Measuring to improve.

Abstract

Rush Prudential Health Plans, a managed care company located in Chicago, Illinois, is implementing a service quality improvement process across the three products it markets in the Chicago area: The Anchor Plan (a primarily staff model HMO), The Affiliates Plan (a network model HMO), and The Plus Plan (a point of service plan). In 1994, the company instituted an annual member satisfaction research study, conducted across the three plans, and began building a link between external customer requirements and internal operations. The research process consisted of three stages: determining external customer requirements, translating these customer-defined "symptoms" into underlying root causes, and developing a service quality improvement action plan. Rush Prudential determined that traditional "report card" surveys would not meet their goals for the information measurement process. A detailed diagnostic telephone survey was used to provide a picture of the entire clinical encounter, from scheduling an appointment through the time a member left the physician's office.