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Chapter 8: Improving Patient Experience

INTRODUCTION

So, we, as human beings, live in a very imprecise world. A world where our perceptions of reality are far more important than actual reality.

–Daniel Keys Moran

Many leaders in healthcare think about delivering care to patients in terms of customer service—even equating a hospital stay to a night in a hotel. When I hear this kind of language, I often feel a tightness in my chest. I just don’t think of patients as customers or consumers.

For example, consider the adage “The customer is always right.” That’s not true of patients. When I worked in telephone triage, I received countless calls from parents who “knew” their child’s ear pain was due to an ear infection and that their child needed an antibiotic. Often, however, those parents were wrong. Imagine if we allowed patients and families to assume such diagnostic roles! Our current practice of overprescribing antibiotics would reach a whole new level. Although patients and families are indeed instrumental in the diagnostic process, they do not have a license to diagnose and prescribe. (For help handling a situation like this, see Script 8.1.)

Script 8.1

What to say when…you are dealing with angry patients or families.

A page of script shows what to say when you are dealing with angry patients or families. The text in a speech bubble corresponding to the text Tell reads as follows: To the patient’s parent: I understand you are dissatisfied with the care you are receiving on our telephone triage line. It is our first priority to provide safe, high-quality service to everyone we care for. (Allow the caller to vent.). An arrow from this speech bubble points to another exchange corresponding to the text Explain. The exchange reads as follows: The patient’s parent is angry: I have four children, and I know when my children have an ear infection. I don’t need an appointment. I need to get an antibiotic for my child! Your response: I know it is very difficult to see your child in pain. You are correct that antibiotics are a good choice for certain diagnoses; however, an antibiotic is not the appropriate treatment if your child has an outer ear infection. (Explain swimmer’s ear.) We can only determine the cause of the pain by examining your child’s ear. An arrow from this exchange points to another exchange corresponding to the text Lead by example. The exchange reads as follows: The patient’s parent remains angry: You try dealing with a screaming child in pain! I know this cry, and it’s not swimmer’s ear! Your response: Keeping your child comfortable is very important. (Review the treatment plan with anti-inflammatory medications, warm compress, etc.) It’s important we treat your child with the most appropriate treatment plan. I highly encourage you to bring your child in for an appointment. I have an appointment available today for you. An arrow from this exchange points to another exchange corresponding to the text Learn the consequence. The exchange reads as follows: The patient’s parent remains angry: Do you know how difficult it is for me to bring all my children out to the doctor’s? Your response: It is very important we examine the cause of your child’s pain. Can you make the appointment today?
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And I don’t know about you, but the last time I checked into a hotel, I wasn’t there seeking healthcare services, and I did not expect hotel staff to assess my pain levels, schedule medical appointments or procedures, or refer me to a specialist. All I wanted was a friendly face at the front desk, a clean room, and lots of clean, fluffy towels!

All that being said, I do see how the hotel industry—as well as the food and service industries—might shed light on service excellence initiatives in health-care. Take Disney, for example. Disney does an outstanding job of preparing cast members to create magical experiences for their guests (Disney Institute & Kinni, 2011). Its orientation program communicates the company’s culture, defines its heritage and traditions, and inspires enthusiasm among new employees, and its employee guidelines clearly and succinctly define the responsibilities of cast members. Disney also accepts corrective criticism from guests regarding cast members (and emphasizes the importance of promptly and courteously recovering from the criticism). Finally, the company clearly distinguishes between expectations of cast members when they’re “onstage,” when guests are present, versus “off-stage” (Disney Institute & Kinni, 2011). It’s no wonder many healthcare leaders who are interested in delivering positive patient experiences look to Disney’s approach to customer service for guidance.

Like Disney cast members, healthcare workers often find themselves “onstage” and should adjust their behavior accordingly. After all, patients do not want to hear staff complaining in the cafeteria, outside patient rooms, or in hallways!

There is no “one size fits ...

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