Our Measurable Indicators Tell Us That Our Patients
Are Experiencing A High Level Of Care (Lesson 7)

Most organisations that care about the experiences they deliver have certain measures surrounding those experiences.

These measures often run right through the organisation and may well be tied to performance indicators. They may even play a part in executive remuneration, so that if experience performance is at a certain level, there will be a decent bonus at the end of the year.

There is just one problem with all of this. These measurable indicators can often be wrong.

Let’s use a simple example. Imagine that John Smith works at a call centre and answers 10 calls an hour. Hooray for John! He is servicing 10 customers an hour. John is doing a pretty good job.

However, just because you know that John is servicing 10 customers an hour, there is nothing to show that the customers are getting what they want. All you know is that John picks up the phone 10 times an hour.

Let’s look at one hour’s worth of calls. It’s entirely possible that of those 10 calls, three of them were from the same customer. Perhaps the phone got disconnected or the person didn’t get what they want and called back.

Of the seven remaining calls, there is no way to understand if John was able to solve their problem, answer their questions, or even if he spoke to them in an appropriate way. John might be really good at answering the phone and really bad at doing his job.

Satisfaction Guaranteed?

When you are using traditional measures, it is very difficult to understand if you are doing what the customer has asked you to do. In fact, service metrics like Net Promoter Score have been found to be severely ineffective predictors of experience.

The biggest reason why they fail is because they are metrics. Distilling an entire interaction down to a few numbers tells you nothing about the interaction itself.

In 2013 the International Journal of Research in Marketing published a satisfaction study which found that such metrics were unable to predict whether growth, margins, or cash flows would change as a result of satisfaction metrics.1

So why is this?

You may have experienced phoning a call centre, getting to the end of the call and being asked if the person answered all of your questions. If the answer is ‘no,’ then what was the point of the entire phone call before that point?

Exactly what the customer wants and needs should be very clearly established at the beginning of the call. You should never need to work out whether or not you’ve given them what they want.

On Target, Off The Mark

In healthcare, this problem of failing to provide the patient with what they want and need can arise in many different ways. We can relate this directly to the example of the call centre. It could be someone telephoning a helpline for information. It could be someone calling a clinic to try and get a prescription renewed.

At the same time, it could also be a question of the number of times a patient needs to go back to a clinic to get their needs met.

Let’s say that you go and see your doctor and they give you three slips. The first requires you to go to a pathology lab to get a blood test. The second requires you to go to a pharmacy to get a prescription. The third requires you to go and get some kind of scan or x-ray.

From the doctor’s perspective, they have met their targets. They can tick the box and move on. They treated the patient, and the patient has walked out the door. The patient is still going on the journey. However, the doctor has no insight into that.


1 van Doorn, Jenny et al. “Satisfaction as a predictor of future performance: A replication.” The International Journal of Research in Marketing. Volume 30, issue 3. September 2013. Pages 314-318.
https://www.sciencedirect.com/science/article/abs/pii/S0167811613000463