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Lesson from Oncology Clinic on Improving Nonclinical-Support for Patients


When your patients are diagnosed with something as difficult as cancer every experience is amplified, including how they perceive overall care based on nonclinical staff interactions. One way to diminish some of that anxiousness is to make certain that your front office staff is empathetic and trained to address tensions that might arise for such patients. This study, published by Mayo Clinic, explores an all too forgotten aspect of patient care, frontline service employees, eg. receptionists. As you will read in this research, a patient’s perception of how the front of the office staff interacts with patients can dramatically influence a patient’s beliefs about the clinicians’ technical skills and expertise. Full text study available at the end of this article.

The study involved 2 stages that took place in an oncology clinic. First, during a 4-week period, 250 patients at each location completed a comprehensive survey about their service perceptions. Three weeks later, 12 receptionists at one of these locations (the “intervention” practice) received a full day of interpersonal skills training and education in communication, empathy, and service recovery; no intervention occurred at the other location. Two months after the initial survey, it was re-administered in the same way to 250 patients at each location. Usable responses came from 772 patients in all.


  1. Mean perception scores for interpersonal attributes, such as empathy as demonstrated by nonclinical staff, were significantly higher for the intervention practice;
  2. Mean perception scores were higher for clinical expertise for the intervention practice;
  3. Overall, “the service training and education intervention for oncology clinic receptionists improved patients’ perceptions of their performance not only on easier-to-evaluate attributes such as friendliness and explanation but also “spilled over” to positively influence perceptions of un- related, harder-to-evaluate attributes such as clinician expertise and skill,” according to the study authors.

The study authors emphasize that the importance of this data cannot be over-emphasized.

They write:  “Patient experience is shaped by every point of contact. Studies show a consistent positive association between patient experience and adherence to therapy, clinical effectiveness, safety, and utilization of care. As emerging value payment models incorporate quality and patient experience metrics into reimbursement rates, it is a wise investment for medical practices to evaluate every touch point of care. In addition, the overall patient experience affects practice reputation, by both word-of-mouth and on- line reviews.”

Nonclinical and clinical-support personnel have a powerful influence on how patients perceive their care experience. The researchers note, “Ignoring this reality means squandering opportunities to start patients out on the right foot at each care visit.” One patient commented on the dehumanization of their experience in the non-intervention office. “We are just like cattle in a corral, line up, hand out your card, don’t make eye contact, don’t ask any questions, here’s your paperwork, move along, next patient.”

How do you find empathic, organized and emotionally astute staff? The authors suggest first hiring the person, not the resume. Skills like teamwork, communication, emotional strength and core values of integrity and compassion can’t be found on a piece of paper. “Hiring staff with emotional intelligence is essential in medical care,” they write. They suggest that multiple people interview candidates and weigh in on the decision; include psychometric and personality tests, as well as open ended behavioral interview questions designed to measure a person’s values and emotional strength.

Beyond this, the study goes on to suggest these five medical practices that focus on nonclinical and clinical-support services:

(1) Creating strong first impressions at every care visit by prioritizing superb front-desk service;

(2) Thoroughly vetting prospective hires to ensure that their values and demeanor align with the organization’s;

(3) Preparing hired staff to deliver excellent service with a commitment to ongoing training and education at all staff levels;

(4) Minimizing needless delays in service delivery that can overburden patients and their families in profound ways; and

(5) Prioritizing the services that patients consider to be most important.

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