What
Hospitals Get Wrong About Customer Focus
You
can get really great care in these giant institutions, as I just learned. But
if you interact with the customers the way they do, your business would keel
over.
Executive director, Ed Kaplan Family Institute for Innovation
and Tech Entrepreneurship, Illinois Institute of Technology
Home
from the hospital. I'm still dealing with the remnants of the mystery infection
that clobbered me. But having escaped, mostly in one piece, I thought it was
time for some reflection as well. First, you spend much more time than you'd
like sitting and sweating in your bendy bed -- sleeping for any reasonable
amount of time apparently being unimportant in the scheme of things. And,
because there really isn't all that much else to do, I kept thinking about
process improvements, systemic changes and - in our crazy data-driven lives -
what should be the realistic expectations of patients in terms of learning, in
context and in real-time, about the plans for and progress of their own care.
Everyone
you speak to inside and outside the hospital is an expert in health
care-- no qualifications, training or experience necessary-- but I'd say a
good place to start is with the idea that the system should fit people, not the
other way around. If there's a theme song for healthcare today, it's got to be
based on Dire Straits' song Money for Nothing ("Now, that
ain't workin', that's the way you do it; money for nothin' and your chicks for
free." ) because in the hospital I heard this refrain day after day:
"that's the way we do it." And you don't get anything for
nothin'.
That
said, you can't get out of any hospital these days - however long your stay -
without being extremely grateful for the people who cared for you 24/7 and the
quality of the care you received. You quickly learn two important things when
you're bed-bound and relatively helpless.
First,
you quickly come to appreciate the critical importance of "friends in low
places." The physicians may think they're in charge, but the real
lifesavers are the everyday people -- nurses, techs, dietitians, and especially
the cleaning people, who make or break your experience.
And
second, you learn about pride. There are NO horrible, boring or even routine
jobs in any business -- it's all up to the individual and what he or she makes
of the job. Any job can be important, creative and challenging if you put your
heart and mind into it; conversely, even the most creative endeavors can become
routine if you don't invest in the process and just walk through the days in an
uncritical stupor. Every hospital staff person I encountered was proud of their
role in my care. They understood that they weren't in the food prep or blood
draw or cleaning business. They were an essential and important part of the
only real thing that matters in medicine: the caring and connection business.
They weren't mindless or interchangeable cogs in some stupid fix-'em factory;
they were individuals whose job it was to demonstrate to me and convince me
that they were there to help me get better and get out. And, they did a great
job. It's never the soldiers who screw things up and lose the war; it's always
the generals.
I'm
convinced that the technical precision, equipment and instruments, and the
level of the medicine being practiced today (even in teaching hospitals) is as
high as it's ever been and that's the very good news. But from the standpoint
of the patient, that's only half the story. The ways of addressing the
patients' mental and emotional issues and needs-- for connection, communication
and information--are still as messed up as ever. That's a big problem
that clearly remains unresolved. It's a people problem -- and the people who
are the problem are the physicians. Whether they're too busy, too tired, too
stressed, too overly-trained to be utterly un-empathetic, or whatever it is,
they suck at serving the interpersonal and informational needs of the patients.
And, because they're on a crazy merry-go-round of rotations that assure that
you couldn't possibly see the same docs for more than a few minutes every few
days, if you're lucky, the prospect that you'll make a real connection with any
of them is next to zero.
These
issues aren't that different from many of the concerns that every business
faces around the critical need to be customer-centric. But what was very
striking in my own hospital experience was that regardless of how many
questionnaires and inquiries are incorporated into reviews and discharge
procedures, if you're consistently asking the wrong questions or focused on
immaterial metrics, you're not going to learn anything of value. The
administrators who run these massive hospitals don't have a clue about how to
ask the right questions. What you measure and pay attention to are what define
and determine the success of your business. Feel-good focus groups, useless
data collection, made-up metrics and ratings that don't address core concerns
are a complete waste of time.
