Looking through fresh eyes

I am always amazed at how quickly we humans become desensitized to our surroundings. For example, about a month ago, I pulled out a half-dozen framed photos to hang in our hallway. Knowing how dangerous I can be with tools and a bright idea, my husband quickly “volunteered” to hang them after work that day. The day turned into a week, the week turned into a month--and you guessed it: The pictures are still sitting on the family room book case. At first, the stack of frames stood out like a sore thumb and annoyed the heck out of me. But after dusting around them a few times and looking past them as I watched television, I began to not notice them.

It’s a phenomenon called habituation. Things become so familiar to us that we forget how our home or office might look to someone seeing it for the first time. In this case, the framed photos have become nearly invisible to us because they are now familiar in what was once a state of displacement. But to a guest coming to our home for the first time the stack of frames would look out of place and may even give the impression of disarray.

The hospital or clinic environment is no different. What may have once been clutter often becomes part of the normal décor. We walk past dying or dusty plants, fail to notice stains in the carpet or tape up paper signs and don’t see them even though they have been hanging for years. I once asked a practice manager why they needed seven signs in the registration area informing patients about their co-pay requirements. She was shocked to see what had been under her own nose for years—she’d never noticed them! One problem was that she rarely (if ever) walked around to the waiting room side of the registration counter. She hadn’t ever consciously tried to see the environment from the patients’ perspective.

Besides becoming immune to clutter, habituation causes us to forget that healthcare is a foreign, often frightening environment for our customers. The sights, smells and sounds of the hospital or the medical terminology and jargon may be commonplace for us, but to our patients and their families, they can be anxiety-provoking.

It is important to remember that we are all judges. In fact it takes about three seconds to form an opinion about a person or place. In health care settings, we have a duty to make sure that everything about the environment and the experience instills confidence in our patients about our level of quality. If a patient sees a dirty environment, it is probable that he will begin questioning quality and safety. It is also likely that he will begin to be wary of infection control. As my favorite nurse manager used to say, “the devil is in the detail.”

Oe slogan we use when mystery shopping medical practices is; “If everything speaks- what are you saying? “ This short question encourages the health care workers to see their surroundings through fresh eyes and to evaluate whether or not the snapshot before them truly represents the organization’s commitment to quality. Think of the patient experience pathway as a series of snapshots--and ask yourself how one particular snapshot would be interpreted. It isn’t just the physical surroundings that create indelible first impressions; it’s also the staff behaviors and statements. Observing staff behavior can set the tone for the patient’s encounter with the provider.

Take a fresh look at your organization and ask yourself: If everything speaks, what are we saying?