Everything a patient hears, sees, smells and touches during a health care encounter should instill trust in the organization. Unfortunately, many of the real life experiences our patients have, end up shattering trust in a split second when an employee speaks without filtering through the patient experience lens. I’m often concerned about comments that I overhear during medical encounters. I figure that I only catch an infinitesimal number of comments myself, so if I continually observe disturbing encounters, how many are really happening out there at any given time?
Just last weekend I accompanied a family member to an emergency room in a large, nationally renowned academic medical center. Her condition was not life-threatening but she has an underlying heart condition that must be considered in every health-related encounter. Learning about her heart condition, the nurse placed the EKG leads on her chest to monitor her heart rate, commented on how slow it was, and left the room. The monitor’s alarm sounded every time her heart rate dropped below 37 beats per minute. After several episodes, the nurse returned, and said, “I’m going to just shut off the monitor so it doesn’t drive us nuts at the nurses’ station,” and left.
What message did she just give? That it is more important that the nurses not be bothered by those pesky alarms than it is to keep track of a dangerously low heart rate. As a nurse, I knew that the patient wasn’t in any imminent danger, but the patient was stunned and concerned by both the comment and the fact that the nurse had turned off the alarm. She even stated that she felt shut off from the staff.
Within minutes of the monitor episode, a lab tech entered the room. She spotted the patient’s purse on the floor and said, “Here, let me put this up on the counter for you. Hospital floors are notorious for being filthy.” I’m going to give the tech the benefit of the doubt. Her intentions were good, but the delivery ended up creating more concern than comfort. Was the place crawling with infectious diseases? Hadn’t the floor been cleaned? Should I be worried about catching something?
Both of these comments occurred with one patient during one hour of one care encounter. How many more were happening at the same time in the millions of encounters happening in thousands of organizations around the globe?
Every encounter with every patient must help to instill confidence. That means everyone who comes in contact with patients must learn to filter their remarks through the patients’ eyes and ears. Think before you speak.
Showing posts with label customer experience. Show all posts
Showing posts with label customer experience. Show all posts
Saturday, April 3, 2010
Friday, March 19, 2010
Care Always
My last feature article was centered on the famous quote, “to cure sometimes, relieve often, care always.” That quotation has always been a centering force for me both as a nurse and as a health care leader. It is a powerful reminder of why many of us choose health care careers. We care about others and want to do our best to cure and relieve, but the driving force is that we care - often deeply. There are times however when the condition or injury is far beyond the scope of modern medicine. When cure is impossible and relief is elusive, what always remains is our ability to care. Today I face one of those times. My father is in hospice and is resting peacefully as he drifts through his final hours. I wait and care. The nurses reposition, soothe, medicate and care. The chaplain prays, soothes and cares. My brothers and sisters and mother gather, support, pray and care.
We are fragile and broken as the fabric of our lives unravels slowly with the loss of our father, husband, and grandfather. Each time I walk to his room from my car I pass employees who each greet me with a warm smile. Even without words, their demeanor makes me feel welcome and I’m glad that I am here. I see the staff interacting with other patients and feel confident that my father is cared for with the same nurturing, compassionate care.
Sitting at his bedside the nurses care for us as though we are as special as the patients. They don’t even need to speak to convey their compassion for our situation. We feel comforted by their actions and their mere presence. Can they cure what will take my father within the next few hours? No. But they can nurture and support both him and us. And for that I am eternally grateful. We cannot always cure, or even relieve. But we can care.
We are fragile and broken as the fabric of our lives unravels slowly with the loss of our father, husband, and grandfather. Each time I walk to his room from my car I pass employees who each greet me with a warm smile. Even without words, their demeanor makes me feel welcome and I’m glad that I am here. I see the staff interacting with other patients and feel confident that my father is cared for with the same nurturing, compassionate care.
