CAN STARBUCKS SAVE HEALTH CARE?

…IF NOT, MAYBE FOUR SEASONS HOTELS CAN!

With so much in the news today about improving health care, let’s remind ourselves who should be at the center of these improvement efforts: patients. In that spirit,

we might look to companies outside the health care sector that have figured out how to deliver consistently superb service. After all, isn’t service the most important element of patient-centered health care?

With their outstanding records as customer service leaders, both Starbucks and Four Seasons offer valuable lessons on improving focus and execution across a range of health care services.

Supporting the “Moment of Truth”

There are two keys to understanding those lessons: 1) finding the “moment of truth” in service delivery and 2) ensuring that everything needed to support that moment of truth is aligned. To secure this alignment, you need to ensure convenience, consistent service standards

and systems that help make the service delivery easier, quicker and smarter.

You’ll find Starbucks’ moment of truth in a fine beverage and the style with which it’s delivered. In routine health care, the moment of truth is the health care service you receive from the doctor or caregiver – not the peripherals around it.

The value in translating retail service and systems know-how into routine health care is beginning to catch on (see Joint Corp inset). It comes down to better systems and service standards, speed and the motivated human capital within an organization who support those systems and standards. This is where Starbucks and Four Seasons excel – and it can happen in health care, too.

The desire for Good Service is universal – the motivation to achieve it is not

When you compare strong retail service to health care service, a key difference stands out: motivation. As we’ve all experienced in retail and health care settings alike, the presence (or absence) of motivation can have a big impact on service.

BY JOHN B. RICHARDS

WITH THEIR OUTSTANDING RECORDS AS CUSTOMER SERVICE LEADERS, BOTH STARBUCKS AND FOUR SEASONS OFFER VALUABLE LESSONS ON IMPROVING FOCUS AND EXECUTION ACROSS A RANGE OF HEALTH CARE SERVICES.

Two insights emerge when you break it down this way:

Everything should be optimized to support delivery of the core service.

In retail, the objective is to stimulate initial trial and repeat. There is strong economic motivation to focus all aspects of the system – attitude, systems and process – on this objective. In health care, the objective is to respond to and manage a single event, not to stimulate repeat (who cares if they come back?). Because the motivation is reactive or defensive in nature, not proactive, the execution around the periphery of the service is likely to be less aligned (perhaps you’ve noticed) and certainly less satisfying.

Great systems facilitate great service

One can’t underestimate the role of systems in any service business, and today, those great systems are digital. A great system allows the human effort to focus on what it does best: delivering the care or the product to the patient or customer.

Starbucks has made a religion of optimizing operational flow and the systems that support it – all part of an ongoing quest to reduce the time of each transaction and allow customers to get what they came for as quickly as possible. Four Seasons wanted a fast front office system so front desk personnel could interact with guests and not stare at the screen (“eyes and smiles” as one general manager famously put it). These are lessons all health care providers can heed.

The second big benefit of good systems (there are many)1 is the ability to speed ordering or appointments and, as needed, payment of the transaction . Neither the entry into the service transaction or the exit of the transaction is something the consumer is looking to celebrate.

Here, Starbucks has added online ordering, Starbucks cards and loyalty systems after becoming an early convert to cashless procedures in its stores. All these efforts were undertaken to make the flow toward that cup of coffee quick and seamless. There was a time when those Starbucks lines were the stuff of legend.

No longer.

Do you think the receptionist at your doctor’s office has ever been asked to think about ways of “melting the line”? I know they have at Starbucks.

Operating standards to define and measure the service experience

Four Seasons Hotels pioneered the creation of systematic operating standards that defined how often creative, but always essential, services were to be executed

1 The promise of big data and its application to health care is truly mind boggling. Here, we focus only on the impact that systems have on good service operations.2 This process later migrated to Starbucks and Elizabeth Arden Red Door. Four Seasons has had well over 125 operating standards, Starbucks ~16, Elizabeth Arden Red Door ~52.

KEY ELEMENT RETAIL SERVICE HEALTH CARE SERVICE

Initial visit/contact • Stimulate demand • React to demand • Manage proactively • Manage defensively

Service “moment of truth” • Consumption of product • Initial consultation and service and treatment

Overall objective • Ongoing consumption • Successful outcome of care • Encourage repeat • No motivation to drive repeat

NEITHER THE ENTRY INTO THE SERVICE TRANSACTION NOR THE EXIT OF THE TRANSACTION IS SOMETHING THE CONSUMER IS LOOKING TO CELEBRATE.

1.

2.

KEY ELEMENT RETAIL SERVICE HEALTH CARE SERVICE

Initial visit/contact • Stimulate demand • React to demand • Manage proactively • Manage defensively

Service “moment of truth” • Consumption of product • Initial consultation and service and treatment

Overall objective • Ongoing consumption • Successful outcome of care • Encourage repeat • No motivation to drive repeat

in each guest experience.2 The standards covered how those services happen, what steps comprised them and what support, if any, was necessary to facilitate their execution (we will leave for another day the story of how toast stays warm throughout its journey from the kitchen to the guest room).

