Someone jokingly said customer care meant that the customer rendered the service. As funny as that sounds, that tends to reflect the quality of customer service with is offered to many clients and customers in various industries in Ghana. The health sector is not immune to this problem.

Whoever coined the phrase “Ghanaians are very hospital people” must have been joking at the time, but it has been widely circulated and believed. Ghanaians are not any more hospital than the people at the North Pole.

Because the health sector has been largely socialized by various governments for political expediency, it has been difficult to inject sound business practices into the sector. The result of this is an entitled patient and a disgruntled service provider.

I have met with patients in both public and private hospitals who are just downright rude to health workers. Those same patients will quietly sit and wait for hours to see some politician in their office. I have also known rude healthcare service providers. There are rude people in every industry.

No one is born with good customer service skills, anymore than anyone is born with the inherent ability to fly a plane. Customer service is a skill. It must be taught.

Major corporations spend significant portions of their revenue on customer care training for their staff. Unfortunately the Health Sector has largely left customer care to the discretion of the staff. Both public and private hospitals are culprits.

People will generally buy goods from people who treat them well, and the same thing extends to the service industry. Banks that have excellent customer service generally do better than those that mistreat their customers. People will keep seeing a doctor they like and trust, and who treats them well. They will keep their distance from one who does not treat them well.

At the bedrock of customer service is quality medical care delivered by highly competent professionals. This is however not enough to make the patient satisfied.

Customers expect attention and communication from their service providers, whether it is at the bank or in a hospital. The hospital patient is however unique. This is primarily because a hospital is not a natural place where anyone would want to visit unless they absolutely had to. The hospital is largely an unfamiliar and scary place for many. This is part of why it is important to make the experience a less painful, if not happy one, for the patient.

One key element which impacts the quality of care is the waiting period. Long waiting periods simply aggravate an already fragile situation. A patient who comes in for an appointment and has to spend 45 minutes in the waiting area before being attended to is more likely to be dissatisfied with the quality of care than one who is promptly seen to. Patient satisfaction has been proven to be inversely related to waiting time. This is not surprising.

In order to reduce waiting times, the first thing a facility needs to do is actually track a patient from the time they entered the facility till the time they left. This can be manually done by the staff, using timing chits which are given to the patients upon arrival at the health facility, with the time the patient gets to each station being documented by the staff at that station. It can also be done using hospital management software, many of which have this feature. It is important to actually measure this index, because it is in measuring the index that you can actually do something about it, and then you can actually see later if you did succeed at it. Generally speaking, even though there is no specific ideal waiting period per se, studies generally agree that thirty minutes is a reasonable maximum. I personally think that for a patient who actually scheduled an appointment and shows up on time, fifteen minutes should be the maximum amount of time they spend waiting to see the doctor. Some other factors which may affect the patient’s satisfaction include the condition of the waiting area, whether or not the staff are friendly, and the availability of entertainment. All these factors can either enhance or diminish the patient’s experience.

It is incumbent upon hospital managements to adopt proper strategies to curb prolonged waiting periods in their facilities. The impact of poor customer service on hospital earnings cannot be overemphasized. Whereas previously patients did not have many options, that situation is fast changing, with the springing up of various health centers particularly in the city. While it may be true that those other facilities may not offer any superior customer service, the patients have not found out yet and will leave your facility first, which will lead to a loss in revenue and possibly reputation for you and your facility. The social media age has brought with it some challenges for health service providers. Various online platforms afford aggrieved patients the opportunity to vent their displeasure publicly. An aggrieved patient could easily post a negative public review.

What factors affect the waiting period in hospitals?

The first factor is inadequate staff strength. Many facilities do not want to invest properly in manpower, and will staff a busy reception with one receptionist to attend to dozens of patients at a time. This of course slows things down significantly, and adds several minutes to the waiting period.

If the number of nurses are disproportionate to the number patients waiting, those patients are going to end up spending longer than expected periods of time waiting.

Other hospital workers such as laboratory technicians, pharmacists and even accounting staff must be adequate. It can be quite irritating for a patient to spend 15 minutes with their doctor and 30 minutes trying to pay to the cashier.

When hospitals fail to hire the right number of staff, the few left doing the work quickly get overwhelmed and become inefficient as a result. The patient bears the brunt of this inefficiency. Names get misspelled, folders get misplaced, minimal attention is paid to the patient, the tendency to be curt with the patient increases by the hour, and the end result is a disgruntled customer right at the beginning of the provision of the service. It is important to adopt best practices from around the world and implement them in our health facilities. There is no need to reinvent the wheel. There are simple algorithms that can tell you how many patients one receptionist can safely attend to, and how many nurses are required to take care of 5, 20, or 50 patients. Some health facility owners are only interested in meeting the bare minimum requirements of staffing, even when their patient load strongly suggests otherwise. For example, the Ministry of Health stipulates that a hospital must have at least 8 full-time nurses, while a clinic must have at least two full-time nurses. The management of the facility must apply the common sense to know whether or not their eight or two nurses are adequate to meet the needs of the patient. If a clinic sees one hundred patients in a day, it would be nonsensical to keep only two full-time nurses on staff. Sometimes too, because of the penny – pinching approach of some business owners, they fail to attract the right caliber of staff. Owning a health facility can be lucrative if done right, and many non-medical persons are opening clinics. This is a good thing for the community because there is increased access. Some of these facilities, however, are primarily profit-driven, which leads the owners to cut costs wherever they can. Unfortunately, they may even cut cost on the essentials, which includes manpower. The outcome of this is facilities that are overcrowded with patients and manned by inadequate staff. 

Service delivery can be greatly enhanced by the right tools. For instance, the use of an electronic sphygmomanometer can greatly streamline the flow of patients in a busy clinic OPD. The use of an infrared thermometer instead of an axillary thermometer can have the same effect. These two equipment alone when properly deployed can cut the patient’s time spent at the nurses’ station in half.

In short, one of the major determinants of customer care is the waiting time in hospitals and clinics. The level of satisfaction by the patient is inversely proportional to the length of the waiting period.

It is important to objectively measure and track the waiting period so as to be able to effect any meaningful change.

The waiting experience needs to be improved for the patient, with proper attention needing to be paid to the air-conditioning, the provision of refreshments and entertainment, and the availability of reading material.

The right caliber and number of staff must be hired, and the right tools must be deployed in order to streamline patient flow.

These will go a long way to affect one of the key determinants of the quality of service.