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In Vivo

Faculty Practice

Our Patients, Our Customers

The Service Excellence Team. From left, David Kahn, Jessica Bikoff, Karen Berger and Bola Akinola (seated).

In its continuing drive to improve the patient experience and the practice lives of clinical faculty at CUMC across departments and specialties, the Columbia Faculty Practice Organization (CFPO) has recently launched a number of new initiatives: a telephone patient satisfaction survey; a new method for selecting employees based on service skills; and systems to streamline patient appointments and registration.

Recognizing that people have become more active as health care consumers, the CFPO made upgrading service in the outpatient physician practice offices – the area under CUMC's administrative umbrella – a priority since the organization was created in 1998.

"Twenty-first century medicine is very different from what it was only a few decades ago," says Karen Berger, assistant vice president for practice development and outreach at CUMC. "We are in an increasingly competitive, 'patient-centric' health care environment where physicians and hospitals must vie to attract and retain patients. Academic medical centers face competition from each other, as well as from private specialty groups and community hospitals. Managed care companies are increasingly adopting a 'pay for performance' model. In this climate, providing the highest quality service is vital to maintaining health, not only of the patient, but of the institution."

To tackle the challenges of these market forces, the CFPO launched the Service Excellence Initiative in 2002, in parallel with a similar effort under way at NYPH.

"From the start, the goal of the initiative has been to transform the culture of clinical care at P&S," says Jessica Bikoff, a member of the service excellence team. "We're working to create an environment where the concepts of customer service and patient satisfaction are so entrenched that they become second nature."

To put the initiative into action, organizational psychologists Ms. Bikoff and Bola Akinola joined CUMC in 2002 as program managers for service quality. They provided training for more than 1,400 employees in areas such as customer service, conflict resolution, stress management, teambuilding, time management, and effective leadership. Since then, more steps have been taken to improve service.

In 2003 a Mystery Callers Survey was launched to improve telephone etiquette in physician's offices. By 2004, the Service Council, a leadership body that consists of one physician and one administrator from each department, was fully operational. The Council established the CFPO Principles of Service and formed work groups charged with incorporating the principles into human resources practices, employee recognition, process improvement and educational resources.


Following lessons from other industries, the Service Excellence Initiative is two-pronged: It seeks both to improve patient satisfaction and improve the work environment. A corporate rule of thumb is that when employees are happier and feel they can do their jobs better, their customers report receiving superior service.

"For the support staff and managers in doctor's offices this initiative raises morale and promotes teamwork and professional development," Ms. Akinola says.

David Kahn, M.D., president of the CFPO and physician-director of the Service Council, puts it this way: "Excellent service is essential to the humanistic practice of medicine and to achieving the best outcomes. The ability of patients to tell us what we need to know about them, to participate in diagnostic evaluations, and to adhere to our advice can only be enhanced by their experience of being well taken care of – conveniently, comfortably and respectfully – when they visit a doctor's office."

In addition, Dr. Kahn says it is important to measure service, to see if we are actually improving and where to focus our efforts. That's why a patient satisfaction survey is under way.

Another important benefit of the initiative: Studies suggest that a better patient-physician relationship results in fewer malpractice lawsuits, a significant finding at a time when malpractice premiums in the United States are skyrocketing.

"We are already starting to make our institution friendlier to patients," says Ms. Berger. "Cultural change doesn't happen overnight, but we'll be successful if we all commit to the process."

—Anna Sobkowski