How OPOs Can Improve Experience Management With Doctors and Nurses

Last year, we got a group of Organ Procurement Industry professionals who work in Hospital Development and Hospital Services together to hold a Best Practices Summit related to their roles serving doctors and nurses in their donor hospitals. (We did something similar for the folks on the Donor Family Services and Aftercare side, and you can read a similar article regarding their unique issues here.)

My job was to set the stage for the amazing presenters we had lined up for the following morning, and I thought the best way to do so would be to talk about something close to the heart of many of the OPO professionals in the room:

How do you measure the actual impact you’re having on the people you work with outside of your own organization? Our own data focus on satisfaction, but that’s only part of the puzzle, because we’ve heard from many doctors and nurses who are extremely critical of their OPO, and yet feel strong levels of alignment and engagement with the OPO’s mission and feel appreciated by the OPO.

Part I of this presentation (5:15-36:31) covers what is summarized in this article.

Let’s begin by observing that providing excellent experiences to customers, partners and stakeholders isn’t easy, and that’s in no small part due to the fact that it’s difficult to understand what the key driver of a great experience really is. For example, look at the organizations which are the most successful in the world and you’ll notice that few of them are familiar:

“Yes, but maybe the brands they operate are more successful,” you might be saying. I thought so too, but I noticed a similar problem with the most successful brands in the world:

You’ll note that while some of these brands are familiar, few of them are brands that most people have any strong feelings towards, and many sort of fade into the background amidst our electronic devices, shopping and daily purchases. (I was also alarmed to see a tobacco brand on the list!)

At this point, I began to wonder if perhaps success was the wrong lens through which I should be looking, and I decided instead to focus on the top customer service brands:

This list starts to gain a sharper resolution on brands which are well-known for treating their customers well, but many of them are still brands that tend to provide occasional encounters rather than being broadly instituted in most peoples’ lives. While I have a strong preference for many of these brands when I can utilize them, I can’t say I’m overly thrilled with most of them in a way that makes me an evangelist for their products or services.

But then, I realized that what I was really searching for wasn’t something that I like, but something that I truly love because it’s an essential part of my life. That led me to this list of the most-loved American brands:

Finally, I could see some brands that I could really connect with, and what I noticed was that many of these brands were connected to intimate aspects of my life because they represent things like quick service restaurants, value shopping, in-home video streaming, home improvement, laundry detergent, toothpaste, breakfast, sweet indulgences, pharmacies and delivery services. These were not just the brands that provided a great experience and a high level of consistency, but which had managed to become a part of our daily lives.

But I also noticed that having a high level of popularity doesn’t appear to correlate with having a high level of success. Sure, popular brands are successful, but they’re not the most successful, and some (like Subway, Walgreens and USPS) are actually struggling to stay successful. In the field of services marketing, it’s been established that delighting customers consistently by going above and beyond their expectations is an expensive (and increasingly difficult) endeavor, and the companies that tend to generate the highest revenues often have middling customer service records.

In other words: you can maximize making money or you can maximize being loved, but it’s really hard to achieve both goals. The tried and true way to get there is to obsess about offering your customers, partners and stakeholders the best experience they can possibly have as consistently as possible.

Being obsessed with experience means monitoring it, and that leads to establishing good metrics. Fortunately, I’m well-versed in metrics, and years of attending Qualtrics conferences has turned me on to the value of Experience Management (XM) and how vital it is for ensuring that your service goes above and beyond.

But before an XM strategy can be employed, it’s important to understand that experience data are completely different from the operational data many organizations gather daily. Operational data reflect what people do, but experience data reflect how people think and feel, and it can be very difficult for those who are used to hard numbers to accept that these softer numbers may actually be the most important data an organization can gather once it has a good system in place.

