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Tuesday, July 12, 2016

The Difficulties of Incenting Performance on Customer Satisfaction or NPS

Here's a new perspective on a debate that has raged for years.  The question is it productive or counterproductive to tie employee incentives into improving customer satisfaction and/or NPS scores.  On the one hand the argument has always been that incentives are a great way to get management and staff to pay serious attention to improving the customer experience.  On the other hand there is the concern that incentives lead to attention being paid to fixing the score rather than addressing real customer issues (aka fixing the store).

Been in a Hospital Recently?

The new discussion is centered on some big money ($1.5 billion) of your tax dollars that’s up for grabs out of Medicare and Medicaid Services, and the prescription drug opioid epidemic.  The plan is certainly well-intentioned.  Patient satisfaction is to be measured on an ongoing basis.  Satisfaction levels account for 30% of each hospital’s performance score, and pain management is one of eight dimensions of that total.  All that leads to a debate about two questions that are required to be asked in the customer satisfaction questionnaires by every hospital receiving federal funding:

  1. “During this hospital stay, how often did the hospital staff do everything they could to help you with your pain?”
  2. “How often was your pain well controlled?”.

Getting the Intended Results?

Some physicians contend that the government's policy and the questionnaires, while not totally causing the problem, are contributing to the problem of opioid over-use.  They contend that the money at stake and the related demand for better scores is influencing presriptive-practice.   After all, the easiest way to eliminate pain is with narcotics, and opioids (though not always necessary) are the drug class of choice.

The opioid-addicted know the game in advance and how their threats and complaints can make desired narcotics more easily available.  Afterall, most patients desire the total absence of pain. The patients' desires and the goal of increasing institutional standing places physicians in a very difficult situation.

What Approach Is Your Organization Taking?

Most companies that we know do - in one form or another - link incentives to overall satisfaction; NPS scores; or other specific questions included in their customer surveys.  The selection of these key question(s) raises many pragmatic issues.

  1. Are they truly the most important factors?
  2. Are they factors that employees can control?
  3. Are they short-term measures that could actually lead to bigger problems in the long term?
  4. How will these questions inhibit or promote ‘gaming’ by customers or staff?
8:33 pm edt          Comments

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