Customer Effort Score: Transactional Vs Relational Feedback

We have covered elsewhere on this blog how Net Promoter Score (NPS) can be a powerful performance indicator for your veterinary clinic. Indeed, it is often billed as the “ultimate question”. However, it is not the only question worth asking...

NPS provides a great overview of how a client feels about your clinic overall. It is a relational metric. That is to say it measures the state of a pet owner’s relationship with you, your team and your clinic. However, it doesn’t tell you a whole lot about what happened today.

A client’s relationship with your business is based on the sum of all their interactions with you. Thus their Net Promoter Score provides a composite view across many touchpoints. Recency bias dictates that they may over-weight their most recent experience. However, if you saved someone’s dog’s life last week but kept them waiting twenty minutes this week, they are still likely to be a “promoter” for your clinic. That’s great news. But the halo effect from last week’s experience obfuscates potentially helpful feedback from the more recent interaction. Think about it - if you could get your promoters to tell you about an emerging issue with waiting times, you could take action to correct the issues before the negative experience is inflicted on a new client forming an opinion of your clinic, or someone who has previously had a less positive experience.

To overcome the limitations of relational metrics, such as Net Promoter Score, you need to layer on transactional metrics. At PetsApp we have had success in using Customer Effort Score (CES).

Customer Effort Score methodology asks:

To what extent do you agree or disagree that [clinic name] made it easy to handle my pet’s issue today?

Traditionally, Customer Effort Score is measured on a scale of 1 (strongly disagree) to 7 (strongly agree). However, at PetsApp for reasons of cognitive load and user interface, we have decided to adopt a 5 point scale.

Customer Effort Score deliberately focuses on the ease or otherwise of today’s experience. It attempts to separate this from any historic goodwill (or, for that matter, ill feeling).

Interpretation of Customer Effort Score also differs from that of Net Promoter Score, although many companies have recently conflated the methodologies, failing to understand their subtly different uses.

Customer Effort Score feedback can be used to produce a directionally indicative average score. However, that in and of itself is not terribly actionable. One way to dive deeper into the numbers is to map a distribution of scores for different customer segments. For example, a clinic might find the following:


In the above example, many of the reportedly effortful experiences turn out to have been for cat owners, while dog owners are having a relatively effortless experience at this clinic. This would become all the clearer by creating separate distributions for the cat and dog owning segments. While the above is just an example, this is not an uncommon finding at veterinary clinics when CES is deployed. This would be a strong indicator that the clinic could benefit from implementing more cat friendly policies, such as separate waiting areas.

In contrast with the above, cat and dog owners report that their interactions with veterinary clinics through PetsApp are approximately equally effortless at 4.6/5 and 4.63/5 respectively (based on a sample of over 40,000 CES responses). This suggests that if you are struggling with Customer Effort Scores, introducing a digital onboarding point for pet owners to present issues is a great shout.

You may be wondering when is the right time to collect relational vs transactional feedback. For relational feedback you don’t want to collect it too often. No one wants to be the slightly pathetic friend constantly seeking reassurance and asking “do you like me? But do you, really?” - save that for kindergarten. Quite apart from the constant surveying being annoying, relational feedback by nature doesn’t change all that much in a short period of time. So, asking for NPS feedback once every 6 months feels about right, and this cadence need not be tied to any particular interaction. In fact, it’s better if it isn’t!

Transactional feedback, on the other hand, is much more time-bound. It is appropriate to ask for Customer Effort Score at the end of each service interaction as part of your approach to quality assurance and continuous improvement. This is exactly what we do at PetsApp, allowing clinics to track CES through the reporting dashboard. And it’s clear that the approach hundreds of clinics are now taking of using PetsApp to layer convenience on top of an already high-trust touchpoint is reaping dividends, with PetsApp interactions having an average Customer Effort Score of 4.63/5. Who knew veterinary care could be so effortless?


We’d love to help you implement Customer Effort Score at your clinic. Book a demo to learn how.

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