Discovery Health Member Services

The Challenge

Discovery Health's member services team handles some of the most emotionally charged calls in any contact centre: claims denials, chronic medication queries, and hospital authorisation requests. Standard QA frameworks — optimised for speed and process adherence — were generating high scores for agents who were technically compliant but leaving members feeling unheard.

CSAT data told a different story from QA scores: members rated calls 3.1/5 on average while agents averaged 88% on QA evaluations. The gap was a symptom of a QA model that didn't measure empathy or emotional containment — the dimensions that actually drove member satisfaction in a healthcare context.

The Solution

QUALICORE's scorecard builder allowed Discovery's QA leadership to redesign the evaluation framework with empathy dimensions weighted at 35% of the total score. Specific behaviours were operationalised: "acknowledges emotional context before moving to resolution," "uses member's name in moment of distress," "confirms understanding before ending call." Each dimension includes scored examples from real (anonymised) calls embedded in the knowledge base.

Coaching plans for low-empathy scores use a structured reflection approach — agents listen to their own call, score themselves on the empathy dimensions, then discuss with their team leader. The approach was built into QUALICORE coaching templates after a pilot showed it outperformed standard feedback delivery.

The Results

Member satisfaction scores (CSAT) rose from 3.1 to 3.9/5 — a 26% improvement — within six months. The correlation between QUALICORE's empathy dimension scores and CSAT feedback became measurable for the first time, validating the framework redesign. Agents with consistently high empathy scores now mentor newer team members through formal peer-coaching sessions, tracked in QUALICORE.

Formal complaints relating to "agent attitude" fell 44% in the same period.