Sitting at his bedside the nurses care for us as though we are as special as the patients. They don’t even need to speak to convey their compassion for our situation. We feel comforted by their actions and their mere presence. Can they cure what will take my father within the next few hours? No. But they can nurture and support both him and us. And for that I am eternally grateful. We cannot always cure, or even relieve. But we can care.
Thursday, December 10, 2009
What are your "Never Events" in the Patient Experience?
The term, “never events” strikes fear in the hearts of anyone in health care. High quality, safe care means that certain things should never occur on our watch. The never events that we have determined in health care are all clinically based. But imagine if we could apply the same concept to customer service and the patient experience. What if reimbursement was tied to certain events? What would we identify as the “never events” in the patient experience? I have pondered this a bit and come up with the Baird top 10 list of “never events” in the patient experience. Could these events be happening without your knowledge? What you don't know, could be hurting you.
Like the Letterman top 10, the Baird list goes from least offensive to most offensive.
Never:
10. point with directions instead of escorting someone to his destination.
9. take personal calls on your cell or send texts when in the presence of customers.
8. transfer a phone call without telling the caller that you are going to transfer then and to whom they are being transferred.
7. talk about your personal problems to the patient/customer
6. say, “I don’t have time.”
5. say, “You’re not the only patient (customer)here. You’ll have to wait your turn”
4. malign the doctors or your co-workers(other shifts, departments or staff) to the patient and family.
3. speak negatively about the patients with your co-workers.
2. say, “You’re not my patient.”
1. say, ”It’s not my job.”
Just imagine what the patient experience might be if we could guarantee that none of these things would ever occur in any of our health care organizations. It may not be the answer to every customer service challenge, but it would be a good start.
Everything about the patient experience must instill trust in the organization, the care and the people. The examples cited above are real-life observations that I have made while either a mystery shopper or as a consumer. During each occurrence, I have reflected on my own reactions and the implications these remarks might have for other patients. In each situation, they erode trust or have a negative impact on the culture by promoting apathy toward the customers’ needs.
Leaders who are serious about fostering a culture that promotes a positive patient experience can start by creating a clear service vision and your own list of never events.
Like the Letterman top 10, the Baird list goes from least offensive to most offensive.
Never:
10. point with directions instead of escorting someone to his destination.
9. take personal calls on your cell or send texts when in the presence of customers.
8. transfer a phone call without telling the caller that you are going to transfer then and to whom they are being transferred.
7. talk about your personal problems to the patient/customer
6. say, “I don’t have time.”
5. say, “You’re not the only patient (customer)here. You’ll have to wait your turn”
4. malign the doctors or your co-workers(other shifts, departments or staff) to the patient and family.
3. speak negatively about the patients with your co-workers.
2. say, “You’re not my patient.”
1. say, ”It’s not my job.”
Just imagine what the patient experience might be if we could guarantee that none of these things would ever occur in any of our health care organizations. It may not be the answer to every customer service challenge, but it would be a good start.
Everything about the patient experience must instill trust in the organization, the care and the people. The examples cited above are real-life observations that I have made while either a mystery shopper or as a consumer. During each occurrence, I have reflected on my own reactions and the implications these remarks might have for other patients. In each situation, they erode trust or have a negative impact on the culture by promoting apathy toward the customers’ needs.
Leaders who are serious about fostering a culture that promotes a positive patient experience can start by creating a clear service vision and your own list of never events.
Monday, August 24, 2009
Make Sure Your Filter is Working
I discovered years ago that it is really important to connect the brain to the mouth before the latter starts moving. Most of us develop an internal filter that starts working at an early age and, with any luck, continues to function throughout our lives. That filter can save us from embarrassment at the very least, and law suits in worst case scenarios. Unfortunately, we all have those nasty little lapses when we find ourselves prying the proverbial foot out of the mouth.
If you work in health care, you had better have a good filter in place because patients and concerned family members need your reassurance and support. If I could teach health care workers just one thing, it would be to make sure that every word and action that they display should build patients’ trust. Having good internal filters running in high gear is a good start.
