Category Archives: Practice Management

A 5-Star Pre-Op Experience is a Booklet Away

Remember the days before navigation systems and Google maps? The best way to plan a vacation included a stop at AAA to get your TripTik. It gave you a detailed door-to-door map of what to expect on your journey.TripTik

With your TripTik, you were ready to go. You had a plan; including important details like locations of rest stops, restaurants and gas stations along the way. Travel stress was virtually reduced because you depended on this important tool to guide your trip. Your TripTik enhanced your vacation experience.

Providing a surgical TripTik

A well-executed pre-op booklet provides the same comfort to your patients. It enables them to look at their surgical journey by smaller segments or to preview the entire trip. It decreases the chances of getting lost or being unnecessarily anxious.

If you think about it, the cosmetic surgery experience has a lot of similarities to the vacation journey. The written documentation is a reference guide for the surgery journey.

Many patients are undergoing surgery for the first time and are nervous and apprehensive. They are unclear about medications, preparations and what to expect post-operatively.

Despite the amount of information available online, patients regard the practice as the expert. They expect the practice to be proactive and anticipate their needs. Personalized pre-op materials provide the patient with the same peace of mind as the TripTik. Pre-op booklets enhance the patients surgical journey.quinn-pre-op-materials

Ensuring peace of mind

Well-informed patients are happier patients. Careful preparation can minimize anxiety and improve compliance. Patients are better prepared for surgery and more importantly, are calmer and less needy during recovery. Pre-operative preparation is vital to patient safety and a key nursing role.

Beginning with the end in mind

Based on RealPatientRatings data from over 88,000 patient responses, a customized pre-op booklet increases patient loyalty by 72%. Pre-op booklets are both a care strategy and a practice growth tactic.


Going back to the basics

Pre-op materials should be well organized and easy for patients to access. The form in which they are delivered impacts the usefulness to patients. Like a TripTik, we believe the materials should be bound and follow the sequence of the surgical journey.

The materials should include:

  • Pre-op preparation
  • Medications to avoid
  • Post-op instructions
  • Detailed recovery information
  • Contact information for key staff members

Make sure all information is current and up-to-date. If there are multiple procedures, either remove any conflicting information or highlight the directions you want the patient to follow.

Sending in advance

We have found patients are more satisfied when they receive the materials prior to their pre-op visit. Encourage patients to write questions throughout the booklet so that their specific questions can be answered at the pre-op visit. The goal is to reduce anxiety and have patients approach surgery with greater peace of mind. As an added bonus, well-informed patients call the practice less frequently after surgery and their questions in post op visits are reduced.

Practices who utilize thorough, personalized materials consistently exceed their patients’ expectations. They receive more 5-star reviews like this and fewer post-op calls.


Take the time to review your materials and ask yourself, are these materials worthy of a 5-star review?

Looking for a way to improve your practice? Make the pre-op experience a priority in 2016. Increase likelihood to return by providing better information to patients during their surgical journey.

This article is part two of a three-part series based on an award-winning poster presentation delivered by April Linden at the American Society of Plastic Surgery Nurses (ASPRN) Meeting in Boston, on October 18, 2015. 

Implementing a 5-Star Patient Education Process to Drive Retention

Part 1: The Coordinated Pre-Op Visit

love-nurseImplementing a patient-centric, high touch pre-op visit can result in a 53% increase in patient satisfaction and a 37% increase in patient’s likelihood to return.

For plastic surgery patients, nursing plays an integral role in the delivery of care and has a direct link to patient satisfaction, which is the ultimate measurement of a successful outcome. Effective communication protocols improve outcomes and expedite the recuperation process.

Implementing a thoughtful and consistent patient friendly peri-operative education component and communication process increases satisfaction and dramatically decreases post-op calls. This plan consists of a coordinated pre-op visit, personalized pre-op materials and a proactive post-operative communication strategy.

More often than not, patients are confused about the surgery process, their specific procedure and have important questions to resolve. Nurses must display empathy and patience regarding their mental state.

To further complicate matters, the human brain forgets 90% of what is learned within 1 week. When we consider that patients will only remember about 10% of the information provided to them, it is clear that the pre-op visit must be a carefully planned process and include effective supporting

The best practice standard is to schedule a 1-hour pre-operative visit 2 weeks prior to surgery.

1. Prepare: Send the patient the personalized education materials in advance with a note encouraging them to review prior to their appointment and place sticky notes on any sections that are unclear.

2. Educate: At the visit, the nurse should review the relevant informed consent materials, and pre and post-op preparation instructions.  In this teaching role, the nurse educates and prepares the patient for the pending surgery process which sets the stage for a successful post-op recuperation and healing process.

3. Review: Next, the patient should be given the opportunity to address all of the items that they have flagged for review.

4. Confirm: As a last step, the nurse should inquire with the patient, “Did this visit cover all of the information that you anticipate needing as you prepare for and recover from surgery? Are there any remaining additional questions or concerns?” The nursing staff must confirm they have met the patient’s needs before they conclude the pre-operative

With proper pre-planning, the visit will be much smoother and meet the patient’s need for information.

