The Calculus of Patient Satisfaction
The Calculus of Patient Satisfaction
The quality expert, Noriaki Kano, taught the service trichotomy of ordinary, extraordinary, and differentiable [Figure C]. Ordinary service concerns a basic expectation whereby satisfaction remains neutral when fulfilled and extremely negative when not fulfilled. Conversely, extraordinary service represents added value that is entirely unexpected and highly appreciated by the recipient. Extraordinary service is positive when fulfilled and neutral when not (since unanticipated). For instance, next-day patient follow-up after an ED visit (as illustrated in the case example) is an extraordinary service that vastly improves the patient experience and can be accomplished at a relatively low cost. The last form, differentiable service, is a blend between ordinary and extraordinary and linearly relates to performance. For instance, door-to-doctor time can either be a negative experience when excessive, neutral when average, and positive when brief.
Consider that each dimension of service generates a positive, negative, or neutral contribution to overall satisfaction. Further, certain service factors have more impact with some patient types than others. Layering the multiple factors creates an aggregate satisfaction score. As we consider the myriad permutations, including specific doctor-nurse combinations, the equation becomes multi-dimensional, extremely complex, and encompasses the branch of calculus called vector analysis.
Ordinary and Extraordinary Service
The quality expert, Noriaki Kano, taught the service trichotomy of ordinary, extraordinary, and differentiable [Figure C]. Ordinary service concerns a basic expectation whereby satisfaction remains neutral when fulfilled and extremely negative when not fulfilled. Conversely, extraordinary service represents added value that is entirely unexpected and highly appreciated by the recipient. Extraordinary service is positive when fulfilled and neutral when not (since unanticipated). For instance, next-day patient follow-up after an ED visit (as illustrated in the case example) is an extraordinary service that vastly improves the patient experience and can be accomplished at a relatively low cost. The last form, differentiable service, is a blend between ordinary and extraordinary and linearly relates to performance. For instance, door-to-doctor time can either be a negative experience when excessive, neutral when average, and positive when brief.
Consider that each dimension of service generates a positive, negative, or neutral contribution to overall satisfaction. Further, certain service factors have more impact with some patient types than others. Layering the multiple factors creates an aggregate satisfaction score. As we consider the myriad permutations, including specific doctor-nurse combinations, the equation becomes multi-dimensional, extremely complex, and encompasses the branch of calculus called vector analysis.
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