A few months ago, my brother, who was undergoing chemotherapy for non-Hodgkin’s lymphoma, contracted pneumonia while visiting family in Florida. He was taken to the nearest hospital with a high fever, chills and violent cough. The ER physician expressed concern about his debilitated state and admitted him immediately to begin IV antibiotics. He was admitted to a nursing unit and was greeted by a nurse who entered the room yawning and said, “Sorry. I’m just exhausted. I’ve been here over 12 hours already. We’re really short staffed and I’m working a double.”
My brother’s reaction? He and his wife both thought, “Oh great, we’re going to get really good care. We’ve got an over-worked, exhausted nurse here. This isn’t going to be good.”
They pointed out to the nurse that the IV bag was empty and the nurse asked, “Do you know what I am supposed to hang? Did the ER doctor say anything?” Again, their reaction was a combination of irritation and anxiety. They thought, “Why was the nurse asking THEM what the doctor ordered? Didn’t the nursing unit and ER communicate? Who was in charge of the care here?” At that point, both my brother and his wife had little confidence that they had made the right choice in going to the hospital for help. They actually felt more vulnerable than before he was admitted.
If I could rewind that scenario and talk with the nurse in advance, I’d ask her to consider the patient’s perspective first and foremost. I’d ask her what impression she’d like to leave with her patients. Then I’d ask her to think of statements and actions that would reinforce the desired impression. In doing so, I’d be helping this nurse to set up that vital filter for her words and actions. The result would be a much more positive patient experience.
These are the kinds of situations that make health care leaders shudder. All it takes is one staff person without an internal filter to set you up for problems ranging from a nasty complaint to a full-blown law suit. Help your staff to see the importance of good filtering. One trick is to consider these questions before opening your mouth:
· Is it true?
· Is it necessary?
· Who will benefit from my remarks?
We throw around the term “patient-centered” care quite a bit. If the patient is going to be at the center, everyone who comes in contact with the patient must filter so that everything that is said and done is truly with the patient at the core.
I get a filter change in my car every 2000 miles. Maybe we’d all benefit from adjusting our internal filters every 2000 words.
Sunday, June 7, 2009
Tough Economy Requires Even Better Service
During tough economic times, education and professional development are often among the first casualties of hospital budget cuts. If your customer service initiative falls into this cost center; think twice before you make that cut. You cannot afford to let your customer service slip especially in tough times. When money is tight, your patients think a bit more before parting with co-pays and deductibles especially if they have HSAs. After all, this $35 co-pay or $2000 deductible is their hard-earned money. That means that when they turn to you for care, they are scrutinizing things even more closely. They expect competent medical care from their providers. What they experience (and ultimately judge you on) is the service around that care. They need to see the value-added experience when they turn to you for care. After all, you aren’t modifying your mission statement with a disclaimer that reads, “we promise to deliver high quality compassionate, patient-centered care except during an economic downturn at which time, all bets are off.” Your mission and brand promise must remain consistent through good times and bad.
An article in Business Week http://tinyurl.com/ajtx4e stresses that the companies that will be the most successful during an economic downturn are those that keep a close watch on service at the front lines. So how can you keep up the training and professional development when funds are tight?
1. Focus on training-the-trainer. An internal team of well trained trainers can work wonders for keeping your customer service efforts alive and well at the front lines. But make sure that the training is carefully aligned with goals and service standards.
2. Seek web-based training opportunities for supervisors and managers that help you to keep focused on your mission. You can get great service leadership content without the travel expenses.
3. Incorporate self-study courses coupled with group discussions for leaders. This helps to hone individual leadership skills and tie these efforts back to organizational goals and personal accountability.
4. Start a book study group with managers and supervisors that focuses on customer service strategies and best practices.
5. Organize a quarterly leadership development curriculum with clear goals and objectives. Bring speakers and trainers into the organization rather than spending money to send individual managers to state and national conferences. The cost to send two or three managers outside of the organization for such meetings will be the same as bringing in a highly qualified speaker/trainer into your organization where they can reach 100 managers and supervisors.
