A customer journey perspective on service delivery system design: insights from healthcare

Unveiling the Negative Customer Experience in Diagnostic Centers: A Data Mining Approach

Introduction

This study aims to identify the negative customer experiences reflected in complaints against diagnostic centers using data mining tools.

Methods

Analyzing customer complaints from a consumer complaints website, the Apriori algorithm was employed to uncover frequent patterns and identify key areas of concern. The frequency and distribution of terms used in complaints were also analyzed, and word clouds were generated to visualize the findings.

Results

The study revealed that major areas of unfavorable customer experience included delayed test reports, erroneous test results, difficulties scheduling appointments, staff incivility, subpar service, and medical negligence.

Discussion

These findings and the proposed model can guide diagnostic centers in incorporating data mining tools for customer experience analysis, enabling managers to proactively address issues and view complaints as opportunities for service improvement rather than legal liabilities.

Perceptions and Current Practices in Patient-Centered Care: A Qualitative Study of Ryan White HIV Providers in South Florida

Background: Patient-centered care (PCC) improves HIV adherence and retention, though lack of consensus on its conceptualization and understanding how it is interpreted has hindered implementation. Methods: We recruited 20 HIV providers at Ryan White Programs in FL for in-depth interviews. Thematic analysis identified core consistencies pertaining to: 1) provider perceptions, 2) current practices promoting PCC. Results: Provider perceptions of PCC emerged under four domains: 1) holistic, 2) individualized care, 3) respect for comfort and security, and 4) patient engagement and partnership. PCC practices occurred at multiple levels: 1) individual psychosocial and logistical support, 2) interpersonal support within patient-provider relationships through respectful communication and active engagement, and 3) institutional practices including feedback mechanisms, service integration, patient convenience, and diverse staffing. Conclusions: Our findings highlight the central tenets of PCC as respectful, holistic, individualized, and engaging care. We offer an HIV-adapted framework of PCC as a multilevel construct to guide future intervention.

Exploring Customer Journeys in the Context of Dentistry: A Case Study

This case study aims to explore how customer journey concepts can apply to a hypothetical scenario, centring on a patient (customer persona) within the dentistry arena, and with a particular focus on special care dentistry. As an educational exercise, this paper may inform dental and allied professionals on how aspects of the customer journey notion may be embedded into their own practices, so that patient-centricity might be better optimised. The hypothetical scenario considers the organisational context, customer persona, contemporary customer purchase decision-making models, and marketing approaches. These components are used to create a customer journey map to help visualise and identify the varying customer–business interactions. The customer journey, focussing on the awareness, initial consideration, active evaluation, pre-purchase, purchase and post-purchase stages, is then conceptually analysed. The analyses reveal that there are areas of friction, attributable to numerous factors. The case study recommends that by introducing digitalisation and omnichannel marketing, alongside existing internally generated and multi-channel marketing approaches, considerable improvements may be achievable. As the patient technology landscape becomes more digital and dental organisations face fiercer competition, dental care providers relying on traditional marketing approaches may well need to adapt and introduce innovative, yet cost-effective digitalisation and omnichannel marketing approaches. Nevertheless, dental care providers, and dental and allied professionals must uphold an underlying duty of care, ensuring that all practises are legal, decent, honest, truthful, and above all ethical.

A Data-Driven Approach to Support the Understanding and Improvement of Patients' Journeys: A Case Study Using Electronic Health Records of an Emergency Department

OBJECTIVES

Given the increasing availability of electronic health records, it has become increasingly feasible to adopt data-driven approaches to capture a deep understanding of the patient journeys. Nevertheless, simply using data-driven techniques to depict the patient journeys without an integrated modeling and analysis approach is proving to be of little benefit for improving patients' experiences. Indeed, a model of the journey patterns is necessary to support the improvement process.

METHODS

We presented a 3-phase methodology that integrates a process mining-based understanding of patient journeys with a stochastic graphical modeling approach to derive and analyze the analytical expressions of some important performance indicators of an emergency department including mean and variance of patients' length of stay (LOS).

RESULTS

Analytical expressions were derived and discussed for mean and variance of LOS times and discharge and admission probabilities. LOS differed significantly depending on whether a patient was admitted to the hospital or discharged. Moreover, multiparameter sensitivity equations are obtained to identify which activities contribute the most in reducing the LOS at given operating conditions so decision makers can prioritize their improvement initiatives.

