November-December 2008 Digging Deep BY ADAM STONEGetting to the heart of consumers’ needs and wants starts with conducting quality research but ends with searching for critical details The traditional customer satisfaction survey—done correctly, it produces the must-have data senior living providers need to hone their services. But while these surveys can effectively measure how communities currently serve residents, they don’t necessarily get to the heart of how communities should evolve to keep to the operational excellence path. Traditional surveys reveal residents’ thoughts and opinions about what their community is doing currently—they don’t necessarily provide those in-depth details needed to make strategic changes that truly affect resident satisfaction. To get at that kind of data, providers must dig deep, comprehensively analyze survey results, and—perhaps most importantly— invest in face-to-face time with residents and their family members. Uncover the DriversA customer satisfaction survey is just the starting point for gathering intelligence, agrees Rob Liebreich, who until recently was director of sales and marketing at Baltimore-based Brightview Senior Living. The real answers lie not in what is said, but in the meaning behind the words. He’s referring to “regression analysis,” a technique used for the modeling and analysis of numerical data. Suppose residents say food quality is very important to them, but they rate the food quality as low. Yet they say their overall satisfaction is high. Regression analysis picks apart the numbers to determine where true “wants” lie. This, in turn, has business ramifications. Without proper analysis, “you may get really stuck on something you didn’t do very well,” Liebreich says. “The trick is to not get pulled off focus from the things that are the real drivers, just because some other area might have scored lower in terms of satisfaction. It’s not that certain things are not important.” “It’s the subtle difference between, ‘I want this’ and ‘I want this and it matters to me,’ ” explains William Nowell, president of Scottsdale, Arizona-based Service-TRAC, a customer service analysis firm. “They may complain a lot about something, but when you do the analysis, it turns out that thing doesn’t really matter. You may complain about your wife’s cooking, you might talk about it a lot, but you aren’t going to leave her because of it.” Through regression analysis and other statistical tools, “you can literally, statistically show that certain things are drivers of satisfaction and loyalty,” Nowell says. “It will tell you exactly what the most important thing is, and how much more important it is.” “When [residents] say they want more community-level things, more capital improvement, we suspect those aren’t always the things they really want to make their quality of life as good as they want it to be,” he says. Leader quantifies his suspicions with a relatively simple test. He asks people to pay for the things they seem to want. For example, he wanted to know whether people would pay for Nautilus use and personal instruction in the health center, amenities in which some had expressed interest. In a pilot test, Country Meadows offered the product for free, and received a positive response. When a nominal fee was tacked on, however, 80 percent of participants dropped out. Clearly, people didn’t want the product quite as much as they said they did. Free telemedicine kiosks likewise drew strong participation, whil a $1-aday charge killed off usage. “A very interesting way to see if seniors want something is to put a cost to it,” Leader says. “Let’s just put some number on it to get some hint as to whether they see this as a value.” Test HypothesesThe good thing about statistics and objective trials like the pay-per-use test is that these assessments don’t depend on personal testimony, which is notoriously unreliable. At Customer Value Partners, a consulting group in the Washington, D.C., area, Managing Principal Anirudh Kulkarni talks about “dominant speaker syndrome.” Get a focus group going and people will be apt to follow whoever talks the loudest. “Very rarely do customers know what it is that they want. They will make things up if asked, everyone wants to be supportive of the focus group agenda, but they don’t always know what they want,” he says. It’s better to glean information from direct experience. Follow residents to the fitness room. Do they work out or do they chit-chat, and what does that tell you? Perhaps another universal weight-lifting system isn’t what the community’s fitness program really needs—even if that’s what several residents said in a recent focus group session. For certain, if a general sense of resident desire emerges, providers should test it before committing significant resources. “You have to collect some data to test your hypothesis. If your hypothesis is that by making these three changes to the dining experience, you can increase your customer acquisition by 5 percent, you run that as a pilot in a single property,” Kulkarni suggests. “Run it long enough to gather meaningful information that will help you decide whether to roll it out across the entire company.” Nowell describes another strategy of working backward through a survey. Residents’ replies to a satisfaction survey may include the observation that the food is cold. Time to buy a new stove? Perhaps not yet. It may pay to start with semantics and precisely pick apart the residents’ remarks. “You have to take those verbatim comments and literally ask questions about what the words they use in these comments actually mean,” Nowell says. “They might say the food is cold. If you go back to that group where 15 people say the food is cold, and ask what they mean by that, they may say it takes too long to bring their food out. So, what’s the real issue here?” Dig deeper to be sure. Is there more? What do they do while they wait for the food? A whole lot of nothing. “It gets so boring at the table,” they say. “Our dining experience isn’t fun anymore.” Now you’ve struck gold. Dig Deeper for SurprisesExecutives looking to meet resident desires have to dig beneath simple survey responses. Residents are dissatisfied with the housekeeping so they assume their rooms are not cleaned to their satisfaction. Perhaps the community needs more staff, maybe, or better supplies. Upgrade all the vacuum cleaners. Spend, spend, spend. Or maybe not. Ask a few more questions, and maybe it turns out that what residents really want is continuity. They want to see the same housekeeping staff week after week, to forge some connection with this person who is part of their physical space. There’s the problem. It’s harder to quantify, perhaps, but more real and more meaningful. Now the provider has gone from a perhaps unnecessary capital investment to a programmatic change. Such a scenario requires softer skills, the ability to ask the right questions, and a commitment to listening carefully to the answers. And these are not merely nice things to know. For an attentive executive, the ability to uncover residents’ unexpressed desires often can lead to tangible and strategic management decisions. Liebreich says such information about residents’ true desires is paramount at Brightview Senior Living, so much so that budgets are built around these findings—which is exactly the point of all the poking and prodding, all the number-crunching in the search for meaningful metrics. Executives must determine not just what consumers want, but also how badly they want it, then budget accordingly. “When you ask the residents what they want, nine times out of 10 they will say they want physical things, they want things they can feel and touch,” Nowell says. “But if you listen to them carefully, if you look at the real drivers of overall satisfaction, they are almost always soft skills, not hard outcomes.” Leader has seen it in a weekly sharing group, where residents tell stories of their lives. They may not say they “want” community, relationships, and meaning, but those things are a big part of their ongoing desires. — Adam Stone is a contributing writer to Assisted Living Executive. Who's Who Contact information for members in this article. Web Link To comment on this article and/or share your experiences, go to www.alfa.org/blogs to access the Assisted Living Executive blog. Selected resources available at ALFA Online:
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