Nursing Customer Service Initiative

Since the implementations of the Affordable Care Act, hospitals across the country have started seeing the impact of less than impressive customer satisfaction scores have on their financial bottom line.1

With a renewed focus on excellence in the areas rated, healthcare leaders are focusing on key areas of quality and satisfaction improvement, since even small changes can have an impact.2

Some believe that urban safety-net hospitals and hospitals handling more complex case more frequently possess an inherent disadvantage in the area of customer satisfaction.3

This is even more crucial for safety-net institutions as the reduction of payments comes not only from the value-based-purchasing approach set forth by the Affordable Care Act, but also by the reduction in half to the money set aside to reimburse safety-net hospitals for the disproportionate share of uninsured patients they see.4

The creativity of nurses at such an institution has devised an interactive, investigative training program for emergency department staff.

The Customer Service Initiative (or CSI) is a program devised by ED nurses at Grady Memorial Hospital, an urban, safety-net academic facility in Atlanta that sees in excess of 10,000 patients every month come through the doors of their department.

Investigation Stations

The CSI program at Grady Memorial was devised as a five-station, investigative approach to customer service, complete with caution tape and a body outline of “Mr. Customer Service” who after some time with less than favorable patient satisfaction scores needed to be “revived.”

In each station, participants were given broad scenarios and directed to act them out, while course moderators where interjecting with challenges a healthcare provider may encounter. The free form, open discussion format of the course engaged even the more challenging staff members, and provided a fun interactive environment for staff member to share difficult customer service scenario, highlight challenges encounter throughout the department and share solutions or successful approaches to solve these challenges.


Don’t Break The Chain.┬áThe first station in the investigation focused on proper use of the chain of command when handling customer complaints, employee disputes or interdepartmental challenges. Staff members shared how they solved difficult customer service situations and moderators reinforced proper chain of command and service recovery strategies.

Collecting Evidence. This second station highlighted the importance of non-verbal cues health care provider can collect from patients and their family members. Staff members experienced backboards with cervical spine immobilization to underline the discomfort and emotional stress patients experience when arriving to this busy level one trauma center. Various other scenarios were used to emphasize how patients and family members may not always voice their concerns, but rather give them away through body language and facial expressions. Moderators underscored the importance of staff members being vigilant to the needs of patient and family members and provided guidance with observing and anticipating patient needs.

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