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How Can Hospitals Polish Their Images?

by Rick Blizzard

First in a two-part series

In order to be successful in this era of healthcare consumerism, hospitals need to know where they stand in their communities -- how much the community supports them, where they stand relative to their competition, and how loyal their current customers are to them. One way to get answers to these types of questions is to conduct a community image study.

For more than 20 years, Gallup has provided healthcare organizations with credible measurement services to assist them in improving their image in the community. By keeping a tight focus on actionable research results, we've helped many hospitals use their data to drive continuous improvements. During that time, we've identified several basic questions any competitive image study should include to determine the position of the organization. The five categories of questions are illustrated in the hierarchy.

1. Awareness

The most basic question for a hospital to ask is: Does the community know we exist? This category includes "aided" awareness questions (such as "Are you familiar with XYZ Hospital?") and "unaided" awareness questions (such as "Please provide names of hospitals in your community").

In rural areas with few healthcare facilities, awareness of a specific hospital can be expected to be high. But in metropolitan areas with many hospital choices, only 20% or less of the community a particular hospital is intended to serve may be aware of its presence. Such unknown hospitals must build awareness before moving on to the higher levels of the hierarchy.

2. Knowledge

After determining who is aware of the hospital, the next question is what do those people actually know about it? Do consumers associate the facility (or other competing facilities in the area) with cardiac surgery, maternity, cancer care, etc.? How do they perceive the service delivery of the hospital? Which hospital in the community do consumers think has the best doctors, nurses, equipment, and technology?

Consumers are often aware of high-profile hospital services, such as heart, cancer, and stroke care, and frequently used services such as the emergency department and maternity ward. Hospitals need to know where they stand in these areas and who the market leaders are, so they can educate the community about what they have to offer.

3. Evaluation

Is what the community knows about a hospital positive or negative? In order to know what their strengths are and where their opportunities for improvement lie, hospitals need to know how the members of the community rank them in comparison with other hospitals.

4. Intent

One important measure in a community image study is whether consumers have a preference for one hospital over another and actually intend to use that hospital. It is not enough to simply ask consumers which hospital they prefer; the survey must also determine what drives this preference and how to incorporate these drivers into a marketing strategy.

One technique is to examine how various perceived attributes of a hospital impact people's preference for it. For example, in one market Gallup studied, a hospital ranked first in the socially desirable attribute of providing care for the poor and uninsured. However, the study also showed that people who assigned that attribute to the hospital were actually less likely to prefer it when it came to their own healthcare needs.

In another community, consumers said that having the best doctors and most modern equipment were the most important factors in determining their preference for a hospital. But when it came to the individual hospital being measured, consumers who identified it as having the best doctors and most modern equipment were no more likely than those who didn't choose that facility as their preferred hospital. The conclusion was that even though consumers were most likely to name that hospital in connection with those attributes, the differences were not great enough in the minds of the community to impact preference. Instead , several area hospitals were all viewed as having acceptable levels of quality for physicians and technology; true differentiation had not occurred.

5. Use

The ultimate measure for a hospital is, do consumers actually use it? If consumers are more likely to express a preference for a hospital than they are to use it, intervening factors such as insurance coverage or physician preference could be at play. In other cases, preference may differ from actual use simply because the preferred hospital is farther away and patients don't feel strongly enough about it to drive the extra distance to go there.

How can hospitals use community image study findings to improve their positions in the eyes of the public? Next week's article will explore this question.

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