This article is part one of a three part series based on a poster presentation delivered at the American Society of Plastic Surgery Nurses (ASPRN) Meeting in Boston, on October 18, 2015.


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Service Recovery: Why Early Warning Systems Aren’t Optional

Concerns about on-line reputation and strategies for reputation management are regular topics at Society meetings. Virtually every physician has experienced at least one harmful review. Negative reviews impact our reputations and, in the extreme, can stifle business growth. Despite the danger, very few practices institute early warning systems to decrease the likelihood of negative reviews.

A smaller subset of physicians who use ratings and reviews to market their practices tell a different story. These practices verify their own quality and use it to attract consumers to their brand. They can attest to the incredible sales and conversion benefits of proactively providing ratings and reviews to consumers for use in their buying process.

Regardless of your perspective on the ratings and review phenomenon, it’s time to adopt an unheralded methodology, service recovery. Viewed through the service recovery lens, a negative review reflects the organization’s failure to ferret out discontent and resolve it internally before it goes viral. Service recovery provides an early warning system that enables practices to resolve service issues privately and internally.

What is service recovery?

“Service recovery refers to the actions a provider takes in response to a service failure.[1] A failure occurs when customers’ perceptions of the service they receive do not match their expectations. By including also customer satisfaction into the definition, service recovery is a thought-out, planned, process of returning aggrieved/dissatisfied customers to a state of satisfaction with a company/service.”[2]

What are the effects of service recovery?

“A growing body of literature on service recovery suggests that a good recovery has a positive impact on satisfaction, recommendation intention, word-of-mouth, loyalty, image, and trust.”[3][4][5][6]


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“Some even argue that a good recovery can increase satisfaction to a higher level than if nothing had gone wrong in the first place, which is referred to as the service recovery paradox.[7][8] See chart showing the increase in customer loyalty after problem resolution.”

How do you start a service recovery program?

Go the source, your patients. Embrace feedback and use their disappointments as opportunities to improve your practice and your reputation. In this digital age, you must follow up to resolve the often justifiable concerns of your patients.

  1. Survey all patients post consult, post treatment and post op.
  2. Rate satisfaction using 5 point scale similar to ratings and reviews. Your internal scores provide insight into what public scores should be from verified patients.
  3. Follow up with individual patients who indicate they have an unresolved problem. Work with them to deal with the issues of concern. The higher the patient’s satisfaction with the outcome, the better it is for your reputation.
  4. Identify and resolve process issues which are reflected in low satisfaction scores of many patients, i.e., late clinics, lack of responsiveness or poor preparation for recovery. Low scores at consult impair conversions. Low scores post op reduce retention and referral.


Wise practices recognize the value of proactive customer service and responsive customer complaint systems. Service recovery processes can harness patient feedback and turn it into a valuable and profitable asset. The stakes are much higher among today’s perpetually-connected consumers, a reality smart practices should not ignore.

Marie Olesen
Founder, RealPatientRatings®
Advisory Board, Center for Services Leadership, W.P. Carey School of Business at Arizona State University

Note: Service recovery is an established methodology in the business environment. I’ve cited these studies because it is important that those of us in medicine adopt these processes rather than question the validity of the concept.

  1. Grönroos, Christian. “Service Quality: The Six Criteria of Good Perceived Service Quality.” Review of Business 9, no. Winter (1988): 10-13.
  2. Lewis, Barbara R. “Service Promises, Problems and Retrieval. Working Paper.” Paper presented at the QUIS, Karlstad, 1996.
  3. Maxham, James G. III. “Service Recovery’s Influence on Consumer Satisfaction, Word-of-Mouth, and Purchase Intentions.” Journal of Business Research 54, no. October (2001): 11-24.
  4. Spreng, Richard A., Gilbert D. Harrell, and Robert D. Mackoy. “Service Recovery: Impact on Satisfaction and Intentions.” Journal of Services Marketing 9, no. 1 (1995): 15-23.
  5. Smith, Amy K., Ruth N. Bolton, and Janet Wagner. “A Model of Customer Satisfaction with Service Encounters Involving Failure and Recovery.” Journal of Marketing Research 36, no. August (1999): 356-72.
  6. Tax, Stephen S., Stephen W. Brown, and Murali Chandrashekaran. “Customer Evaluations of Service Complaint Experiences: Implications for Relationship Marketing.” Journal of Marketing 62, no. April (1998): 60-76.
  7. Hart, Christopher W. L., James L. Heskett, and W. Earl Jr. Sasser. “The Profitable Art of Service Recovery.” Harvard Business Review 68, no. July–August (1990): 148-56.
  8. McCollough, Michael A., and Sundar G. Bharadwaj. “The Recovery Paradox: An Examination of Customer Satisfaction in Relation to Disconfirmation, Service Quality, and Attribution Based Theories.” In Marketing Theory and Applications, edited by Chris T. Allen, 119. Chicago: American Marketing Association, 1992.