1. The Secrets of Satisfaction
What satisfaction research can tell OPOs about building positive partnerships
with doctors, nurses and administrators.
Presented by
David Rich and Sean Jordan

2. Who We Are
The Research & Planning Group is an independent marketing and opinion research firm
that specializes in conducting a wide range of studies for the healthcare industry.
We have been conducting studies for OPOs since 1998, and over the last six years, we have
conducted the hospital partners study we’ll be talking about today for 15 different OPOs
across the country.
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3. The Hospital Partners Study
The purpose of the hospital partners study is to provide participating OPOs with an
understanding of how they can improve the relationships they have with the physicians,
nurses and administrators who work with them on organ and tissue cases.
The study is designed to provide both a quantitative and a qualitative assessment that can
be compared:
• laterally (across the industry to other OPOs)
• and longitudinally (comparing each repetition to the baseline and the trend to
measure each OPO’s individual performance over time).
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4. The Objectives We Address
The hospital partners study has four distinct areas of focus:
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•
•
Service Satisfaction
Communication (during and after cases)
Education
Overall Assessment (similar to a SWOT analysis)
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5. The Research Method We Employ
RPG conducts the hospital partners study using a in-depth telephone interviews.
They deliver a number of advantages over other methods, including:
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•
•
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A pre-set response rate in the form of quotas
Human interviewers who can ensure responses are deep and meaningful
Conversational interviews that allow hospital partners to fully express themselves.
Flexibility for busy hospital partners who want to participate when it’s convenient for
them
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6. The Sampling Plan We Set
The population for the study is defined as all hospital partners who have worked with an
OPO at least three times in the last two years on a donation case.
Each OPO provides RPG with a list of these partners and sets a quota for how many
hospital partners will be included in the study.
To incent participation, physicians are offered an honorarium of between $150-200,
depending upon the region, payable to themselves, the sponsoring OPO or a charity of
their choice.
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7. The Results We Deliver
Our analysis is centered around the idea of splitting hospital partners into cohort groups
and trying to understand how these groupings impact satisfaction and their perceptions of
the sponsoring OPO.
We look at different “slices” of each sample to see where differences might exist, and
because we have both qualitative and quantitative data, these “slices” aren’t restricted to
traditional demographic breakouts.
For example, one slice we often compare is Highly Satisfied hospital partners versus those
who indicate that the OPO Needs Improvement. Comparing the data collected from these
two groups helps us to better understand what is really driving satisfaction.
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8. The Threshold for Excellence
OPOs who meet the following two criteria on a 10-point scaled question exceed what we
refer to as the threshold for excellence:
A mean score of 9.00 or above
80% or more partners expressing high satisfaction
When an OPO fails to meet the threshold for excellence for one or more variables, we
prioritize which areas require the most attention and help the OPO to develop a strategy
for improvement.
Once an OPO has reached this point, there is little that can be done to improve upon
satisfaction for a variable and the strategy shifts to maintaining this high level of
performance.
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9. Participating OPOs in 2012-2013
Name of OPO
Center for Organ Recovery and Education (Pittsburgh, PA)*
California Transplant Donor Network (Oakland, CA)
Donor Alliance (Denver, CO)
Gift of Life (Ann Arbor, Michigan)
Iowa Donor Network (North Liberty, IA)*
Indiana Organ Transplant Organization (Indianapolis, IN)
Lifeline of Ohio (Columbus, OH)
LifeSource (St. Paul, MN)
Louisiana Organ Procurement Agency (Metairie, LA)
Mississippi Organ Recovery Agency (Flowood, MI)
Mid-America Transplant Services (St. Louis, MO)
New York Organ Donor Network (New York, NY)
Unyts (Buffalo, NY)
Washington Regional Transplant Community (Annandale, VA)
Short
Name
CORE
CTDN
DA
GLMI
IDN
IOPO
LOH
LSMN
LOPA
MORA
MTS
NYODN
UNYTS
WRTC
Level of Participation
Physicians
Hospital Staff
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
*CORE and IDN participated in 2011 and shared their data for comparison.
