This week, I was on a business trip and had a snag when renting my car. The rental agent did not have a car available at 6 p.m. when I was scheduled to pick up a car and told me that the car had been arranged for pickup at 9 p.m. Instead of accommodating the change in schedule, the agent argued with me on the validity of my reservation time – to the point of flipping her computer screen to show me that her system said that I was the one in error. It was more important for her to be right about me being wrong than just to provide the service of renting me a car and taking my money.
This exchange made me think about the customer service experience. My previous occasions with this rental car company in several locations and was typically positive. So why did this one irritate me? Maybe it was the fact that in a 50/50 error situation, that the attendant would rather argue with me than apologize for the chance that it was their fault. Maybe it was that even though I was the customer, I was the one apologizing. Perhaps it could have been her implication that only a reprehensible person would ever return a car with an incompletely filled gas tank.
I then thought about what happens in our LivingCenters. There are many occasions where misunderstandings occur and mistakes are made. In fact, because of the amount and complexity of information exchanged, it would surprise me if some minor misunderstanding didn’t arise during each admission. What is our approach when no one knows why something is recorded incorrectly? Do we argue with our patients? Does having us “prove” that it wasn’t our fault do anything to enhance the patient experience?
Why it’s important
Patient Satisfaction – Patient satisfaction obviously is important in any business, and even more so in healthcare. Our most vulnerable population depends on us, and their emotional experience is vital to their satisfaction. In the skilled nursing facility, we may not be able to get them back to 100 percent function, or may not be able to cure their chronic, progressive illness, but certainly we should be able to do everything we can to alleviate physical and emotional suffering. At Golden Living, we measure patient satisfaction via admission and discharge surveys using electronic tablets. Longer stay patients also get interim satisfaction surveys.
Liability – It is a truism that “friends don’t sue friends.” The quality of the relationships which we develop and maintain has an inverse relationship to the number of lawsuits and complaints.
Regulation – Surveyors will observe how we treat our patients. Do we knock before entering a room? How is sensitive information conveyed when the roommate is within earshot? Are we sensitive to comfort needs? Surveyors will interview our patients randomly and ask about how they are being treated. F tags can be associated with care that is lacks attention to patient dignity, for example.
Quality of care – When my father was in a different skilled nursing facility, how he was treated would affect his ability to get care. If it seemed like he was irritating someone with a request, he’d just not complain. While this may seem to a staff as him being a “good patient, ” this also mean that there were potential times when he had pain or discomfort and it was not being addressed. It would break my heart to leave the building knowing that he totally was dependent on others for his comfort and that he was sometimes holding back his discomfort.
What would Disney do?
In his book, If Disney Ran Your Hospital, Fred Lee describes three levels of caring. They are competence, courtesy and compassion. People are hired for their competence, and that’s a given. We train our staff to be courteous during orientation, require this as part of ‘service excellence’ and try to measure this during customer satisfaction surveys. The third and final level is compassion. Lee describes this as an emotional level of caring. An employee may be let go for incompetence, or repeated discourtesy, but generally not be dismissed for lack of compassion. Compassion seems to come from within oneself.
Compassion however, makes courtesy come out naturally. Even when I was having a bad day, was behind on rounds and had a patient’s family member asking me a question I had already answered twice, it would be much easier for me to find the right words when I kept in mind my relationship with the patient, the families and how much I cared about them.
Steps to take
How is the customer service culture in your facility? Is there something you can do about it as Medical Director?
Set the tone – as a respected, frequently the most tenured leader in the LivingCenter, the Medical Director can set the tone. This is done by example as well as by instruction. A LivingCenter’s culture can change with leadership, and in particular if there is turnover in staff, the consistency that you bring can make a huge difference.
Pass on the feedback – Since Medical Directors generally are not seen as “company” personnel, it is likely that you get feedback about customer service every day from your patients. This unique perspective gives you the opportunity to pass information on to the staff and facility leadership which they may not otherwise receive. Giving direct feedback to staff also really is appreciated. It is a telling sign when the patient says, ”Oh – please don’t tell anyone. I don’t want my aide to get mad at me.” We must grow a culture that allows criticism and feedback without fear of retaliation.
Check the scores – do you know how your LivingCenter is doing on the customer satisfaction scores? What categories are in need of improvement? Golden Living also has done “mystery shopper” surveys. QAPI meeting is a particularly good time to discuss customer satisfaction.
RAVE about it – the Golden Living family of companies has instituted an employee recognition system. If you notice someone in the LivingCenter doing something in an outstanding fashion, you can give them a boost by mentioning it to your ED or DNS. They can give “RAVE points” which get posted with the nature of the reason on a site which is like social media. This can be another way for you to reward customer satisfaction and to recognize their attitude and efforts. Your ED can explain the RAVE system to you in more detail if you like.
Customer service is vital to our patient experience. As leaders in our LivingCenters, you as Medical Directors can help set or maintain the tone. When this culture exists, patient interactions with staff improve, and the mood generally is better, and everyone’s day is better. Let’s see what we can do to foster this. If you have ideas or best practices that have worked in your LivingCenter, please let me know, so I can share it in future editions of this newsletter.
For more reading:
Lee, Fred, If Disney Ran Your Hospital, 9 ½ Things You Would Do Differently, Second River Healthcare Press, 2004.