Best practices for basic and advanced skills in health care service recovery: a case study of a re-admitted patient.

BACKGROUND: Service recovery refers to an organizations entire process for facilitating resolution of dissatisfactions, whether or not visible to patients and families. Patients are an important resource for reporting miscommunications, provider inattention, rudeness, or delays, especially if they perceive a connection to misdiagnosis or failed treatment. Health systems that encourage patients to be "the eyes and ears" of individual and team performance capitalize on a rich source of data for quality improvement and risk prevention. Effective service recovery requires organizations (1) to learn about negative perceptions and experiences and (2) to create an infrastructure that supports staff's ability to respond. Service recovery requires the exercise of both basic and advanced skills. We term certain skills as advanced because of the significant variation in their use or endorsement among 30 health care organizations in the United States. BEST PRACTICES FOR BASIC SERVICE RECOVERY: On the basis of our work with the 30 organizations, a mnemonic, HEARD, incorporates best practices for basic service recovery processes: Hearing the person's concern; Empathizing with the person raising the issue; Acknowledging, expressing appreciation to the person for sharing, and Apologizing when warranted; Responding to the problem, setting time lines and expectations for follow-up; and Documenting or Delegating the documentation to the appropriate person. BEST PRACTICES FOR ADVANCED SERVICE RECOVERY: Impartiality, chain of command, setting boundaries, and Documentation represent four advanced service recovery skills critical for addressing challenging situations.
CONCLUSION: Using best practices in service recovery enables the organization to do its best to make right what patients and family members experience as wrong.