low for comfort and your patients are cold, especially when undressed for an exam.

Staff may reveal that it’s hard for them to smile and be friendly to the patients each day, when you walk in the back door without greeting them and grumble about how bad things are with managed care. These are the types of issues that can be identified and resolved before going on to bigger strategic issues.

So where do you begin the challenge of getting an “honest” opinion from the staff and the patients? Develop and conduct a combination of well planned interviews and surveys.

Detailed information about patient perceptions can be gained through patient interviews when handled appropriately. To begin with, identify which patients should be targeted and what are the objectives of the survey. A random survey will provide opinions on a cross-section of the patients. On the other hand, targeting all new patients within the last 12 months will help identify how patients are entering the practice and determine whether or not their needs are being met. If one of the objectives of the survey is to collect information directly related to the patient encounter, it is advantageous to conduct the interview within three days following a patient visit.

Once it is determined who will be interviewed and why, a survey instrument must be developed. Develop a script and a list of key questions to be asked. The interviewer will then have the tools to gather consistent information from each patient. To solicit detailed responses, questions should be open ended. This form of qualitative survey enables you to gather greater detail than is possible in a written survey.

A written survey, which is quantitative, is generally used to reach more people with less cost and energy spent for each response. It is recommended that the written survey include a stamped response envelope and be mailed to a third party or a post office box. Patients tend to be more direct with their responses and don’t shy away from uncomplimentary opinions when it is not being mailed back to the office. In addition, you eliminate the potential for employees to read responses and dispose of a response that states unfavorable comments about them.

Interviewing employees to solicit their opinion about the practice and the physicians is particularly challenging. If a physician or manager interviews them, they will avoid negative responses for concern of hurting someone’s feelings or fear of retribution. Interviews should be conducted by someone who does not know the employees. In addition, the interviewer must ensure there will be complete anonymity. There are firms that specialize in conducting telephone surveys at a reasonable fee.

The construction of the survey instrument for employees is as important as the one developed for patients. Identify what it is you want to find out and design questions that will provide the right information.

Employees are sensitive to putting their opinions in writing, as well. They will be reluctant to write a response that points to them and will want to be assured “the doctor” (and in some cases the manager) will not see the responses. It is for this reason that many practices engage the services of a health care marketing consultant. This information may otherwise be difficult to obtain, and time must be dedicated to analyzing the data and preparing an action plan to expedite strategic planning.

All survey responses need to be compiled systematically and analyzed to provide you with tangible results you can act on. Gathering detailed information and staff and patient perceptions is critical to the strategic planning process.

A commitment to strategic planning begins with a willingness to look inside the practice with a critical eye. Once this is accomplished you will be in a position to respond to marketplace needs. This is an important step in adapting to a changing market, strengthening your position and preparing for a somewhat unpredictable future.

Rebecca Anwar, Ph.D., is a senior health care consultant with The Sage Group, Inc. based in Philadelphia.

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