Who Is Your Actual Customer? It’s A More Important (and Nuanced) Question Than You Might Realize

One of the issues OPOs struggle with is in defining who their customer is. This is a controversial topic that many OPOs define differently. From a logical point of view, the transplant recipient should be the customer, since he or she is the ultimate beneficiary of donation. And yet the transplant recipient has so little autonomy or influence in the decision to accept a needed organ that the word “customer” fails to describe the entire interaction.

Of course, I’d suggest that the word “customer” is itself a problematic term for organizations because it rarely descriptive of reality. The word “customer” is traditionally used to describe the person who receives a product or service from a seller in a transaction, but the truth is that most transactions are not simple, and most transactions include so many middle parties (including the purchaser, who may not be the ultimate user of the product) that the term is really best-used to define who is ultimately being served by the transaction.

Many of the leaders in the OPO world tend to agree with this sort of logic, and as a result, many OPOs have shifted to viewing their transplant centers, donation centers and donor families as customers because these are the individuals they ultimately serve. Even though all three of these groups play a very different role in shaping the donation process, each is important in ensuring that the process actually happens.

The Evolution of Customer Measurement – From Identification to Experience

Customer measurement has evolved significantly over the last century from merely understanding who the customer is to measuring ideas such as satisfaction and loyalty to their likelihood to recommend to understanding their journey to ultimately thinking about their entire experience.

Measuring customer experience (CX) has led to a broader field of experience management (XM), where organizations attempt to be proactive in how they anticipate customer needs. Most customers experiences fall within an expected range, and deviating from expectations often reflects mediocre service design. The ultimate state to avoid is disappointment, which is where a service provider falls significantly below a customer’s expected standard. The ultimate state to attempt to achieve is delight, which is where a service provider goes far beyond a customer’s expectation.

Delight is a wonderful goal, but it becomes problematic if it’s not baked into an iterative service design. It’s very easy to delight customers when standards are low, but when standards are high, what once was classified as delight becomes standard. Ultimately, the organizations who have the best customer experience are those for whom there is a culture of obsession with delighting customers as often as possible.

Myths About Experience Management (XM)

In talking with organizations about customer experience (CX) and experience management (XM), we’ve heard many myths such as the following:


MYTH: XM is about pampering your customers.

REALITY: XM is about delighting your customers by anticipating and exceeding their expectations every step of the way.


MYTH: XM is only important for customer service interactions.

REALITY: XM relates to every external interaction with your customers and is at the heart of internal process development.


MYTH: XM is about doing everything for your customer with a “white glove” approach.

REALITY: XM is about understanding how your actions can be most valuable for the customer and where your customer would like to participate in the service. (Consider the “Ikea Effect”, where customers express higher levels of satisfaction and lower standards for perfection because they are involved in the construction of their furniture)


MYTH: XM is incredibly expensive and doesn’t generate an effective ROI.

REALITY: XM is expensive, but it’s an investment that will pay off many times over because it will attract and retain customers who become fanatics for your brand.

Emotional Triggers in Experience Management

Human beings are emotional creatures who respond to environmental stimuli in deeply personal (and often probabilistic rather than predictable) ways. Our ability to consider new ideas and think through alternatives is at its best when we are relaxed and comfortable with what is going on around us.

When we grow uncomfortable, defensive or fearful, our brain shifts into a different state where we desire relief or escape from our unfortunate situation. This is illustrated in diagrams such as Robert Plutchick’s famous Wheel of Emotions, which suggests that emotions tend to interact in predictable ways which can impact our general mood and response to environmental stimuli.

Understanding how a customer’s experience can trigger different emotions can be a powerful tool for shaping positive experience management, and avoiding negative triggers that begin with emotions like annoyance, boredom or apprehension can help to ensure customers are more highly focused on the positive aspects of service design.

How to Measure Experience Data

If I spill a cup of coffee, what do I need to measure in order to know what to do next?

