Think about the first flight you took as a child, or the first flight of your children. Did your parents, or did you warn “There will probably be long lines in security and we’ll have to wait for a while. The food isn’t very good. It might be a bumpy ride. Your ears may feel like they’re imploding. You’ll have to sit still for hours on end in a small space.”? Probably not. Most likely you or your parents said “We’re getting to go somewhere new and exciting.” Or “We’re going on an adventure.” Consider how much that framing can affect a person’s perceptions.
"Managing up" is the act of providing information to a customer that highlights positive aspects of the service/organization. Many have heard that this can be a valuable tactic for better patient perceptions, but maany have also questioned the ease with which they can manage up. Many organizations are faced with real difficulties, whether it is older facilities, high turnover rates, a questionable financial future, etc. These organizations forget that even they are still able to provide excellent care to many of their patients and talking about that excellent care puts patients’ minds at ease.
Managing up is not about lying. It’s simply about highlighting the positive to put people at ease. Whether patients are in your care for a small outpatient procedure or a long inpatient stay, they are in a foreign environment. Not every healthcare encounter has people shaking in their boots, in fact most probably do not. However, healthcare encounters put people in unfamiliar territory and you can help them acclimate by providing information. If you are in an older facility, so what? Maybe you have a really experienced nursing team or maybe you have the latest technology that the patient will take advantage of, or maybe they will be treated by an extremely caring and patient physician…every person should know something about their organization that puts patients at ease. This is a very effective tactic for better patient perceptions, but more importantly, it’s the right thing to do.
Friday, November 5, 2010
Friday, September 24, 2010
Get Down
No, I'm not advocating for a dance party.
I moved to a new city within the last year and have been salon hopping since I arrived. Everywhere I tried was expensive and...just ok. But, I think I may have recently found "the one." I walked in to a very welcoming environment and met my new stylist. The first order of business was making me comfortable which included getting me some water, showing me where the bathrooms were, giving me a shirt to change into, asking if I needed any magazines, etc. Next, we started talking about the plan and I was so impressed when my stylist squatted down to speak with me. She got down on my level (I was seated...I'm not thaaaat short). I think I've had one doctor that sat down to chat me throughout my life(and of course, I thought he was excellent). In fact, I even witnessed a person yell "we can't have doctors sitting down!" when one of my colleagues mentioned this idea in a presentation. I know that some nurses and physicians do this, but definitely not all, and I'm sure more could be open to doing things a little bit differently for the benefit of the patient.
Taking those steps for comfort in the beginning (from water to squatting...no pun intended) allows for more open dialogue. No matter who the patient is, hospitals, doctor's offices, and clinics are all foreign environments. The more we can make customers or patients comfortable, the less foreign the environments seem.
I moved to a new city within the last year and have been salon hopping since I arrived. Everywhere I tried was expensive and...just ok. But, I think I may have recently found "the one." I walked in to a very welcoming environment and met my new stylist. The first order of business was making me comfortable which included getting me some water, showing me where the bathrooms were, giving me a shirt to change into, asking if I needed any magazines, etc. Next, we started talking about the plan and I was so impressed when my stylist squatted down to speak with me. She got down on my level (I was seated...I'm not thaaaat short). I think I've had one doctor that sat down to chat me throughout my life(and of course, I thought he was excellent). In fact, I even witnessed a person yell "we can't have doctors sitting down!" when one of my colleagues mentioned this idea in a presentation. I know that some nurses and physicians do this, but definitely not all, and I'm sure more could be open to doing things a little bit differently for the benefit of the patient.
Taking those steps for comfort in the beginning (from water to squatting...no pun intended) allows for more open dialogue. No matter who the patient is, hospitals, doctor's offices, and clinics are all foreign environments. The more we can make customers or patients comfortable, the less foreign the environments seem.
Wednesday, September 22, 2010
The Importance of Teaching the "How"
In two completely independent situations, I was recently confronted by leaders of healthcare organizations who were very down on customer service, stating that they had implemented every best practice that is out there (rounding, discharge calls, scripting, etc.) and nothing had moved their scores. They both swore that they had nearly 100 percent compliance on the actions and they had documentation to prove it.
Taking these statements as fact, the conversations were steered toward the quality of the actions. What training or measurements were in place to ensure that all staff were doing these best practices in a way that best communicated to the patient that they cared? Ultimately, the finding was that very little focus was put on how to do the best practices, and instead many of these initiatives had been rolled out with very little training.