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10. The Variables We Measure
Overall Assessment
Strengths of OPO
Weaknesses of OPO
Opportunities for OPO
Perceived Problems for OPO
Overall Satisfaction
Service Variables
Quality of Services
Involvement
Support Shown to Families
Response Time
Professionalism
Respect Shown
Communication
Communication During
Process
Communication Following
Process
Follow-up Information
Way Concerns Were Handled
Education
Understanding of Donation
Process Within Hospital
Effectiveness of Education
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11. The Variables We Measure (cont’d)
Service Variables (A Hospital Physicians)
Variable
Quality
Involvement
Support Shown
Response Time
Professionalism
Respect Shown
Mean Score
%Highly Satisfied
Above Threshold
8.78
8.63
8.97
8.85
9.20
9.39
69%
70%
76%
73%
82%
90%
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5
8
6
10
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12. The Variables We Measure (cont’d)
Communication Variables (A Hospital Physicians)
Variable
Communication During
Communication Following
Follow-up Information
Way Concerns Were Handled
Mean Score
8.39
8.11
7.96
7.57
%Highly
Satisfied
63%
55%
58%
56%
Above
Threshold
2
2
2
1
Education Variables (A Hospital Physicians)
Variable
Understanding of the
Donation Process Within
Hospital
Effectiveness of Education
Mean Score
%Highly
Satisfied
Above
Threshold
8.17
50%
2
7.70
41%
1
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13. Overall Satisfaction
A Hospital Physicians
Placement
Highest
Average
Lowest
Mean Score
9.25
8.21
7.32
%Highly Satisfied
75%
54%
26%
Hospital Staff (Nurses and Administrators)
Placement
Highest
Average
Lowest
Mean Score
9.45
8.88
7.95
%Highly Satisfied
86%
76%
69%
No OPOs exceeded the threshold for excellence for Overall Satisfaction
for physicians; two exceeded it for hospital staff.
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14. Overall Satisfaction (cont’d)
Top Performers for Overall Satisfaction
(in alphabetical order):
A Hospital Physicians
Hospital Staff (Nurses / Administrators)
Gift of Life MI
Indiana Organ Procurement
Satisfaction Champion
Iowa Donor Network
Organization
Lifeline of Ohio
Mississippi Organ Recovery Agency
Mid-America Transplant Services Satisfaction Champion
Donation Follow-Up Champion
Mississippi Organ Recovery Agency Satisfaction Champion
Unyts Collaboration Champion
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15. Overall Satisfaction (cont’d)
Highly-satisfied hospital partners tend to feel very strongly-aligned with the life-saving
mission of their OPO and also tend to be highly satisfied with most of the service
satisfaction touch points this study measures.
They tend to be more positive about their partner OPOs in most areas, but tend to have
many of the same concerns as their less satisfied counterparts when it comes to the need
for consistent, collaborative communication and protocols and a greater amount of inhospital education to help prepare them for the donation process.
Few physicians question the manner of front-line OPO representatives even if they might
question the medical expertise, communication capability or service quality provided by
these representatives.
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16. Overall Satisfaction (cont’d)
Hospital staff tend to express higher levels of satisfaction overall than physician partners,
but this is not always the case. In some organizations, these groups are well-aligned, while
in others, they express two very different types of experience in dealing with the OPO.
Whereas physicians tend to speak about organ donation case experience, hospital staff
are more likely to be tissue-centric in their thinking.
Having both of these dimensions helps the research team to determine if concerns are
systemic or due to consistency, also helps the research team to explain to each OPO how
to feel about the data as a whole.
As one of the participating organizations said during a research presentation covering both
types of hospital partners, “if we were only talking about hospital staff, we’d be
celebrating right now; if we were only talking about physicians, we’d be embarrassed.”
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17. Overall Satisfaction (cont’d)
The most common suggestions for improving overall satisfaction include:
Improving communication both during and after the donation process, particularly with
regards to follow-up.
Building stronger relationships with hospital partners and more collaborative
communication during cases.
Focusing on improving the consistency and speed of response times for cases, or being
better at communicating when to expect OPOs arriving onsite to respond to cases.