I had a
volunteer conduct a questionnaire about my relationship with one of the main
docs allegedly "responsible" for my care. He had to show me a picture
of the doctor, who I barely recognized, and had maybe seen once in my entire
visit for a couple of minutes. As he started asking about whether the physician
and I had "good" substantial conversations about my questions and
concerns, I actually started laughing. This was a complete waste of time.
First, because the one thing that is abundantly clear is that no one at the
hospital does anything by themselves - there are always 3 or 4 people in every
meeting, visit, conversation, etc. So, trying to evaluate my engagement and
involvement with a single doc was a joke. And second, I had no idea what this
doc's role was even supposed to be in my overall care so I couldn't really
address anything substantive anyway. It was an inquiry straight out of Alice in
Wonderland.
There
are no easy or quick answers because the health care system is completely
broken (albeit still better than anywhere else in the world), but here are a
few things that anyone with the slightest interest in the experiences of their
patients should address immediately.
(1) Antibiotics Shouldn't Be A là carte
I'm the
patient. What do I know? There's a drug to prevent blood clots that might arise
from being bedridden. Seems to make sense. But here's the thing, the schedule
said to administer the drug 3 times a day, but I was asked by
some very considerate folks from time to time if I wanted the shots. Would this
instill a great deal of confidence in you? How the heck do I know whether I
should have the shot or not? Healthcare consumers don't want more choices and
alternatives - we want answers and expertise.
(2) The Patient Shouldn't be the Last to Know
I
fasted overnight several nights for no reason. Tests that were set for the
following days, which required no food or drink for 8 hours prior, simply
disappeared from the schedule. No explanation. No reasons given. Just gone.
Emergencies, illnesses and changes in a hospital are all inevitable and readily
explicable if someone cares enough to do the patients the courtesy of telling
them what's happening and why. Ignorance is curable; indifference is what kills
the experience and ultimately the culture.
(3) The Patient is Entitled to A Consistent Single Point
of Contact
I had
rotating teams from cardiology, infectious diseases, internal medicine (maybe -
not sure), and probably some others, and they would stop by from time to time
to update me on the narrow and obscure aspects of their particular areas of
investigation. But they had no apparent information or connection to the
activities of any of the other teams. There was NO ONE who appeared daily to
actually tell me what was going on with my care and progress (or lack thereof).
And it's not even clear who that person is supposed to be.
If you
think that problem-solving and way-finding for inbound inquiring customers in
your own business is easy, you're sadly mistaken and you should spend a little
time calling your business and trying to navigate your website. Nobody does it
well - but when you're also stuck in a bed, the data deficiencies are even more
obvious.
(4) "Rounds"
Ought to be in the Room, not the Hall
I
learned what little I knew about my prognosis by eavesdropping on the morning
briefings (rounds), which were being held outside my room, where someone who
seemed to know something about where things stood would brief the rest of a
group of other doctors about my condition. It would have been so nice and
helpful had they taken the time to share the updates with me as well. Frankly,
the guy in the room next door (who always had his door open) probably got better
info about my treatment than I did simply because they stood right in front of
his door. HIPPA Hooray. There's a sign that says I can get help on the phone in
a zillion different languages, but, of course, I have no idea who to call.
Are
answers easier to come by in your business?
(5) It's Harder to Pee in Starbucks
It
appears to me that any mope -- completely devoted or utterly deranged -- can
walk into the hospital, hop onto the elevators, ride to some floor and wander
into any patient's room without being questioned or challenged. It's honestly
much harder to get into the restrooms at Starbucks. No visitors' passes
required, no surgical masks offered, no invitations or permissions necessary,
no limits on guests -- drop on in whenever you please. Just like Bakers Square,
come for the meal, stay for the pie, no extra charge for the MRSA.
No one
expects overnight cures and simple solutions - but if you're not completely
customer-centric today and fanatically focused on their experience and
expectations, you're nothing.
PUBLISHED
ON: MAR 19, 2019