  • Should I try to calculate how much coffee I’ve spilled?
  • Should I try to predict the pattern it will produce?
  • Should I try to determine the likelihood of causing a stain on the floor?
  • Should I research how much my spill will cost to clean up?
  • Or should I simply recognize that there’s a spill and make an effort to clean it up?

Focusing too much on metrics (and not enough on understanding how customers think and feel at every step of your interaction) leads to very poor service design. The examples of this are all around us.

  • Consider cable providers and telecommunications companies, who respond to customer complaints by trying to sell more service.
  • Consider retailers with agonizing return policies designed to keep a few customers from abusing a service many customers need.
  • Consider car dealerships, where high-pressure tactics for expensive add-ons can make the experience of buying a car fraught with wearying compromises.
  • Consider commercial airlines, where stretching customers to their breaking point in terms of low-frills service to preserve low-cost fares has taken much of the joy out of flying.

Fortunately, there is a method to ensuring that service design is constructed well from an experience management point of view:

  1. Outline the customer journey and identify key points where interactions occur or the course shifts.
  2. Validate your internal understanding of this journey with external feedback from your customers.
  3. Identify the most prominent areas where customer experiences are most likely to deviate.
  4. Build metrics around measuring those areas (some internal, some external) and focus on reducing variation
  5. Once those areas have been improved and gaps have been minimized, return to step 1.

Applying XM to Donation-Side Hospital Partners

The first three steps outlined above can largely be addressed through good experience research with donation-side doctors and nurses. Our own Hospital Partners Study is designed for this purpose, but if an OPO already conducts research to gather good data, we recommend utilizing that instead.

The most prominent areas that show up in our own survey tend to be:

  • There is a need for greater preparation for participation in cases. This often gets entangled with a desire for education, but really refers to helping doctors and nurses understand the role they’ll be playing in each specific case and not presuming that they remember the details from their last case.
  • There is a need for connecting hospital partners to donor families, whether it’s through inviting them to be present during an approach, keeping them in the loop about how the donor family is doing or including them in events like Moments of Silence or Honor Walks. We even recommend sharing donor family satisfaction data with these partners, because the donor families are often their primary point of contact in the hospital and the people with whom they build the strongest relationships case to case.
  • There is a need for ensuring hospital partners have a consistent experience no matter which OPO representatives are on site. Silos between HD and clinical have to be dismantled and all OPO staff need to be able to provide effective communication about the process.
  • There is a need for ensuring that hospital partners are not left out of the epilogue to the donation story. Hospital partners don’t want to be part of a transaction; they want to be part of an experience, and they want to know that what they participated in helped both the recipients and the donor family. Ensuring that they receive consistent and timely feedback immediately after a case and longer-term follow-up in the weeks or months after a case helps to ensure they remain in the loop.

Ultimately, all of these areas point to a new way of thinking about how hospital partners interact with the donation process. The old way involves a linear process that repeats many times, but the new way involves thinking about a constantly reoccurring cycle with many points of entry:

Once some discussions have occurred to collect data and address the above, step four can be addressed by developing metrics to measure those areas (some from internal data, some from continued gathering of external data) to focus on reducing variation. These metrics need to be built into your processes and recorded for every case.

  • Internal metrics generally come from case documentation.
  • External metrics generally come from obtaining feedback from donation-side hospital partners.

Once those areas have been improved and gaps have been minimized, it’s important to begin the process over and begin looking for new ways to iteratively improve the hospital partner experience. But don’t discard your metrics! Your goal should always be to maintain your high performance in areas you’re already measuring while looking for new opportunities to grow and improve service.

Remember as well that XM is not about temporary boosts to metrics – it’s about institutional change. Doctor and nurse needs will change over time, but the more proactive you can be in identifying them, the easier it is to adjust your service model to account for them.


We hope this article has been helpful to you, and we want you to know that we’re here to be a resource however we can be on anything you’d like to know about marketing research!

There are many other videos from our Best Practices Summit for Hospital Development and Hospital Services roles – you can find them here!

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