Chapter 23
A Matter of Perspective
Paaige K. Turner and Robert L. Krizek
Case Overview
This case examines the complexities of viewing patient/consumer satisfaction as a single, fixed concept. Metropolitan Medical Group is experiencing declining patient satisfaction and revenues and wants to know why. Mike Taslow, the CEO, hires Betty McDaniel as the new Director of Patient Care to create a seamless experience for patients. Since Betty has worked in a different organizational environment, she spends her first three months observing patient interactions and interviewing staff, doctors, and patients. At the end of three months, Betty suspects that Mike’s question, “Why aren’t patients satisfied?” might be too narrowly focused.
Learning Objective
This case illustrates the structural and personal implications of assuming a single interpretation of patient/consumer satisfaction.
Keywords and Definitions
Emergent or informal networks—relationships that emerge between and among organizational stakeholders through communication interactions in contrast to formal organizational charts.
Formal networks—organizational communication channels mandated by the organization and reflected in the organizational chart.
Hierarchical ordering—the arrangement of system components in complex ways that involve subsystems and suprasystems.
Information—transfer model of communication–communication is a tool for transferring information from one person or place (a source) to another (a receiver).
Interdependence—the functioning of one component of a system relying on the other components of that system.
Network analysis—mapping of the flow of information and relationships among people.
Patient/consumer satisfaction—a complex process balancing consumer expectations with the perceptions of the service or product in question (Newsome & Wright, 1999).
Permeability—degree to which the boundaries of a system allow information and materials to flow in and out of that system.
Task and relational dimensions of communication—messages perform at least two functions: task (the transfer of information) and relational (the defining of the relationship between the sender and the receiver).
Transactional model of communication—communication is a process whereby senders and receivers interpret the meaning of messages based upon the present situation, their individual experiences, history, and cultural influences.
Obstacles/Challenge
1) To increase patient satisfaction with the goal of reversing declining revenues
2) Identify factors
likely to influence patient satisfaction
Patient insensitivity due to lack of
policies and procedures or inability to follow policy and procedure.
Entry and admittance policies
objectify persons seeking care.
Excessive wait time.
Waiting rooms are not "kid-friendly."
Patients may have unrealistic
expectations
Patients and staff may have different
perceptions of what is appropriate waiting time.
Strategies and Challenges
1) Need to develop a satisfaction audit which yields hard data about the factors which influence satisfaction and contribute to dissatisfaction
2) Need to conduct focus groups with clinic staff to generate potential strategies to enhance patient satisfaction.
3) Satisfaction is the
congruency between expectations and outcomes. Need to develop strategies
to help
patients/clients/consumers develop realistic expectations.
Discussion Questions
1. Who are the various stakeholders in this case? From the perspective of each stakeholder, briefly answer the following questions:
a) What makes a patient’s experience satisfactory or dissatisfactory?
b) What would a seamless experience look like?
c) Who is responsible for successful communication?
d) Where do the stakeholders’ definitions of satisfaction come from?
e) How did these differing perspectives affect the communication during Ms. Dillard’s office visit?
2. Analyze the communication of MMG using systems theory. a) What are the various organizational sub-systems? b) How does the bypassing of formal channels and relying on informal channels affect patient satisfaction? c) How is the staff and physicians’ concept of patient satisfaction reflected in the flow of information; d) How is the staff and physicians’ concept of patient satisfaction reflected in the structural processes of the organization? e) Are the staff and doctors’ perceptions consistent with the patients’ perceptions of satisfaction? f) How have staff and doctor’s interpretations of patients influenced the organization’s handling of patients? g) What systemic communication procedures or practices would you recommend to enhance patient satisfaction?
3. How might Betty rephrase the question, “Why aren’t patients satisfied?” to reflect what she found?
4. How is a patient different from a consumer? How are they the same? How is speaking with a doctor different from, or similar to, speaking with a service technician at a TV repair shop?
5. What are the implications of this case study for communication theorists’ understanding of task vs. relational dimensions of communication?
6. What changes might the organization make to improve patient/consumer satisfaction? What individual or systemic forces might inhibit those changes? What might be some of the unintended consequences of those changes?
7. What communication theories can health care organizations draw upon to ensure patient satisfaction while addressing declining revenues in the health care field?
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