Tuesday, July 10, 2012

7th Rule for Customer Satisfaction Surveys

A little over a year ago I wrote my rules for satisfaction surveys (see http://www.medicallaboratoryquality.com/2011/06/satisfaction.html)  which basically points to keeping them short, focused, and customer friendly.  In my opinion the rules are a pretty solid foundation for effectively learning information from your clients about the quality of service that you provide.
Since the original writing I have appreciated another truth, that I think is strong enough and valuable enough to become a seventh (7th) survey rule.  

Ask the question that needs to be asked, even if you may not like the answer.  

It’s very easy to create surveys that will always give you positive feedback by simply avoiding any potentially controversial or challenging issues, but how can you study or learn what people think if you don’t open up the discussion.  I will give an example.  

Previously I wrote about our supplemental gram stain program [ see http://www.medicallaboratoryquality.com/2012/06/eqa-and-continuing-education-saving.html ] and that we have recently done a new participant opinion survey .  Well the report is now complete and the results are available.   You can read the report at http://www.cmpt.ca/pdf_other_surveys/2012_Supplementary_Gram_Program.pdf

First I can tell you about the easy to interpret positives. 
When we asked if the survey responders were the people that actually looked at the slides we found that the vast majority did, either as the primary examiner or the reviewer.  That is a good thing because it enhanced the value of their response.

The vast majority thought the slides were of a consistent good quality and looked like and stain like typical clinical samples.  Second one hundred percent of respondents thought the program provided acceptable or better quality educational value.  And third, when thinking about all the slides, and their delivery and the educational value ninety-six percent give us a thumbs-up.  All-in-all I consider that a positive message.

But despite that if we have a single problem it has been working through the technical aspects of laying down good host inflammatory cells into the slides so that they look like typical clinical samples.  That has been a real struggle.   

In our larger Gram stain program we asked participants in 2008 about the cells and 30 percent gave us a thumbs-down as either unacceptable or poor.  So we have spent a lot of research and development time trying to solve the problem, and from our perspective we have moved forward a long way.   
Without getting into detail we have done a lot of work on cellular fixation and storage and their delivery onto the glass slides. From our Quality Control we see less rounding up of cells and greater stability.  We have also learned how to apply either neutrophils or mononuclear cells (aka lymphocytes) so that we can provide slides to simulate both acute and chronic meningitis.  

So when it came time to do this new survey it was clear that we had to ask about the quality of the cellular component.  What would be a great story would be for us to find a clear level of improvement in the participants opinion.  Unfortunately it did not work out that way.  

 While there was improvement, it was neither substantial nor significant.  

I could be satisfied that a clear majority see the cells as OK, but that is not how Plan-Do-Study-Act works.   We have some more thoughts on how to get to the root of the problem.  Maybe it is a damage during transport issue, or maybe it is an interpretation issue.  We have to get the participants slides back and see what they are seeing.  It will take some more planning and some more time.  But at least we are working with information and the knowledge that we are in the right direction.

So the old Clinton model of Don’t Ask and Don’t Tell does not work as a Quality monitoring strategy.  Ask the question that needs to be asked, and continue on. 

Continual improvement. 

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