Being less aggressive about the donation process with the donor families or more
sensitive to the families (and, by extension, the hospital partners themselves).
Helping hospital partners to do a better job of understanding donation criteria and
protocols through good in-hospital education.
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18. A Different Perspective
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19. A Different Perspective (cont’d)
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20. A Different Perspective (cont’d)
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21. A Different Perspective (cont’d)
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22. The Shape of the Data
The data distributions suggest quite clearly that there is a need for OPOs to place their
focus on improving communication and education if they want to improve overall
satisfaction.
But it’s also important that we understand the relative importance of each variable. For
that, we can turn to a process called multiple regression analysis.
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23. Modeling Satisfaction
Service Variables Model
(A Hospital Physicians)
Variable
Importance
Involvement
(Collaboration)
High
Response Time
High
Professionalism/
Respect
Medium
Support Shown to
Families
Low
Goodness of Fit
58%
Communication Variables Model
(A Hospital Physicians)
Variable
Importance
Communication
during donation
process
Effectiveness of
education
High
Low
Combined Model
(A Hospital Physicians)
Variable
Importance
Involvement
(Collaboration)
Goodness of Fit
High
Response Time
High
Professionalism/
Respect
Medium
Communication during
donation process
Medium
Goodness of Fit
63%
35%
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24. The Secrets to Improving Overall Satisfaction
We can see from the data that while every variable we measured is important, some have
a greater impact on overall satisfaction than other.
The data suggest that an approach to improving overall satisfaction should follow a
progression. Once a level is sufficiently mastered, the OPO can move on to the next level.
The research team strongly advises against attempting to address all four levels at once.
Each level requires an in-depth look at organizational protocols and behavior.
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25. The Secrets to Improving Overall Satisfaction – Level 1
Collaboration – Ensure that hospital partners are being included in all aspects of the
donation process and not marginalized in any way.
Suggested actions
• Huddling with hospital partners to help them understand their role in the process.
• “Morning report” emails to affected hospital partners when a case is going on.
• Sending Hospital Coordinators in pairs to split logistics and communication into two
tasks. Put the best communicators in charge of roping in hospital partners.
Move on when: Collaborative tools are in place, have been pilot tested effectively and
appear to be meeting the needs of hospital partners.
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26. The Secrets to Improving Overall Satisfaction – Level 2
Consistency of Communication– Develop accountability indicators to ensure that
communication protocols are being applied consistently during cases.
Suggested actions
• Track use of tools like huddling to ensure consistency of use.
• Measure both internally (OPO staff) and externally (follow-up spot check with hospital
partners).
• Use measurements to improve training and development, not for punitive action.
Move on when: Accountability measures show that communication during the donation
process is being handled consistently to specified standards.
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27. The Secrets to Improving Overall Satisfaction – Level 3
Feedback and Follow-Up– Develop stronger systems for providing feedback (immediately
after cases) and follow-up information (long-term outcomes) to hospital partners.
Suggested actions
• Automate systems as much as possible.
• Create opportunities for information to be available on demand.
• Conduct debriefing with hospital partners following cases or email a case report to
those involved.
• When information is available on case outcome, however scant it is, share it.
• When information cannot be provided on case outcome, have a system for ensuring
follow-up occurs once the information becomes available.
Move on when: Accountability measures show that communication during the donation
process is being handled consistently to specified standards.
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28. The Secrets to Improving Overall Satisfaction – Level 4
Educational Offerings– Develop new opportunities and systems to provide education to
hospital partners about donation criteria and the donation process.
Suggested actions
• Think 21st century – replace old styles of education with new ones. Use on demand
education instead of traditional events.
• Use both high-tech (apps, streaming videos, websites) and low-tech (info cards, one
sheets) methods to provide information.
• Focus on the stories, not the statistics.
• Work more closely with medical schools to ensure med school students learn about the
donation side of cases (rather than merely transplantation).
Education requires constant refinement. What works today may not work five years from
today, and partners will not benefit if you are providing the same training over and over.