In customer service, just doing something doesn't necessarily mean that you get, or even deserve, an excellent rating from your customers. And for many individuals, they need training, practice and validation to make new patient interactions become comfortable and sincere. A few months ago, I was at a local grocery store and while checking out, the young woman tried to engage me in conversation, as many register employees will do. "Did you find everything okay?" she asked. "Yes," I replied. "Are you watching the Husker game this afternoon?" "Of course," I answered. "Any big plans for tomorrow?" she asked. At this point, the conversation was quite uncomfortable for me, but not because of the questions themselves. She was struggling to make conversation and ultimately didn't seem to care about the answers I was giving. I could see that she wasn't sure what else to ask me, and the belt full of groceries was making her nervous about the looming silence. She ultimately sensed my discomfort, and at that moment, she probably did the best thing she could have to recover the situation. She blurted out, "My boss told me today that I need to talk with the customers or I'll be fired, and I'm just not very good at it!"
Now, to be clear, I am not advocating that employees share their trial and tribulations with customers, because frankly, they don't want to hear them. But in this instance, her sharing her personal struggles with me, broke the ice, and ultimately led to a positive interaction. Further, she was learning and seemed to have an interest in doing better, and I give her credit for that.
When it comes to customer service, how well an action is done is equally important to the action itself. If you feel that a best practice (especially those that have been proven successful over and over again) didn't work to improve patient perceptions in your department, I urge you to try again. This time, develop strategies for training staff on the patient interaction, identify top performers that others can observe, and find ways to evaluate the quality and not just the quantity. Further, remember that it may take some time for your staff to get comfortable with the new interactions, so don't give up too quickly.
Taking these statements as fact, the conversations were steered toward the quality of the actions. What training or measurements were in place to ensure that all staff were doing these best practices in a way that best communicated to the patient that they cared? Ultimately, the finding was that very little focus was put on how to do the best practices, and instead many of these initiatives had been rolled out with very little training.
In customer service, just doing something doesn't necessarily mean that you get, or even deserve, an excellent rating from your customers. And for many individuals, they need training, practice and validation to make new patient interactions become comfortable and sincere. A few months ago, I was at a local grocery store and while checking out, the young woman tried to engage me in conversation, as many register employees will do. "Did you find everything okay?" she asked. "Yes," I replied. "Are you watching the Husker game this afternoon?" "Of course," I answered. "Any big plans for tomorrow?" she asked. At this point, the conversation was quite uncomfortable for me, but not because of the questions themselves. She was struggling to make conversation and ultimately didn't seem to care about the answers I was giving. I could see that she wasn't sure what else to ask me, and the belt full of groceries was making her nervous about the looming silence. She ultimately sensed my discomfort, and at that moment, she probably did the best thing she could have to recover the situation. She blurted out, "My boss told me today that I need to talk with the customers or I'll be fired, and I'm just not very good at it!"
Now, to be clear, I am not advocating that employees share their trial and tribulations with customers, because frankly, they don't want to hear them. But in this instance, her sharing her personal struggles with me, broke the ice, and ultimately led to a positive interaction. Further, she was learning and seemed to have an interest in doing better, and I give her credit for that.
When it comes to customer service, how well an action is done is equally important to the action itself. If you feel that a best practice (especially those that have been proven successful over and over again) didn't work to improve patient perceptions in your department, I urge you to try again. This time, develop strategies for training staff on the patient interaction, identify top performers that others can observe, and find ways to evaluate the quality and not just the quantity. Further, remember that it may take some time for your staff to get comfortable with the new interactions, so don't give up too quickly.
Tuesday, September 21, 2010
"These women are going home with babies, what more do they want?"
I do NOT believe that sentiment is shared by most of that OB nurse's colleagues, and in fact, I don't believe she typically felt that way either. I believe I caught her on a bad day. I know, how terribly optimistic of me?!?! I believe the nurse that said that to me, who I'll call "Nurse Hammer," has given EXCELLENT care to hundreds, probably thousands of patients.
Nurse Hammer works on a specific unit with specific people and while she's delivered great care before, this was undoubtedly not the first time she'd rolled her eyes or sighed in disgust. Perhaps she argued with her spouse or child that morning, perhaps she had taken care of an unruly patient the day before, or maybe she was concerned about possible layoffs. All of these and many more are real possibilities and have real consequences on a person's mood and demeanor. The problem is when colleagues let them affect patient care. Notice I said "colleagues."
I trace what this nurse said to me back to a lack of teamwork. When Nurse Hammer said this to me, her colleage that worked on the same unit simply looked at me and shrugged her shoulders. One of Patrick Lencioni's "Five Dysfunctions of a Team" is the avoidance of accountability. To him, accountability "refers specifically to the willingness of team members to call their peers on performance or behaviors that might hurt the team" (pg 212). Nurse Hammer's colleague should have called her on her dismotivating bahavior. Of course, that's not an easy thing to do, but have you ever heard of a happy couple that never had a fight? Conflict is a product of - and vital to - caring.
If you're a nurse, there's probably a reason and "making millions" probably isn't it. Rather, it's rewarding to care for people when they're sick, bring new life into the world, hold people's hands when they're leaving it. Yet, caring for your colleagues is also important if you want to deliver exceptional care to your patients ALL the time and sometimes, that means confrontation.