CONCLUSIONS

Data-driven based approaches for understanding the patient journeys coupled with appropriate modeling techniques yield a promising tool to support improving patients' experiences. The modeling techniques should be easy to implement and not only should be capable of deriving some key performance indicators of interest but also guide decision makers in their improvement initiatives.

Benefits and limitations of business process model notation in modelling patient healthcare trajectory: a scoping review protocol

INTRODUCTION

The adoption of business process model notation (BPMN) in modelling healthcare trajectory can enhance the efficiency and efficacy of healthcare organisations, improve patient outcomes while restraining costs. Existing systematic reviews have been inconclusive regarding the effectiveness of BPMN in modelling healthcare trajectory. The aims of this scoping review are to map and aggregate existing evidence on the benefits and limitations associated with BPMN in healthcare trajectory, highlighting areas of improvement on BPMN and its extensions in healthcare. We will assess BPMN's ability to model key dimensions or concepts of the healthcare process and to meet the needs of stakeholders. The review will highlight the advantages of this approach to support clinical activities and decision-making processes associated with the healthcare trajectory, proposing a conceptual framework for improving the use of BPMN in healthcare.

METHODS AND ANALYSIS

This study will be performed in accordance with the methodological framework suggested by Arksey and O'Malley. A wide range of electronic databases and grey literature sources will be systematically searched using predefined keywords. The review will include any study design focusing on the application of the BPMN approach for optimising healthcare trajectories, published in either English or French from 1 January 2004 to 9 December 2021. Two reviewers will independently screen titles, abstracts and full-text articles and select articles meeting the inclusion criteria. A customised data extraction form will be used to extract data. The results will be presented using descriptive statistics and thematic analysis on qualitative data.

ETHICS AND DISSEMINATION

Research ethics approval is not required. Review findings will be used to advance understanding about BPMN, its extensions and application in healthcare trajectory optimisation. The review will develop recommendations on tailoring BPMN strategies for optimising care pathways and decision-making processes. Findings will be disseminated in peer-reviewed journals, conferences and discussions with relevant organisations and stakeholders.

Definition and conceptualization of the patient-centered care pathway, a proposed integrative framework for consensus: a Concept analysis and systematic review

BACKGROUND

Confusion exists over the definition of the care pathway concept and existing conceptual frameworks contain various inadequacies which have led to implementation difficulties. In the current global context of rapidly changing health care systems, there is great need for a standardized definition and integrative framework that can guide implementation. This study aims to propose an accurate and up-to-date definition of care pathway and an integrative conceptual framework.

METHODS

An innovative hybrid method combining systematic review, concept analysis and bibliometric analysis was undertaken to summarize qualitative, quantitative, and mixed-method studies. Databases searched were PubMed, Embase and ABI/Inform. Methodological quality of included studies was then assessed.

RESULTS

Forty-four studies met the inclusion criteria. Using concept analysis, we developed a fine-grained understanding, an integrative conceptual framework, and an up-to-date definition of patient-centered care pathway by proposing 28 subcategories grouped into seven attributes. This conceptual framework considers both operational and social realities and supports the improvement and sustainable transformation of clinical, administrative, and organizational practices for the benefit of patients and caregivers, while considering professional experience, organizational constraints, and social dynamics. The proposed attributes of a fluid and effective pathway are (i) the centricity of patients and caregivers, (ii) the positioning of professional actors involved in the care pathway, (iii) the operation management through the care delivery process, (iv) the particularities of coordination structures, (v) the structural context of the system and organizations, (vi) the role of the information system and data management and (vii) the advent of the learning system. Antecedents are presented as key success factors of pathway implementation. By using the consequences and empirical referents, such as outcomes and evidence of care pathway interventions, we went beyond the single theoretical aim, proposing the application of the conceptual framework to healthcare management.

CONCLUSIONS

This study has developed an up-to-date definition of patient-centered care pathway and an integrative conceptual framework. Our framework encompasses 28 subcategories grouped into seven attributes that should be considered in complex care pathway intervention. The formulation of these attributes, antecedents as success factors and consequences as potential outcomes, allows the operationalization of this model for any pathway in any context.

