{"id":4391,"date":"2015-12-05T10:02:36","date_gmt":"2015-12-05T09:02:36","guid":{"rendered":"http:\/\/www.saasoft.com\/blog\/?p=4391"},"modified":"2015-12-05T10:02:36","modified_gmt":"2015-12-05T09:02:36","slug":"surprised-and-delighted","status":"publish","type":"post","link":"https:\/\/hcse.blog\/?p=4391","title":{"rendered":"Surprised and Delighted"},"content":{"rendered":"

\"idea_bulbs_pop_up_150_wht_16515\"<\/a>Quality is subjective. It is in the head and the heart of the beholder.<\/p>\n

We feel quality when our experience exceeds our expectation.<\/em><\/p>\n

And this simple definition of quality has some profound implications.<\/p>\n

\n

The first is that to measure quality we need to know both parts of the quality equation … we need to know both the expectation and the experience.<\/p>\n

Why is that?<\/em><\/p>\n

One\u00a0reason is because we can set expectation much more easily than we can\u00a0set the experience.<\/p>\n

Example:\u00a0 Suppose I am a hospital and I am interested in the perceived quality of the service that I provide to patients.\u00a0 So I\u00a0implement a\u00a0quality survey and I ask the patients one question as they leave.\u00a0 I ask\u00a0“Were you satisfied?” The exit poll data is assiduously collected, processed\u00a0and presented at the monthly\u00a0Quality Committee meeting. If our average satisfaction score this month is better than last month we “high five” and if it is less then we “deep dive”.<\/em><\/p>\n

Q1: What is the relationship between the satisfaction score and\u00a0the actual experience?
\n<\/em>A1: Satisfied means that experience equals expectation. That’s all.<\/em><\/p>\n

Q2: What is the easier way to improve satisfaction scores?\u00a0Improve experience or reduce\u00a0expectation?
\nA2: Reduce expectation.
\n<\/em><\/p>\n

And that is what we do. We take the path of low resistance to improving satisfaction. We set low expectations. We talk only about what might go wrong. Never about what will go right.<\/p>\n

\n

The message here is that to understand\u00a0quality we have to measure\u00a0both expectation and experience.\u00a0\u00a0And when\u00a0harvesting feedback we need to ask both<\/strong> questions.<\/p>\n

Compare these two alternatives:
\nQ: Were you satisfied with the service you received in outpatients today?<\/em>
\nA: Yes<\/em>.<\/p>\n

Q: What did you experience in outpatients today and\u00a0what was your expectation?<\/em>
\nA: I\u00a0struggled to find a parking place and I was a bit\u00a0worried that\u00a0I would be late for my appointment, but\u00a0I ended up waiting\u00a0over\u00a0two hours anyway.\u00a0I did not know how long the wait would be and I was then worried that I had not put enough time on the parking ticket.\u00a0But\u00a0it is what\u00a0I expected because the appointment letter said that I\u00a0need to allow up to three hours. My appointment took ten minutes and\u00a0the doctor was nice.<\/em><\/p>\n

\n

We assume that because we usually experience queues and delays then it would be\u00a0much more difficult to improve patient satisfaction by actually improving their experience … in other words …\u00a0eliminating the avoidable root causes of the queues and delays.<\/p>\n

So we don’t bother trying. We just\u00a0reinforce the\u00a0low expectation.<\/p>\n

\n

Another reason we need to know both expectation and experience is because\u00a0it is our expectation that drives our decision.<\/p>\n

If we expect a poor experience we are much less likely to\u00a0choose that option.<\/p>\n

Here is how we learn this avoidance behavior:
\nStep 1. We start with a reasonable expectation\u00a0and no experience.
\nStep 2. We\u00a0have a poor experience,\u00a0we feel disappointed, and we lower our expectation.
\nStep 3. If we have a choice then we avoid the experience. If we have no choice then we accept\u00a0it.
\nStep 4. We experience what we expected\u00a0(but at least have avoided further disappointment).<\/p>\n

But\u00a0are we actually satisfied?\u00a0Or are we just resigned to the fact that is all we can hope to expect.<\/p>\n

Have we learned to become helpless, skeptical or even cynical?<\/p>\n

\n

Knowing the patient expectation\u00a0provides a goldmine of opportunity for a healthcare\u00a0organization that wants to improve the quality of its service.<\/p>\n

Engagement in change does not follow from disappointment – it follows from delight – or more specifically delight\u00a0accompanied by surprise.<\/p>\n

We feel surprised and delighted when\u00a0we experience something that exceeds our expectation.<\/p>\n

\n

So recall the story of\u00a0the satisfied outpatient<\/em> with the sense of resigned acceptance.<\/p>\n

Then\u00a0read the feedback below that was shared with me this week … feedback from a doctor in training who has just completed the Foundations of Improvement Science in Healthcare (FISH) course … the free offer.<\/p>\n

“To be honest, I was very surprised with the content of the course … in a \u00a0good way – so much so that I sat and completed it over two days!\u00a0<\/em><\/p>\n

I was fully expecting a generic online management course filled with the usual buzz words and with no real substance or learning point to take away from it (I’m generally very sceptical of such things as I feel many courses are primarily money making exercises with little real value as the developers are well aware that healthcare professionals need to tick off the management box at their appraisals).<\/em><\/p>\n

What I actually found was a course that presented the problems of a chaotic department (that I’m all too familiar with as a radiologist) and actually broke down the problem into its root causes and fundamental components in a logical way with simple and effective strategies to improve a service. Considering each process in terms of a series of streams and stages and presenting these functions as a Gantt chart is brilliantly simple, demystifies what actually happens in a process, and is a simple way of identifying all the faff that goes on around the real value work that we – something that I was all to aware of prior to the course but didn’t really know how to tackle. What I have learned is definitely a valuable foundation in managing the various processes of a department such as my own and I will certainly make use of these tools in the future.”<\/em><\/p>\n

Does that sound like a surprised-and-delighted reaction?<\/p>\n","protected":false},"excerpt":{"rendered":"

Quality is subjective. It is in the head and the heart of the beholder. We feel quality when our experience exceeds our expectation. And this simple definition of quality has some profound implications. The first is that to measure quality we need to know both parts of the quality equation … we need to know … <\/p>\n

Continue reading “Surprised and Delighted”<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[],"class_list":["post-4391","post","type-post","status-publish","format-standard","hentry","category-reflections"],"_links":{"self":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/4391","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4391"}],"version-history":[{"count":0,"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/4391\/revisions"}],"wp:attachment":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4391"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4391"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4391"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}