So, in answer to Nurse Hammer's question "...what more do they want?" Your patients want teamwork.
Nurse Hammer works on a specific unit with specific people and while she's delivered great care before, this was undoubtedly not the first time she'd rolled her eyes or sighed in disgust. Perhaps she argued with her spouse or child that morning, perhaps she had taken care of an unruly patient the day before, or maybe she was concerned about possible layoffs. All of these and many more are real possibilities and have real consequences on a person's mood and demeanor. The problem is when colleagues let them affect patient care. Notice I said "colleagues."
I trace what this nurse said to me back to a lack of teamwork. When Nurse Hammer said this to me, her colleage that worked on the same unit simply looked at me and shrugged her shoulders. One of Patrick Lencioni's "Five Dysfunctions of a Team" is the avoidance of accountability. To him, accountability "refers specifically to the willingness of team members to call their peers on performance or behaviors that might hurt the team" (pg 212). Nurse Hammer's colleague should have called her on her dismotivating bahavior. Of course, that's not an easy thing to do, but have you ever heard of a happy couple that never had a fight? Conflict is a product of - and vital to - caring.
If you're a nurse, there's probably a reason and "making millions" probably isn't it. Rather, it's rewarding to care for people when they're sick, bring new life into the world, hold people's hands when they're leaving it. Yet, caring for your colleagues is also important if you want to deliver exceptional care to your patients ALL the time and sometimes, that means confrontation.
So, in answer to Nurse Hammer's question "...what more do they want?" Your patients want teamwork.
Thursday, September 16, 2010
The Egyptians discovered many things, great customer service not included.
I recently vacationed in Egypt along with my better half. We spent some time in Cairo, toured the Valley of the Kings and Karnak Temple in Luxor, hiked to the top of Mt. Sinai, and much, much more. But one thing we never really found while we were vacationing was consistent customer service. I usually steer clear of the bad side of service because there are usually so many great examples to talk about. But, I can't ignore the teachable moments of these "what not to do" moments:
If someone pays you money to drive them somewhere, show up at least somewhat close to the time expected, and if they have to come and find you and wake you from your slumber, be a little apologetic.
If you make a milkshake, do not let it sit in the sun for 15 minutes until it's grossly luke warm before delivering it to customers (especially when they're already doubled over with stomach cramps).
If someone pays you to drive them somewhere, don't stop on the middle of the highway and leave your car running while you go to get a snack.
Don't sleep on the job...at the counter, in your chair, or on the floor of your store.
When driving a cab without AC in 100 degree heat through dusty streets, take down the dangling soccer ball in the window so that it doesn't hit passengers in the head with every bump.
I should say that it's a charming country, but excellence in service simply isn't something that's there, yet. How does this apply to healthcare? Obviously, we're not hitting patients with soccer balls, feeding them rancid milkshakes or sleeping on the job. We do, however, give patients experiences that they may talk about, just as I am speaking about my trip to Egypt. If an experience is "ok," it sparks very little conversation, but if it's awesome (or awesomely bad) it sparks many.
If someone pays you money to drive them somewhere, show up at least somewhat close to the time expected, and if they have to come and find you and wake you from your slumber, be a little apologetic.
If you make a milkshake, do not let it sit in the sun for 15 minutes until it's grossly luke warm before delivering it to customers (especially when they're already doubled over with stomach cramps).
If someone pays you to drive them somewhere, don't stop on the middle of the highway and leave your car running while you go to get a snack.
Don't sleep on the job...at the counter, in your chair, or on the floor of your store.
When driving a cab without AC in 100 degree heat through dusty streets, take down the dangling soccer ball in the window so that it doesn't hit passengers in the head with every bump.
I should say that it's a charming country, but excellence in service simply isn't something that's there, yet. How does this apply to healthcare? Obviously, we're not hitting patients with soccer balls, feeding them rancid milkshakes or sleeping on the job. We do, however, give patients experiences that they may talk about, just as I am speaking about my trip to Egypt. If an experience is "ok," it sparks very little conversation, but if it's awesome (or awesomely bad) it sparks many.
Friday, September 10, 2010
It's amazing, but nobody's happy...
Louis C.K. is a comedian and not just a comedian, but a funny one with the occasional message. I watched him a few months back on Conan (when Conan hosted the Tonight Show)and haven't been able to forget a few things he said. He spouted "Everything is amazing right now and nobody is happy." His examples included the person that gets annoyed when they have to sit on the runway for 20 minutes as opposed to marveling at the miracle of flight ("We get to do what birds do!") and the annoyance we all have when our phone delays for a few seconds...because it has to go to space! He's got a point.
