Kerry D. Solomon, MD, had a very specific vision in mind when he left the Medical University of South Carolina and went into private practice. He wanted to deliver state-of-the-art, best-in-class cataract and refractive surgery with an emphasis on surgical outcomes, customer service, and the patient's experience. He wanted patients to be impressed by how well they could see after surgery and amazed at the attention to detail and the level of personalized attention that each member of the team delivered, from the initial call through the end of the postoperative period. He wanted his team to work as a welloiled machine and to exude professionalism like the staff at a Ritz Carlton or Four Seasons hotel.

Dr. Solomon's goals arose from his keen awareness that patients can choose where they go for eye surgery, and he wanted them to select his practice over all of the others in the area. The majority of his patients come to him via word of mouth based on other patients' positive experiences.

With his vision clearly in their minds, Dr. Solomon's team members (Figure) set out to redefine the patient's journey in the practice. They began this daunting task by breaking down each “touch point” of a patient's progression through the evaluation process for either cataract or LASIK surgery. The staff timed how long each task took to execute and how long the patient waited before and after it was completed. Dr. Solomon and his team leaders identified the critical factors for success for each step and created mandatory best practices that would be implemented by every staff member.

The following touch points highlight the team members' process to ensure that the patients in their practice were treated like family and received the best care and service.

Welcome Area/Check-in

The front desk is patients' first in-person “touch point” when they enter a practice. It is important to set the stage for a positive experience by promptly greeting patients as they enter and immediately gathering the data needed to facilitate the process. The front desk staff should also establish proper expectations of what will happen during the visit.

Checkpoints for Check-in

1. Was anything mailed to the patient prior to his or her visit?

• educational materials
• lifestyle questionnaire
• practice forms

2. Did the patient complete these materials and bring them to his or her appointment?

3. Was the patient called to confirm the appointment? When called, was he or she asked to review the mailed materials?

Checkpoints for Welcome Area

1. Is the area clean and organized?
2. Are brochures visibly displayed and up to date?
3. Is water/coffee available?
4. Is there an overwhelming number of magazines?
5. Is there a balance between magazines and educational materials?

Testing

Although this touchpoint appears to be pretty straightforward, a few qualities in the testing area help to ensure the patient has a top-notch experience. The information gathered during this time is critical to a successful visit.

Efficiency. The technician should be able to expertly navigate through the series of tests accurately and efficiently.

Precision. These results matter. The surgeon counts on them to provide the best recommendation to the patient. It is important to train and retrain technicians to execute the tests and use the equipment with precision and ease.

Education. The educational process happens throughout the patient's journey, and the testing area is no exception. Technicians should use this time to gather important information about the patient and his or her desired visual acuity in a conversational manner.

Checkpoints

1. Did the technician ask the patient about his or her hobbies or lifestyle?
2. Did the technician explain that different technologies may enable the patient to see better without glasses?
3. Did the technician briefly explain what each test was for and what to expect next?

Evaluation

The evaluation is the surgeon's time to shine. If their visit is progressing properly, patients will now have a basic understanding of their condition, their desired visual acuity, and the procedures that may be offered to them. Armed with test results and the medical evaluation, the surgeon can make the best recommendation possible.

This is the critical point of the journey: patients have been waiting to speak with the expert. Surgeons should take their time with each patient and help him or her understand what types of intervention they can offer. Surgeons and their staff do this every day, but patients hear this information only once.

Checkpoints

1. Did the surgeon make a solid recommendation?
2. Did the surgeon ask the patient if all of his or her questions had been addressed?

Scheduling

The road to surgery is almost complete, but the patient's journey extends far beyond the procedure. Scheduling surgery is a big step, and in a world of advanced-technology procedures, it is often one that requires the patient to agree to a major expenditure. This is the time to ensure that all of his or her additional questions are answered and that the patient is comfortable with the surgeon's recommendation. A careful explanation of the covered and noncovered services is a must, and offering financial service plans is always valuable in helping the patients to achieve their goals.

Checkpoints

1. Did the staff re-educate the patient if necessary?
2. Did the scheduler offer financial service plans?

Surgery

The big day is finally here. The patient's journey must continue to include the same level of service at the surgery center/ hospital. Putting patients at ease requires a team effort. The more organized everything is, the better the experience will be. Staff members should make sure that all important information has been communicated to the patient in advance so that the only thing left for him or her to do is relax and put his or her vision in the surgeon's trusted hands.

Checkpoints

1. Were postoperative instructions provided in advance?
2. Will a team member call to check on the patient that evening?

POSTOPERATIVE CARE

The journey is complete. The patient has achieved his or her desired visual acuity and has experienced exceptional clinical expertise and customer service. This visit permanently seals the impression and immediately segues into word-of-mouth referrals. Happy patients tell a few people, whereas unhappy patients tell many. For that reason, it is essential to maintain quality all the way to the end. These patients are now part of the practice's family.

Checkpoints

1. Did a staff member ask for a testimonial?
2. Did a staff member remind the patient to tell his or her friends about his or her exceptional journey?

CONCLUSION

Dr. Solomon and his team use this approach every day, and it's the one that brought the cataract evaluation experience down from more than 3 hours to slightly more than 1 hour. Their patients routinely comment that they are thrilled, not only with their vision, but also with the service they received.

Dawn Thompson is the cofounder and director of BMC Strategic, a consulting and advertising agency that provides services to manufacturers and surgeons. Ms. Thompson may be reached at (415) 531-0367; dthompson@bmcstrategic.com.