The Client Orientated Scale of Improvement, & Why it is More Important Than Ever

I wrote many years ago about the COSI and why I felt it was an important tool for hearing healthcare. My mind was brought back to it recently when I commented on a post on one of the Facebook Audiology Groups.

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With thanks to Tom Dixon of Worcester Hearing

I have always felt that the Client Orientated Scale of Improvement was a hugely important document for us and our customers. I have always believed that COSI is an integral part of best practice in the Hearing Profession.

I also believe that best practice hearing care is the key to survival for the audiology profession across the world. In response to the changing needs and requirements of consumers, we can only cement our place in the journey to hearing better by taking action.

Part of that action will be adherence and promotion of best practice hearing care in all its facets. The other part will be our flexibility and willingness to integrate change within our practices. Change that we may not like, but that will need to be undertaken.

Making an Emotional Connection

Using the COSI will make a strong emotional connection to your Patient, they will believe that you are interested in their problems and more importantly that you are interested in dealing with their problems.

In my experience, I find that many professionals shy away from the COSI because they are not sure where it will fit either in their consultation or follow up. I think that many professionals really don’t understand the real power of the COSI. Some think it is just another validation method and therefore can be taken or left. Even some of the people who use it don’t quite understand how it may be the most powerful tool that they have ever used.

At it’s most simple level the COSI is just a record of the difficulties that a Patient has in their day to day life. But it is a far more powerful tool than just a clinical record of problem areas. If used properly, it can allow you to emotionally connect and engage deeply with the customer

Connect & Acknowledge

Used properly, it will allow you to connect with a Patient, gain their acknowledgement of lifestyle impact, manage a Patients expectations and gain agreement on a set strategy for dealing with the core issues. Used properly, it will cement your relationship with the customer in a deeper way.

I know that you ask about the problem areas already. The question I would ask is, are you doing it in the right way? Do you ask enough of the right questions and most importantly do you listen? Do you really listen to the answers and truly understand what they are saying?

You need to use open questioning, open questions will generate deeper information instead of simple yes/no responses. Not only do you need to ask about the areas where they have problems. You need to understand what effect they have on their daily lives and relationships.

Look For The Emotional Impact

When they give you the problem areas, dig deeper, get a clear instance of a situation. Ask them what exactly the problems are in the situation Dig deep, and when you have all the answers and led the Patient on a journey through that situation, ask them, How does that make you feel, how does that impact on you?

If you have done your job properly they will tell you. It might be emotional, it might even be hard to listen to, but it generally will be the truth, unvarnished and direct. There may be tears, if so it may be awkward for you, I generally put my hand on their arm for a moment in order to show acknowledgement of the pain.  

It is the acknowledgement of their problems and the emotional impact that helps you cement your relationship. Always remember, you may have heard these things many times, but the person in front of you may be acknowledging the emotion and feeling of loss for the very first time.

Be respectful of that and their willingness to outline their problems. Explain that you understand it is difficult to discuss and thank them for their honesty. In each situation that is important to them, grade their current ability, ask them their expected ability and then most importantly agree with them a realistic final ability.

Be honest with them, tell them directly what you feel you can do well and more importantly what you may not be able to do so well. It will allow you to begin setting their expectations and helping them understand how hearing technology is related to lifestyle requirements.

I have said it before, why should you do this? There are several reasons, best-practice care, commercial sense, but I think the most important reason is that it is the right thing to do for the customer. That is what we are supposed to be about, doing the right thing for the customer.

What’s The Benefit?

Your customer will believe that you are an honest, compassionate and caring practitioner. That is a very good place to be, because at the minute, many people seem to believe that we are money hungry greedy gougers.

You will have helped them to truly recognize their difficulties and acknowledge the deeper impact on their lifestyle and even who they are as a person. You will also manage their expectations openly and usually without rancour.

You will gain agreement for a course of action and in fact plan that action out. The customer begins to talk about when’s instead of ifs. You help your customer acknowledge the trauma and then lead them through it to a solution.

You allow them to openly express their feelings perhaps for the very first time. If for some reason they can not do business with you, I can guarantee that they will ensure that they will tell their friends to do business with you.

A Living Document

The COSI needs to be a living document, you need to refer back to it throughout their continuing journey with you. It serves to assess how they are getting on with their hearing aids as they progress.

It also acts as a reminder of how bad things were, and if it gives them a clear way to understand how thing have got better. When you have addressed the problem areas, refer back to the COSI document to see if you need to add new areas as their lifestyle changes.

The COSI is a powerful tool for many reasons, you should integrate it into your practice. As I said, it will deliver deeper engagement, more than that, it will allow you to differentiate yourself and drive the customer experience that we will all need to address in the coming years.

About Geoffrey Cooling

Geoffrey Cooling is an Irish hearing care blogger and the author of The Little Book of Hearing Aids and Audiology Marketing in a Digital World. He has been involved in the Hearing Healthcare Profession since 2007 when he qualified as a hearing aid audiologist. He has worked in private practice and for a major hearing aid manufacturer. He has become recognised as an authority within the field of hearing care and hearing aids.

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