Service design for improved satisfaction: Decoding the mechanism for impact of patient callback in emergency healthcare

Healthcare delivery is becoming a significant proportion of the service economy around the world. Within healthcare, the emergency department (ED) constitutes one of the most challenging areas of service delivery. Patient (customer) arrival is highly unpredictable, job scope is variable and uncertain, and timely service response is essential to save lives. In addition, emergency physicians and hospitals may soon be monitored and compensated based on patient satisfaction measured after service delivery. In this paper, we seek to understand how a process design piloted at two academic EDs-involving the addition of a new process step that uses health provider follow-up patient calls after discharge from the ED-influences patient assessment of the service. We examine the overall impact of this process redesign on patient satisfaction as measured by the "likelihood to recommend" question on patient surveys and develop an identification strategy to uncover the mechanism by which callbacks influence patient satisfaction. Our findings indicate that the follow-up callback design improves patient appraisals across the board, and not just as a service recovery tool where it moderates the assessment of select patient groups. These findings can help hospitals implement a redesign of the ED service process for callback in an effective manner. Underlying fundamental implications and future work possibilities are discussed.