Is healthcare perfect? Of course not. Can/should it improve? You bet. The point, however, is that we fail ourselves and our colleages by focusing too heavily on what grinds our gears and not enough time on recognizing success. Next time, before you start complaining about the coworker that sends too many emails, or not getting that shiny, new piece of equipment, or having to walk the extra 10 steps to a different supply closet, I'd encourage you to stop and "ohhh" and "ahhh" at your environments. You're in healthcare. You get to improve lives of people every single day.
"Half our patients love us. The other half isn't all that far off. We do great things, here." What if every meeting at a hospital started with that? (Those precise numbers might vary, but they're not far off from the average hospital). Whether you're a nurse or technician or doctor that directly cares for a patient or an administrator that enables the care, you should be thinking - heck, even saying - "Wow, this is an amazing place for care."
And then you should go figure out how to make it even better.
Is healthcare perfect? Of course not. Can/should it improve? You bet. The point, however, is that we fail ourselves and our colleages by focusing too heavily on what grinds our gears and not enough time on recognizing success. Next time, before you start complaining about the coworker that sends too many emails, or not getting that shiny, new piece of equipment, or having to walk the extra 10 steps to a different supply closet, I'd encourage you to stop and "ohhh" and "ahhh" at your environments. You're in healthcare. You get to improve lives of people every single day.
"Half our patients love us. The other half isn't all that far off. We do great things, here." What if every meeting at a hospital started with that? (Those precise numbers might vary, but they're not far off from the average hospital). Whether you're a nurse or technician or doctor that directly cares for a patient or an administrator that enables the care, you should be thinking - heck, even saying - "Wow, this is an amazing place for care."
And then you should go figure out how to make it even better.
Tuesday, April 6, 2010
The Value of Good News
Today I got a call at work from my children's daycare. The first thought that went through my mind was "Uh oh, who's sick?" Then it was, "Did I forget to pack bottles for Callen?" It even flashed through my mind that maybe my husband forgot to drop the kids off this morning. But to my surprise, it was the caregiver who takes care of my 7-month old son, and she was calling just to let me know that he was having a great day. This woman interrupted a project I was working on and sparked unnecessary anxiety in me, but even still, the news she delivered made my day!
In health care, we have to deliver bad news all the time. Sometimes that's telling a patient his blood pressure is high; other times it's reporting that a routine test result came back abnormal; and still other times it's telling a family member that their loved one didn't make it through the night. We never like delivering bad news, but it's part of our jobs. But what about good news? Our patients come to us every day, many fearing -- even just a little -- that we are going to give them bad news, and hoping that we will tell them everything is or will be okay.
So, why do some providers still use a "no news is good news" policy?
From a safety standpoint, this policy leaves significant room for error. What if the test never actually happens? What if negative results never get passed along to the patient and the patient goes on believing that everything is okay. Further, though, how long does a patient worry? If I don't hear back in a day or two am I clear? Maybe I should wait a week? Maybe a few weeks? The "no new is good news" policy minimally reduces workload for the provider, but is it in the best interests of our patients? Undoubtedly no.
Delivering good news should be a part of our jobs. Not only do patients deserve to know that they are healthy, but the delivery of good news can help a patient feel confident in his provider and ultimately strengthen the patient/provider relationship. Before today, I thought my daycare was really good. I knew that they kept an eye on my kids and would react appropriately on the rare occasions when things went wrong. But most days are good days in the life of a child (even though it doesn't always feel that way!), and now I know that they keep on eye on the good things, too. Thank you, Bergan Mercy Child Care, for all that you do!
In health care, we have to deliver bad news all the time. Sometimes that's telling a patient his blood pressure is high; other times it's reporting that a routine test result came back abnormal; and still other times it's telling a family member that their loved one didn't make it through the night. We never like delivering bad news, but it's part of our jobs. But what about good news? Our patients come to us every day, many fearing -- even just a little -- that we are going to give them bad news, and hoping that we will tell them everything is or will be okay.
So, why do some providers still use a "no news is good news" policy?
From a safety standpoint, this policy leaves significant room for error. What if the test never actually happens? What if negative results never get passed along to the patient and the patient goes on believing that everything is okay. Further, though, how long does a patient worry? If I don't hear back in a day or two am I clear? Maybe I should wait a week? Maybe a few weeks? The "no new is good news" policy minimally reduces workload for the provider, but is it in the best interests of our patients? Undoubtedly no.
Delivering good news should be a part of our jobs. Not only do patients deserve to know that they are healthy, but the delivery of good news can help a patient feel confident in his provider and ultimately strengthen the patient/provider relationship. Before today, I thought my daycare was really good. I knew that they kept an eye on my kids and would react appropriately on the rare occasions when things went wrong. But most days are good days in the life of a child (even though it doesn't always feel that way!), and now I know that they keep on eye on the good things, too. Thank you, Bergan Mercy Child Care, for all that you do!
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