The question isn’t IF you can afford to continue your customer service efforts, it’s HOW you will continue your customer service efforts. Once you shift your focus to that mindset, you’ll be much more likely to find good solutions that fit the budget and keep your team aligned with the mission.
An article in Business Week http://tinyurl.com/ajtx4e stresses that the companies that will be the most successful during an economic downturn are those that keep a close watch on service at the front lines. So how can you keep up the training and professional development when funds are tight?
1. Focus on training-the-trainer. An internal team of well trained trainers can work wonders for keeping your customer service efforts alive and well at the front lines. But make sure that the training is carefully aligned with goals and service standards.
2. Seek web-based training opportunities for supervisors and managers that help you to keep focused on your mission. You can get great service leadership content without the travel expenses.
3. Incorporate self-study courses coupled with group discussions for leaders. This helps to hone individual leadership skills and tie these efforts back to organizational goals and personal accountability.
4. Start a book study group with managers and supervisors that focuses on customer service strategies and best practices.
5. Organize a quarterly leadership development curriculum with clear goals and objectives. Bring speakers and trainers into the organization rather than spending money to send individual managers to state and national conferences. The cost to send two or three managers outside of the organization for such meetings will be the same as bringing in a highly qualified speaker/trainer into your organization where they can reach 100 managers and supervisors.
The question isn’t IF you can afford to continue your customer service efforts, it’s HOW you will continue your customer service efforts. Once you shift your focus to that mindset, you’ll be much more likely to find good solutions that fit the budget and keep your team aligned with the mission.
Friday, March 6, 2009
Going Viral from a Waiting Room Near You
• OMG he’s beautiful. 8 lbs. 3 oz. The doctor is looking him over right now. More later.
• Mom is doing great. Just out of surgery and in recovery. No word from the doctor yet. I’ll keep you posted unless nurse Ratched confiscates my laptop. She has vetoed cell phones in the waiting room. Not sure why.
• Here she is! One hour old and already stealing our hearts. Labor went fast and our nurses were fabulous.
• We’re still in the waiting room. Apparently we didn’t make the list of high priorities. Should I file a change of address form? LOL
These short comments are just a sample of the correspondence that could be shooting through cyberspace from your waiting rooms, patient rooms and just about any other nook or cranny of your hospital. Today’s consumers are wired and communicating non-stop using laptops and cell phones to share opinions and keep loved ones up-to-date on their breaking news. I know because I’m one of them.
Between my Blackberry and my laptop with its trusty air card, I’m able to log in and stay in touch with family and friends at all hours of the day and night and from any location in the world. And for me it’s great because as the nurse in a large but close knit family, I am usually the one to keep my nine siblings up to speed on medical events involving my parents. There have been times when I have felt like a medical correspondent broadcasting live from various hospital waiting rooms as I deliver the updates to anxiously awaiting family members. Frankly I love it. When my grandson was born in January, I was able to share the big news within minutes.
In addition to old-fashioned email, the uncensored, real-time communication venues like Twitter and Facebook allow patients and family members to post their thoughts, opinions and even photos of their life’s most important events to viewers from around the world. And rest assured; many of those events are happening within your four walls. While we talk about transparency, our consumers are throwing back the curtain and unveiling their health care encounters with millions. We can’t hide and we can’t spin. What we can do, is make sure that we are consistently performing at our best. Keep raising the bar.
• Mom is doing great. Just out of surgery and in recovery. No word from the doctor yet. I’ll keep you posted unless nurse Ratched confiscates my laptop. She has vetoed cell phones in the waiting room. Not sure why.
• Here she is! One hour old and already stealing our hearts. Labor went fast and our nurses were fabulous.
• We’re still in the waiting room. Apparently we didn’t make the list of high priorities. Should I file a change of address form? LOL
These short comments are just a sample of the correspondence that could be shooting through cyberspace from your waiting rooms, patient rooms and just about any other nook or cranny of your hospital. Today’s consumers are wired and communicating non-stop using laptops and cell phones to share opinions and keep loved ones up-to-date on their breaking news. I know because I’m one of them.
