The goal of this initiative is to improve the overall quality of our healthcare professionals (HCPs) as perceived by our healthcare facilities (HCFs). During my tour of duty in sales, the most common reason why decision-makers were not interested in Clipboard Health is that they perceived agency nurses to be low quality. As one HCF administrator put it, “We avoid staffing agencies like the plague. No offense to you, but we have found that the quality we get from those agencies is just terrible.”

I believe that “HCP quality” is persistently a key success factor for CBH, one at least as important as the availability of staff. HCP quality is likely to be even more important for new customer types such as home health agencies.

In Uber’s early days, customers were afraid of the quality and trustworthiness of the drivers. Uber solved this and obtained customer trust by building quality through a combination of ratings, background checks, and other interventions. Once Uber achieved perceived quality higher than incumbent taxi agencies, its business model proved itself and its growth skyrocketed. Clipboard Health has an opportunity to do the same using some of the same tactics.

User Problem That We’re Solving

  1. HCPs need actionable feedback so that they know what to improve. I believe that many nurses who are perceived as low quality don’t realize this, and wouldn’t know how to improve even if they did.
  2. HCFs need a way to communicate what they’re looking for in HCPs, both so HCPs know what to improve and so CBH knows how we can differentiate between (and ultimately advise) HCPs.
  3. HCPs need to be incentivized to prioritize quality.

Summary and context

I hypothesize that in many cases the reason why agency HCPs are perceived as lower quality is there are insufficient methods for communicating feedback to them. Whereas full-time HCPs have regular meetings with their supervisors and can learn over time about their supervisors’ preferences, per diem HCPs cannot. I believe that we need to provide a mechanism for supervisors to communicate feedback more effectively to HCPs.

I propose a rating system similar to Uber’s. HCFs should be able to rate the HCP after each shift and provide some qualitative feedback; HCPs should receive that feedback and see their ratings in their app to boost their morale.

Although it may be interesting to eventually establish a relationship between ratings and compensation, I suggest that we avoid linking the two for now. This is due to worries that this may trigger competitiveness problems at the HCP level and create disputes about the content of the ratings. I believe the greatest value of this system today is that it enables HCFs to communicate expectations to both HCPs and CBH.

While there are many ways that we could improve HCP quality (including, for instance, launching an academy for HCPs) I suggest that we begin with a rating system. Having ratings on HCPs would allow us to objectively measure the effectiveness of higher-touch interventions such as a training academy for nurses.

Investment hypothesis

When we provide objective feedback to HCPs through ratings. HCP quality will improve.

We can measure this improvement by measuring the average rating of a cohort of HCPs over time. Suppose that, one month after launch, the average HCP rating is 3 out of 5 stars. If three months later the average rating for that cohort was 4 out of 5 stars we would have evidence that the rating system is inducing HCP improvement. (This, of course, should be split-tested to measure impact.)

There are multiple ways that this feature could contribute to revenue.

This feature could result in greater shift volume from existing HCFs.

A good leading indicator of an HCF’s future shift volume would be the change in the average rating it assigns to CBH HCPs. If that figure goes up from month to month, it’s reasonable to assume the HCF will post more shifts in the future.

It could result in a higher rate of DM Call Connects → Opportunities.