Keep your methods fresh and you information current and you’ll keep your partners
engaged.
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29. Three More Thoughts
We don’t need to drill down very far in the data to understand that collaborative
communication is the key to improving satisfaction. The OPOs who are the best
collaborative communicators also tend to be the best at providing services that meet with
a high level of overall satisfaction.
You will be most effective if you reach for the low-hanging fruit first. The structure we
have presented will help you to do that, but if you see an opportunity that’s within reach,
don’t be afraid to pursue it.
Remember that satisfaction is a moving target. The purpose of opinion research is to help
you move from a reactive position to a proactive position.
When you are reactive, you will be limited in your focus and your capabilities. But when
you are proactive, you have time to plan, to develop, to refine and to experiment – all of
which will provide you with huge advantages down the road.
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30. Roadmap to Success
What we have learned from hearing 15 OPOs respond to the hospital partners study
Presented by
David Rich and Sean Jordan

31. Things Have Changed Since We Started
1. Physicians see you as a benefit now rather than a threat. They used to look at OPOs
as stealing their patient and they felt a great loss and sense of failure as a doctor if
they couldn’t save their patient.
2. Physicians are on your side. Even though they may not always act like it, they are on
your side. That wasn’t always the case, but for the past six years, that is the case and
the trend is growing stronger.
3. Physicians need to be included as key players in the entire donation process. We’ve
had ICU doctors tell us that after a positive interaction with an OPO staff person, they
are able to spot cases that they would have otherwise overlooked. Without the active
involvement of the physician, there is no donation.
4. Physicians need to be communicated with constantly throughout the process of the
donation. Regardless of how they are behaving, you can trust that the bottom line is
that they want to know what is going on and how they helped to make the case a
success.
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32. First Turn
Make communication with physicians a top priority throughout the process.
It begins with the Huddle at the beginning. Make the Huddle a mandatory, never to be
forgotten part of the routine, regular protocol for each donation case.
Even if the physician doesn’t appear to be interested or doesn’t have the time, it is
essential that your team make every effort to invite and let the Physician know who is
involved, what is expected of the Physician, and that he/she will be constantly informed.
Set up the expectation for communication.
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33. Second Turn
Provide a daily report via email or in person to the physician on the status of the donor
and email whenever there is a change in the donor’s condition.
Remember, deep down most every physician really cares and wants to be in the know.
Even if they push you away, they still want to know.
Daily reports will be greatly appreciated by all your hospital partners. It shows that you
care about THEM and that they have an important part in the process.
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34. Third Turn
After a case, follow up immediately with a full report on what occurred during the case.
Do everything you can to brief everyone involved, and especially every physician
involved—be transparent about conveying the news, whether it is positive or not.
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35. Fourth Turn
After transplant surgery, follow up as soon as there is information about the outcome,
regardless of the success of the outcome.
Give them as much information as you are allowed about the recipients and organs.
This information is of vital interest to all hospital partners and especially physicians.
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36. Fifth Turn
Conduct a full debriefing session analyzing and discussing what occurred from start to
finish.
This should include the physician or be reported to the Physician if she or he cannot be
present.
Include the physician in this process and she or he will feel a part of your team. It’s a great
opportunity to bond and educate.
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37. Sixth Turn
Read and re-read carefully and do not dismiss what the Physicians have had to tell us in
the research.
Embrace it, act on it, and benefit from it. The statistical information is valuable as a
measurement, the heartfelt words of the physicians will give your staff the focus and
direction to be successful.
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38. Seventh Turn
Executive OPO leadership must develop relationships with Attending Physicians, all
active Physician partners, and key Residents.
Physicians need to know that someone in leadership knows them and is accessible to
them.
Senior management does not need to micro-manage the donation process, just meet and
let the physicians know that they have a connection with top brass at the OPO.
Physicians may never make a call, but knowing they can and knowing whom to call is
important to them.
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39. OPO Insights
Also, please be sure to check out our free blog, OPO Insights, which contains all sorts of information
on the research we have conducted and read over the years!
Find out more at http://opo.researchplan.com!
the Research & Planning Group
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