Between my Blackberry and my laptop with its trusty air card, I’m able to log in and stay in touch with family and friends at all hours of the day and night and from any location in the world. And for me it’s great because as the nurse in a large but close knit family, I am usually the one to keep my nine siblings up to speed on medical events involving my parents. There have been times when I have felt like a medical correspondent broadcasting live from various hospital waiting rooms as I deliver the updates to anxiously awaiting family members. Frankly I love it. When my grandson was born in January, I was able to share the big news within minutes.
In addition to old-fashioned email, the uncensored, real-time communication venues like Twitter and Facebook allow patients and family members to post their thoughts, opinions and even photos of their life’s most important events to viewers from around the world. And rest assured; many of those events are happening within your four walls. While we talk about transparency, our consumers are throwing back the curtain and unveiling their health care encounters with millions. We can’t hide and we can’t spin. What we can do, is make sure that we are consistently performing at our best. Keep raising the bar.
Wednesday, August 20, 2008
“Sorry” can go a long way--but when is it too little, too late?
In my business, I live, eat and breathe customer service. And yet, I really don’t think my standards are higher than most people’s. I am perhaps, just a bit more observant. Because I coach and teach health care providers and support staff about how they can improve their customers’ experiences, I’m always on the lookout for best practices as well as glitches--whether the encounter takes place at a restaurant, hotel or hospital. Then, solicited or not, I feel compelled to share my wisdom. Putting on my consultant cap, I offer what I think are great suggestions--only to be met with glazed looks or worse, the “Who-do-you-think-you-are-to-be-giving-me-advice?” smirk. More than once, my husband Mark has been beside me whispering, “They don’t care. Move on. Let’s go.” Apparently, he's actually the more observant one because he clearly sees that my words of wisdom are being squandered on the deaf.
When I’m the patient, I do the same thing. I can see what needs to be improved, and I gladly share tips and pointers. What’s funny is that when I’m hired by an organization to do assessments, they actually do heed what I have to say. When I offer it for free, it has little or no value. Take, for example, my own health care providers. I’ve come to realize that I probably tolerate much more than I should in the spirit of teaching and coaching.
I recently found a lump in my breast. Very concerned, I called first thing in the morning to request a mammogram. Mind you, this practice allows self-referral for mammograms so this wasn’t unreasonable. Instead, I was told that I couldn’t be seen without first going through my provider, who wasn’t in at the time. I was then told that the triage nurse would call me. By 3:45 in the afternoon, I was pretty sure that I’d been forgotten. I called back, and was again assured that the triage nurse would call me. It was a Friday afternoon, and you can guess what happened. No call. A long weekend with a nagging concern loomed ahead of me.
When Monday came, I fully expected the phone to ring with the triage nurse ready to give me the information that I needed--and perhaps an apology for not calling on Friday. At 11:00 AM I went online to find a new provider, but the truth is, I didn’t want or need the hassle of starting over. Here was the quandary: Do I stay with a provider that doesn’t respond to their patients without dogged persistence? Or, do I try someone else? It really comes down to whether I expend my energy fighting for help from my existing provider or expend it on a search into the unknown for what might just be another setting with the same level of incompetence. Frankly I don’t think that consumers should have to expend this type of energy. And guess what? I have great insurance. You would think I might be able to cut through a bit of hassle.
By 2:00 on Monday afternoon I called my provider office back and let them know that I had not been called on Friday. They offered to set me up with an appointment in ten days. I said, “No thank you,” hung up, and went back to my online search. At 2:30 on Monday afternoon the triage nurse called, opening with, “I understand you have some concerns.” I told her “No, on Friday I was concerned. On Saturday and Sunday I was concerned, but now I am angry.” I asked her to clarify for me what I should really expect when her clinic tells me that I will get a call back. Perhaps my expectations were too high in expecting that it meant the same day. After a little banter back and forth she finally conceded with, “Well, I guess you should have expected a call last Friday and for that I apologize.” Convincing? Hardly. I nearly had to pull the apology out of her when it was clearly a “service recovery” opportunity. When she offered me an appointment in 10 days I laughed out loud. So much for the possibility of service recovery. Somebody must have missed that seminar.
