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Looped In: The Measuring Customer Satisfaction Initiative

Understanding and Improving the Customer Experience Across ISG Systems  

Chelsea Brigg

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My Journey into Hospice Care
for Empathy Building 

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WE MUST FIRST BUILD EMPATHY

The term Human-Centered Design perhaps misses the mark. While design is an element of what we do, it is not the focus. When peeling back the HCD processes and methods, our core duty is problem solving through the lens of an impacted group. The problems we work to resolve just happen to have a design element (usually). For example, here are a few problems I have worked to address:

• The public needs to receive health guidelines from the world’s leading medical researchers.
• US citizens need highly informed legislation that leverages up-to-date policy research.
• Caregivers of sick children need to quickly find and schedule with specialty care physicians.

While it might seem like a matter of semantics, the focus on problem solving over design does have merit. Approaching work from the perspective of acting to solve problems on someone’s behalf implies a very specific call to action: we must first deeply understand that group of people and how they are impacted by the problem. Or in simple terms, we must first build empathy.

Sometimes as Human-Centered *Problem Solvers*, we walk into a project with empathy in hand because we too have had the same problems as our audience. For me, this has rarely been the case. I have almost always worked to resolve problems for people living entirely different lives than myself. For this reason, it has always been paramount to begin new work by immersing myself in the realities of the problems at hand and understanding the people who are impacted. Sometimes this process takes me to unexpected places. The most memorable of which led me to spend my Sundays at a local hospice supporting terminally ill patients and their families.

Image RemovedI was hired as the lead user experience architect for the development of a new VITAS Healthcare website, one of the largest hospice organizations in the country. My excitement for the opportunity was somewhat overshadowed by the fact that I had personally never set foot in a hospice and did not understand the scope of the problem space. I typically would start a project like this by interviewing people who were experiencing an existing process. But in the case of hospice care, it felt inappropriate to reach out to patients and family members with such a request. I realized early on that if I wanted to truly understand the problems of these groups in a real way, I needed to immerse myself in a hospice.

A CALM PRESENCE

As I started interviewing dozens of internal VITAS stakeholders during the day to understand their perspective on the problem space, I also worked to become a certified hospice patient companion at night. I picked up a volunteer shift at a local hospice and spent a few hours each week going from room to room supporting patients and their families.

When patients did not have visitors, I would keep them company, read nature poems, watch old movies, or even act as a bridge in communicating their needs to the care staff. I spent most of my time in rooms without visitors that had dressers without flowers or cards. I would help patients’ families and visitors however I could, as they said their goodbyes. Even simple things like a calm presence or grabbing a soda for someone during such a time could be meaningful. Family members sometimes needed someone to talk to about the weight of the experience. I listened much more than I spoke, and here are three themes I heard most often:

• Patients’ families are often unaware of hospice benefits provided by American taxpayers through CMS. This leads them to wait too long before getting the support they need. I often heard people say, “we wish we knew about hospice sooner.”
• Families also wait to initiate care because of misconceptions about hospice and palliative care. A key misconception is that hospice happens at a hospice. Many hospice patients simply receive care in the privacy and comfort of their home.
• Families often need just as much support as patients during and after their loved one’s hospice experience. For this reason, many hospice organizations offer free services to family members to support their spiritual and mental health.

As I sat with patients and families each week, it became clear how I could use the VITAS project to not just “design” a new website, but to alleviate problems with the hospice experience. I understood how we could use the site navigation and homepage to address some of these themes. And how integrated marketing capabilities could help with awareness and misconceptions. I had built a level of empathy that made me a better problem solver and advocate for hospice patients and their families.

5 mins

In recent months you may have heard about the ISG Measuring Customer Satisfaction Initiative and wondered what our team is up to. Here we’ve answered some common questions about the work, how to get involved, and everything you should know to be looped in. 

What is CSAT? 

Customer satisfaction refers to initiatives that allow an organization to gather feedback from its customers about how well it is delivering its products and services and how it might improve delivery. Customer research methods allow us to answer a wide range of questions to better serve our customers. We often prioritize research methods that answer specific and immediate questions for our projects at hand. How much time do users spend on a critical task? Do customers understand our instructions? Though, questions that yield insights for the totality of the customer experience (CX), such as customer satisfaction questions, help us to strategically inform project planning and prioritization across the enterprise. 

While customer satisfaction as an idea is a general one, CSAT is more defined and refers to a particular type of customer feedback survey. CSAT surveys allow customers to assess and provide feedback, both quantitative and qualitative, on customer service and product quality. 

CSAT surveys are an ‘always on’ method of continuous data collection that allow us to measure aspects of the CX. These surveys typically provide insights related to: 

• Overall customer satisfaction 
• Ease of use 
• Efficiency 
• Open-ended, qualitative feedback 

Most commonly, CSAT surveys are delivered to customers via email or in the context of a user interface, with a site intercept survey tool/form. The latter has many benefits, most importantly that customers can answer questions while immersed in the experience when it is most fresh in their minds. 

Measuring the CX with a CSAT survey is an excellent step toward continuous improvement, but it’s what we do with the insights to drive and improve the experience that really counts. For this reason, it’s crucial to have a process in place for making sense of data, especially open-ended, qualitative feedback. 

What You Need to Know About the Initiative 

The goal of the ISG Measuring Customer Satisfaction Initiative, simply put, is to create a consistent and repeatable external customer feedback loop across ADOs and ISG-supported information systems, allowing teams to measure the CX and efficiently improve these experiences based on these new customer data points. 

Our benefit hypothesis is that obtaining CSAT data will result in: 

• Consistently tracked customer satisfaction and opportunities for improvement 
• Ability to provide consistent, recurring framework for reporting and objective-setting from ADOs on research and design 
• Business cost and time savings by reducing mistakes and need for rework  
• Quantitative indicators of how HCD adoption leads to improved customer satisfaction 
• CMS/ISG alignment with other agencies to improve the public’s trust in federal government  

Our focus is to create customer feedback loops across external-facing ISG systems via site intercept surveys. We are specifically addressing external-facing systems for the first phase of this work and hope to also expand this work to internal-facing systems in the near future. The site intercept survey tools we’ve prioritized for this work include Survey Monkey, an enterprise solution, and Touchpoints, a GSA developed tool for government agencies. 

How We Can Help 

The HCD Center of Excellence is here to support you as you participate in the initiative. We can partner with you through key tasks, such as: 

• Establish and test a site intercept survey tool
• Determine questions for satisfaction, ease of use, and efficiency
• Define a statistically relevant sample for continuous data collection
• Resolve PRA coverage and Information Collection Request (ICR) for site intercept survey
• Complete and submit Third Party Website and Applications (TPWA) form for the site intercept tool
• Determine approach for survey display 

Next Steps 

As we partner with teams across ISG to accomplish this work, we also plan to share our progress through case studies and lunch ‘n’ learns. If you have any questions about CSAT surveys, the ISG Customer Satisfaction Initiative, or would like to be added to our email distribution, please contact us at hcd@cms.hhs.gov. We look forward to working together and keeping you looped in to this work. 

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