Proposals were tested, often timed and costed out, then shopped and measured for execution. Key to service execution was a “miss or make” mentality. Was the service executed to standard, or not? By defining the guest experience and comparing and scoring various locations, the company maintained a systematic view of its overall performance across each standard and experience.

So, when the phone rings, it must be picked up by the third ring and answered by a “real person.” I wonder if this happens in your doctor’s office or the clinic you visit? Does your clinic seem to obsess over the waiting time when you arrive or how long it takes the phone to be answered? Four Seasons and Starbucks do.

Motivated, focused staff

Four Seasons is legendary for its motivated, focused service staff. Management recognized this as a key priority in the early 80s. Treat people well and let them know you trust them, and the entrepreneurial service spirit to do the right thing will take over. They have achieved universal excellence by placing management priorities in the right place – with front line service people.

And, while Starbucks is no Four Seasons and doesn’t need to be (its service experience is certainly different), in its own way, Starbucks achieves superb performance in its sector. Their turnover is the lowest among quick-service restaurants (by far), and they offer a visible support structure that appeals to its typical target “partner,”3 including stock options, education support and advocacy of a host of causes that matter to this age group.

As a result, both companies perennially make the lists of the best companies to work for (wasn’t I lucky?). They understand that happy, motivated employees give good service. Certain health care companies are beginning to take this approach seriously, though those that cater to routine needs still fall noticeably short.

Addressing the motivation gap in health care by making the service objective clear and the environment supportive of service personnel will shorten the path to service excellence. I’d like my sprained ankle or gall bladder to get the same attention as my cup of coffee or hotel stay.

3 Starbucks called its retail store employees “Partners” from the beginning – getting the relationship off on the right foot.

ELEMENT ACTION OBJECTIVE

Systems Drive speed and ease of access Speeding intake and departure allows for greater focus on the essential service Operating Standards Define and measure the Identify bottlenecks, lower cost, service experience pinpoint weaknesses Well-treated staff A staff treated well means A positive attitude encourages a customer treated well service, problem solving and could improve outcomest

I’D LIKE MY SPRAINED ANKLE OR GALL BLADDER TO GET THE SAME ATTENTION AS MY CUP OF COFFEE OR HOTEL STAY.

John B Richards is the former

Executive Vice President of Four

Seasons Hotels, the President

of North American Operations

for Starbucks Coffee Company

and the CEO of Elizabeth Arden

Red Door and Dean and Deluca

during the formative growth

years of these companies. He

is currently an Advisory Partner

and Principal at the New England

Consulting Group. He has driven

service innovation across travel,

hospitality, QSR, retail and

healthcare services.

The Journey Ahead

If Starbucks and Four Seasons can, in fact, save health care, it will be by example: convenience-oriented systems, a defined service objective and measured customer experience with standards supported by a motivated and appreciated staff. They would also convey the understanding that an organization should devote the most time and attention to the service itself, not the peripherals around it.

And, before I begin to get hate mail from the AMA, or my doctor refuses to see me on my next visit, let me be clear. Routine care providers such as Minute Clinics, urgent care centers and nascent operations such as the Joint Chiropractic have begun to apply sound Starbucks-oriented retail principles to health service. But the journey is just starting (I would hazard a guess that a minute clinic never takes a minute – nor do the organizations that back them have strong service traditions).

More sophisticated health care visits (often hospital oriented), that by their nature take longer and involve more people, have also begun to see the impact of Four Seasons-oriented service attitude and discipline in some clinic operations. But those efforts also need to go much further and become more ubiquitous.

The experience of seeing a great doctor for an essential service shouldn’t be spoiled by a poorly trained or motivated service person on the front or back end of that experience (ask anyone who’s had to deal with a bureaucrat in the VA health system).

Companies like Starbucks and Four Seasons weren’t successful by accident. Our health care service shouldn’t be either.

THE LITTLE COMPANY THAT COULD The Joint Corp, a chiropractic services company, is beginning to

pave the way in patient-centered health care. The company provides affordable chiropractic care in retail-oriented clinics with no insurance, no appointments and quick, focused care. Its 350+ clinics are already in 30 states, serving more than 800,000 patients a year in visits that typically take 5-7 minutes. How is this possible? Guess.

Integrated patient record keeping and patient management systems

Defined operating standards

Doctor focus and attitude

Focus on routine care with no insurance speeds intake, convenient locations and no appoint-ments encourages repeat visits

The patient visit with ~16 standards allows for diagnosis of the visit to speed the process further

The company employs over 850 chiropractors. With no paperwork to worry about, the doctor can focus on care and enjoy his or her work again