Who Is a Hospital’s “Customer”?

Abstract

The Centers for Medicare & Medicaid Services (CMS) now includes the patient experience in calculating a hospital's reimbursement for services rendered. CMS's addition has led hospitals to incorporate customer service initiatives whose goal is to improve the patient experience, with varying degrees of success. A possible reason for the less-than-successful outcomes may be organizations' failure to identify who the customer is and what is important to that customer. This study used focus groups at an acute care, for-profit hospital in the southwestern United States to gather the perspectives of healthcare team members and patients on who should be labeled a hospital's customer and what factors influence customer satisfaction. The data reveal that neither patients nor physicians considered patients to be customers, with the possible exception of elective surgery patients. In contrast, administrators viewed patients as customers, regardless of the circumstances surrounding the patient's admission. Nursing and other service staff often applied both the customer and the patient labels to their patients. Most participants viewed physicians as a hospital's customers. The following were found to be important predictors of patient satisfaction: effective interdisciplinary relationships, adequate nurse staffing levels, high-quality and good-tasting food, minimal wait times, and hospital cleanliness. The study further determined that physician satisfaction is influenced by having a permanent healthcare team (nurses, hospitalists) taking care of their patient, good communication and care coordination, operating room readiness, and hospital staff recognizing the physician by sight throughout the facility. This study's results may be useful for hospital administrators interested in using customer service initiatives to improve the overall patient experience in their organization.