Surveying Referrers Provides Valuable Guidance

During a client consultation via conference call last month, I was asked what other radiology practices are doing to deliver reports. “What they are doing is less important than providing what your referrers want,” I replied. “How do we find out?” asked the practice representative. “Ask them,” I said. The balance of the conversation brought to light the fact that this particular practice had not surveyed its referrers in at least a year. Worse, the practice had done nothing with the results, which made the entire effort a waste of time. Patient-satisfaction surveys are commonplace: Most outpatient imaging centers routinely survey their patients. At San Gabriel Diagnostic Center in West Covina, Calif, a new program is being launched that will ask every patient to complete a brief survey—one that will take less than a minute to complete, but will ask about experiences in the key areas of the practice. The same cannot be said for referring-physician surveys. One exception is Newport Diagnostic Center in Newport Beach, Calif, where referrers are surveyed quarterly. With patient or referrer surveys, both of these centers use the information to fix problems and expand successes. Regular meetings at both locations help turn responses into calls to action. One Survey, Multiple Uses If you are not surveying your referring physicians at least semiannually, you are missing out on information critical to the success of your center. There are five reasons that you should survey referrers at least twice a year. First, you can catch problems in the early stages. Many times, for example, referrers will forgive the occasional lapse in report delivery, provided the slow responses are not for stat reports. If slow or cumbersome delivery becomes chronic, though, some referrers will choose a competitor over choosing to contact you about the problem. By the time you find out that they are unhappy, it is too late. Second, you can capitalize on what you are doing right. When you survey referrers, you discover what you are doing well. When that happens, you have the opportunity to expand a program beyond its current scope. It may come as no surprise that many referrers are unaware of some of the successful programs and services offered by your practice. Third, you can reward people. Nothing motivates staff more than praise. Not even a financial reward is appreciated as much as saying, “John, you were mentioned six times in our survey as someone who is taking very good care of our patients, and I just want you to know that we are aware of it and appreciate the fine work you are doing.” Sure, right about now, John would probably appreciate a gift card from a gas station, but that’s optional. The kind words are not. Fourth, you can thank referrers. Those who respond with negative comments should be acknowledged and should receive a personal note of thanks for their candid remarks. They should also be told what steps you are taking to improve. Those who respond with compliments should be thanked with a note or a phone call for their continued trust in your team. Fifth, you can market to others. No one liked braggadocio, so it is important to mention your good results in a simple, objective format. There’s no need to shout out the fact that 97% of your referrers rated your care as excellent. Just post the numbers, and your intelligent audience will figure it out—and no, it will not hurt if you add a discreet message that you are very pleased with the results. Getting Them Out and Back Once you have made the commitment to a regular survey program, there are several options for delivering the questionnaires and receiving them. For the most honest responses and the highest return rate, mail your survey to your referrers along with a self-addressed, stamped envelope. Do not insist on getting the name of the physician or the practice; make it optional. That mail system, however, is not feasible for many centers. In that case, the survey can be posted on your Web site in the password-protected area for physicians. If possible, keep the responses anonymous here, too. Another effective way of delivering and receiving surveys is to use your outside representatives to deliver them and ask referrers send them back to you by fax. The results may not be as numerous as for the mail method, but giving the surveys to the representatives to distribute gives them something new to talk about on their rounds and puts some action behind the talk that you are truly interested in improving your performance. The final step in the survey process is the distribution of the results. Each department manager should have a copy not just of the results for his or her area, but of all of the results. Along with this distribution, managers should be asked to create action plans to fix problems and reward good behavior. Accountability is key, and managers should be asked to provide updates, particularly on the problem-solution topics. Without this crucial last step, there is no point in conducting a survey. What to Say Keep your survey length down to one page. In your introduction, make it clear that completing the survey will take only a few moments of the respondent’s time. Because you have only one page and are promising that a short amount of time will be needed to complete the survey, your topics should be broad. Suggestions include report-turnaround time, quality of reports and images, patient care, scheduling, and accessibility of your physicians. If you have competitive issues, you can use your survey to address, head-on, some of the areas in which you are vulnerable, to determine how much they mean to your referrers. If your survey asks referrers to rate your level of service, use a scale of one to six, not one to five. Using an even number forces respondents to make a clearer decision, rather than settling on the three that is the default response in many one-to-five scales. Follow this link to a page on the Web site of the American Board of Radiology that provides a sample referring physician survey that is part of the board’s Practice Quality Improvement Projects (see the bottom of the Web page): http://theabr.org/DR_MOC_PQI.htm Properly designed and executed, surveys can be your most powerful self-improvement tool and morale booster.