Doctor speaking with patient

Managing Customer Service: An Outpatient Approach

Next to preserving positive patient outcomes and maintaining standards of care, customer service may be the highest priority for an ambulatory surgery environment.

Understandably, outpatient centers strive to provide a positive patient experience. As consumers become more health care-savvy and outpatient centers become more competitive, service becomes the deciding factor for our patients. Take family birthing centers as an example of how the patient is being cared for. These centers may be slightly ahead of outpatient centers in the service arena. Many years ago, labor and delivery rooms began their transition to family birth centers. Their ultimate goal has been to incorporate all members of the family into the positive experience of the birth of a new sibling. These centers have enhanced this experience for many new families. Today, many outpatient surgery centers are working hard to follow suit.

Ambulatory surgery centers are being renovated or enhanced across the United States. Each center seems to have a focus of the holistic experience for patient, family and friends. Centers focus on environment, layout, patient flow, service initiatives and staffing patterns.

The environment can be utilized to aid holistic healing and enhance the overall experience for the entire support system. The outside environment of the center can add seasonal distractions during times of waiting. Families may stroll along quiet pathways, sit in peaceful gardens or ponder at magnificent views. The view and peace may also assist with the holistic healing experience.

The layout of the actual facility should offer easy access, easy navigation and pleasant decor. Many facilities develop centers with centralized check-in and pre-op areas. The public enter the facility through this point. Navigation is guided by color coded halls, artistic wall-hangings and minimal signage. Many new ambulatory surgery centers have also gone to great lengths to incorporate natural light. Skylights and walls of glass compliment many public areas.

Patient flow has been closely studied to maximize efficiency for the staff while preserving a positive patient experience and adhering to patient privacy rules. Some centers have been designed to segregate pre-op and post-op patient populations. Other centers have designed horizontal processes with patients moving left to right throughout their surgical experience. Still other surgery centers have focused on large pre-op holding areas to finish lines and preps in an effort to maximize OR efficiency.

Service initiatives can really enhance the patient experience. This is an area where staff and management must get creative. One facility has developed a get well card that follows the patient throughout their experience. Each nurse caring for the patient signs the card. The card is given to the patient with their discharge instructions as an expression of their caring and hopes of a quick recovery. Another facility has implemented an elaborate follow-up program. Patients are called at three, six, nine and 12 months post-op. The patient’s feedback is solicited on their care, recovery and complications. This information is valuable to measure customer service and patient outcomes.

Finally, ambulatory surgery centers place a great amount of emphasis on appropriate staffing patterns. The correct skill mix must be maintained at the correct times throughout the schedule. Dedicated resources are necessary in pre-admit testing, registration, pre-op, intra-op, and post-op areas. Appropriate resource consumption in these areas will aid productivity as well as customer service.

Outpatient centers are in a very competitive environment today. These and many other approaches are being used to improve the patient care experience and possibly gain a competitive edge.

Lori Robertson's most recent work includes facility clinical utilization role development, perioperative clinical management and perioperative resource management. Robertson began her nursing career at Shock Trauma in Baltimore, Maryland, and has staff experience in surgical services donor kidney program; transplant surgery, vascular surgery resource nurse, and team leader for GU/GYN and Minor Surgery. Currently, Robertson is assistant director for perioperative services, OR/endo/anesthesia at Rockingham Memorial Hospital in Harrisonburg, Virginia. She can be contacted at

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