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Mary Ann Morris, who manages general services and Mayo Clinic volunteer programs at Mayo Rochester, likes to tell a story about her early days at the Clinic. She was working in a laboratory—a job that required her to wear a white uniform and white shoes. And after a frantic morning getting her two small children to school, she arrived at work to find her supervisor staring at her shoes. The supervisor had noticed that the laces were dirty where they threaded through the eyelets of the shoes and asked Morris to clean them. Offended, Morris said that she worked in a laboratory, not with patients, so why should it matter? Her supervisor replied that Morris had contact with patients in ways she didn't recognize—going out on the street wearing her Mayo name tag, for instance, or passing patients and their families as she walked through the halls—and that she couldn't represent Mayo Clinic with dirty shoelaces. "Though I was initially offended, I realized over time [that] everything I do, down to my shoelaces, represents my commitment to our patients and visitors…. I still use the dirty shoelace story to set the standard for the service level I aspire to for myself and my co-workers."1

A dirty shoelace hardly seems meaningful in the high-stakes context of caring for ill people. However, a shoelace is something a patient or anxious family member can see, a small but tangible piece of evidence about an organization and the intangible, technically complex medical services it offers. In effect, the shoelace plays a surrogate role, helping to tell a service organization's story. The shoelace is a clue about quality, one of many Mayo Clinic uses to tell its story cohesively, distinctively, and compellingly. The Clinic's clue management is exemplary, melding intuition and purposefulness in the quest to create a superior experience for patients. This chapter explains how Mayo orchestrates clues about quality—down to the shoelaces—based on the concept of managing clues to create the customers' service experience.

Customers Are Detectives

Customers always have some kind of experience when they interact with an organization. An experience is inherent; a positive experience is not. In interacting with organizations, customers consciously and unconsciously filter clues embedded in the experience and organize them into a set of impressions, some rational and others more emotional. Anything perceived or sensed—or conspicuous in its absence—is an experience clue. If customers can see, smell, hear, or taste it, it is a clue. A doctor who enters an exam room to meet a seated patient and remains standing while questioning the patient is likely to convey a different set of clues than a doctor who immediately sits down and interacts with the patient at eye level. Specific clues carry messages, and the clues and messages converge to create the customers' service experience that influences customers' feelings. What customers feel while the experience is occurring becomes part ...

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