Long story short, I got in for the diagnostic mammogram and ultrasound and everything checked out just fine. But what about the other patients who aren’t as persistent or outspoken? I had one foot out of the door, ready to leave this practice and never come back when this statistic came back to me; Over 90% of unhappy patients will leave a practice and never tell them why they left. I was going to be one of the silent movers. But old habits die hard. Once again, I put on the consultant hat and offered my unsolicited observations to the clinic manager and director of women’s services. This hadn’t been an isolated incident for me. I had forgiven (but not forgotten) a previous omission as an isolated incident. Now, however, I sense a pattern.
What would you do?
When I’m the patient, I do the same thing. I can see what needs to be improved, and I gladly share tips and pointers. What’s funny is that when I’m hired by an organization to do assessments, they actually do heed what I have to say. When I offer it for free, it has little or no value. Take, for example, my own health care providers. I’ve come to realize that I probably tolerate much more than I should in the spirit of teaching and coaching.
I recently found a lump in my breast. Very concerned, I called first thing in the morning to request a mammogram. Mind you, this practice allows self-referral for mammograms so this wasn’t unreasonable. Instead, I was told that I couldn’t be seen without first going through my provider, who wasn’t in at the time. I was then told that the triage nurse would call me. By 3:45 in the afternoon, I was pretty sure that I’d been forgotten. I called back, and was again assured that the triage nurse would call me. It was a Friday afternoon, and you can guess what happened. No call. A long weekend with a nagging concern loomed ahead of me.
When Monday came, I fully expected the phone to ring with the triage nurse ready to give me the information that I needed--and perhaps an apology for not calling on Friday. At 11:00 AM I went online to find a new provider, but the truth is, I didn’t want or need the hassle of starting over. Here was the quandary: Do I stay with a provider that doesn’t respond to their patients without dogged persistence? Or, do I try someone else? It really comes down to whether I expend my energy fighting for help from my existing provider or expend it on a search into the unknown for what might just be another setting with the same level of incompetence. Frankly I don’t think that consumers should have to expend this type of energy. And guess what? I have great insurance. You would think I might be able to cut through a bit of hassle.
By 2:00 on Monday afternoon I called my provider office back and let them know that I had not been called on Friday. They offered to set me up with an appointment in ten days. I said, “No thank you,” hung up, and went back to my online search. At 2:30 on Monday afternoon the triage nurse called, opening with, “I understand you have some concerns.” I told her “No, on Friday I was concerned. On Saturday and Sunday I was concerned, but now I am angry.” I asked her to clarify for me what I should really expect when her clinic tells me that I will get a call back. Perhaps my expectations were too high in expecting that it meant the same day. After a little banter back and forth she finally conceded with, “Well, I guess you should have expected a call last Friday and for that I apologize.” Convincing? Hardly. I nearly had to pull the apology out of her when it was clearly a “service recovery” opportunity. When she offered me an appointment in 10 days I laughed out loud. So much for the possibility of service recovery. Somebody must have missed that seminar.
Long story short, I got in for the diagnostic mammogram and ultrasound and everything checked out just fine. But what about the other patients who aren’t as persistent or outspoken? I had one foot out of the door, ready to leave this practice and never come back when this statistic came back to me; Over 90% of unhappy patients will leave a practice and never tell them why they left. I was going to be one of the silent movers. But old habits die hard. Once again, I put on the consultant hat and offered my unsolicited observations to the clinic manager and director of women’s services. This hadn’t been an isolated incident for me. I had forgiven (but not forgotten) a previous omission as an isolated incident. Now, however, I sense a pattern.
What would you do?
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