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GPTB | COMMENTARY

August 17, 2004

Rearview No Place to Look for Future Hospital Image

by Rick Blizzard, D.B.A.
Health and Healthcare Editor
As a senior consultant for Gallup Healthcare, Dr. Blizzard helps to lead Gallup's efforts to measure and serve the healthcare industry. In his 12 years at Gallup, Blizzard has consulted extensively with healthcare organizations about public, patient, physician and employee perceptions and their implications.

Community image studies, which measure the public's knowledge of, and feelings about, an organization, allow healthcare decision-makers to plot strategy based on data rather than subjective opinions. But while necessary, measurement and analysis are not sufficient to improve a hospital's community image. Managers must organize and interpret the data in a logical way in order to use them with some degree of success.

Using community image data to support decision-making requires answering four basic questions about where a hospital stands in the eyes of the community.

  1. Where are we now?
  2. Where do we want to be?
  3. What are we doing right?
  4. What are the biggest barriers to reaching our objectives?

Where Are We Now?

First, hospitals must deduce what their communities feel about them at the time of the survey; this is the basic function of community image measurement. If you do not know where you are, it is impossible to plot a course to where you want to be. 

Community image is not formed overnight and will not change overnight. I've known hospital CEOs who have received calls from former patients complaining about experiences that happened five years earlier. I once stopped to ask directions to a hospital where I was presenting. The person I asked for directions didn't recognize the name. It turns out that the hospital I was looking for had changed its name more than five years before, but the person still identified it by its old name.

Once a hospital knows where it stands, it's important not to try to completely reverse the community image all at once.

Where Do We Want to Be?

The next step is for a hospital to decide where it wants to be in five years -- a reasonable period of time for community image change. A hospital's leaders may decide they want to increase the percentage of people in the community who prefer their hospital to their competitors, and increase the percentile of their patient satisfaction scores by a certain number of points. Once these decisions are made, that vision can be communicated to all levels of the organization.

What Are We Doing Right?

Rather than focusing on fixing what is wrong, hospitals should first determine what strengths they can build upon. For example, a healthcare organization should be dominant in its core market, and the initial focus should be on building performance in that area. Focusing on growth in secondary markets where the hospital isn't as strong is shortsighted if it leads to erosion of the core market.

What Are the Barriers to Reaching Our Objectives?

How can hospitals overcome the barriers to achieving a more positive community image? For example, if there is a nurse staffing problem, can the hospital reduce nurse turnover and increase recruitment by making their hospital a more desirable place to work?

Planning for the Future With a Rearview Mirror

When conducting community measurement, it's important to remember one basic truth: Current community image reflects the market structure of the past, because people's opinions about an organization are based on what has already happened. Strategies for improvement based on community image data must be designed to succeed in the future, because the competitors' strategies may also change.

The military developed the concept of "war games" in order to learn to anticipate responses from the enemy. This concept can work for hospital strategic planning. Here's how: After conducting its basic environmental assessment, including community image data, a hospital executive team divides into groups -- one for its own facility and one for each of its primary competitors. Each team develops improvement strategies for the coming year for its assigned organization. This helps executives to consider likely future competitor strategies, and modify their own accordingly.

Planning for future competitor strategies, rather than fighting the competitive wars of the past, makes sense and also moves numbers. Hospitals must ask themselves whether they are trying to move into the future while focusing on the rearview mirror, or developing strategies appropriate to the competitive landscape of years to come.

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