Service design in the healthcare space with a special focus on non-clinical service departments: A synthesis and future directions

Although there has been a tremendous change in the way diseases are diagnosed and treated, the ways in which health care delivery has been managed has seen very little change.Several academic studies have arisen in the area of service design, but an amalgamation of this research, especially in the area of healthcare services is not available. The aim of this systematic review is to evaluate the published research on service design in healthcare and accordingly identify the gaps and scope of future research. After analyzing the articles and reviewing the Service design in healthcare literature, the following are our main contributions: (i) clarification of the service design concept and the developments that appears in the literature review of service design in the healthcare sector; (ii) classification of the service design tools and techniques that are most commonly used in the healthcare sector; (iii) demonstration of the service design as the preponderant construct that is used as a tool and technique to improve quality and efficiency in the healthcare service.The resultant systematic review reveals a change in the type of research carried out, the service design tools used and a shift towards service design from using the co-design tool to other methods. The paper highlights the gaps in the very limited amount of empirical work in the non-clinical healthcare space and accordingly a model is recommended.

What does the patient have to say? Valuing the patient experience to improve the patient journey

Background

Patient-reported data—satisfaction, preferences, outcomes and experience—are increasingly studied to provide excellent patient-centred care. In particular, healthcare professionals need to understand whether and how patient experience data can more pertinently inform the design of service delivery from a patient-centred perspective when compared with other indicators. This study aims to explore whether timely patient-reported data could capture relevant issues to improve the hospital patient journey.

Methods

Between January and February 2019, a longitudinal survey was conducted in the orthopaedics department of a 250-bed Italian university hospital with patients admitted for surgery; the aim was to analyse the patient journey from the first outpatient visit to discharge. The same patients completed a paper-and-pencil questionnaire, which was created to collect timely preference, experience and main outcomes data, and the hospital patient satisfaction questionnaire. The first was completed at the time of admission to the hospital and at the end of hospitalisation, and the second questionnaire was completed at the end of hospitalisation.

Results

A total of 254 patients completed the three questionnaires. The results show the specific value of patient-reported data. Greater or less negative satisfaction may not reveal pathology-related needs, but patient experience data can detect important areas of improvement along the hospital journey. As clinical conditions and the context of care change rapidly within a single hospital stay for surgery, collecting data at two different moments of the patient journey enables researchers to capture areas of potential improvement in the patient journey that are linked to the context, clinical conditions and emotions experienced by the patient.

Conclusion

By contributing to the literature on how patient-reported data could be collected and used in hospital quality improvement, this study opens the debate about the use of real-time focused data. Further studies should explore how to use patient-reported data effectively (including what the patient reports are working well) and how to improve hospital processes by profiling patients’ needs and defining the appropriate methodologies to capture the experiences of vulnerable patients. These topics may offer new frontiers of research to achieve a patient-centred healthcare system.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06341-3.

Examining the relationships between innovation, quality, productivity, and customer satisfaction in pure service companies

Purpose

This study investigates the relationships between innovation, quality, productivity and customer satisfaction in pure service companies. Previous studies have shown a negative relationship between quality and productivity in services. However, we argue the two can be positively related when innovation is present.

Design/methodology/approach

This paper develops and tests hypotheses using secondary data from COMPUSTAT, KLD STAT and the American Customer Satisfaction Index (ACSI). We test these hypotheses using ordinary least squares regression and conduct additional testing using path analysis.

Findings

The findings show that quality and productivity are positively related when innovation is present in pure service companies. The findings also reveal find that innovation is antecedent to both service quality and productivity which in turn positively affect customer satisfaction.

Practical implications

Both companies and customers can increase their outcomes including higher levels of service quality, productivity and customer satisfaction. Managers should therefore design innovative systems that enable customers to participate in service production. Other innovative systems may help to increase capacity utilization by smoothing high and low demand times, thus increasing both service quality and productivity.

Originality/value

This study contributes to service research by identifying innovation as the key to simultaneously increasing service quality and productivity. The authors find empirical support for a model in which service quality and productivity have a complementary relationship leading to customer satisfaction with innovation as an antecedent, and we do so using a sample of pure service firms.