Is the Glass Half Full, part 1

I’ve seen a few articles recently about the things hospitals and physician offices are doing in an effort to raise their patient experience scores. Valet parking, full service espresso bars and the like are popping up everywhere. Nice features, to be sure, but is that really what we’re talking about? What if we work in an older building that isn’t so pretty? Are we doomed?

We’ve all heard the bit about seeing the glass half-full as opposed to half-empty, right? It’s supposed to give us some insight as to whether we are optimists or pessimists, whether we choose to see things in life as possibilities or problems.

What if I told you there was another option?

What if instead of trying to decide if the glass if half full or half empty, we instead looked around to find someone who might be thirsty?

This is how I choose to see things in life. It’s not about optimism or pessimism; it’s about seeing what’s available and finding someone who needs it. It’s about helping. It’s about looking outside ourselves and sharing an act of kindness with another.

This kind of approach to life led me to a career in the ‘softer’ side of healthcare. It’s not the glass of water, itself, that should be the focus. It’s what we do with that glass of water that matters. If we are in a position to share that water with someone who needs it, we should. It doesn’t matter if it’s only half a glass. A thirsty person will appreciate it.

The patient experience movement isn’t about perfection and prettiness, it’s about connection. Physicians, nurses, medical techs, call center workers, front desk receptionists, etc., all have rough days, days they feel they just don’t have enough gas in the tank to make a patient’s experience perfect. They’re tired, they’re stressed, they’ve just been yelled at by the last patient.

But taking just a moment or two to connect, to really listen, find a way to ease a little bit of suffering… that’s what the patient experience movement is about. The harpist in the lobby, the gorgeous waterfall feature, the perfectly appointed private room… those are all nice, but they’re not what makes the biggest impression on patients. Patients want to be heard, cared for, listened to.

I used to work in a hospital that was in desperate need of a make-over. It was surrounded in that market by other hospitals that were absolutely gorgeous. But people drove miles out of their way, past those fancy lobbys and tuxedoed food service workers to come to our hospital where they were treated with kindness, compassion and dignity.

Our glass was definitely half full. We didn’t look nearly as pretty as they did. But we took our half full glass and offered it to those who needed it.

Recognize that what you have, even if it isn’t perfect, may be exactly what someone else is thirsty for. Don’t worry if it isn’t filled to the top. The act of kindness in sharing with someone is what matters.

Are you optimistic? Pessimistic? How about empathetic or compassionate?

9 Things New Patients See

I recently moved 2000 miles away from the city in which I was born and raised. It was exciting, scary, a little sad, but ultimately a good decision. There are so many things to do when you move across the country; one of them is establish with a primary care physician.

Yesterday, I got to see a healthcare system with brand new eyes. I had no preconceived notions about what to expect, I just wanted to find someone close by that looked nice. So, what do new patients actually experience? How do we make them feel good about choosing us?

·       Have a great website. That’s where most people go when they’re trying to find new health services. There’s really only one hospital here, so it wasn’t much of a decision, but the physician finder feature on the website was great. I was able to learn a little about each doctor and felt very comfortable with my choice.

·       Have really friendly and knowledgeable people answer the phone. When I called as a new patient, the person on the other end could not have been more helpful.

·       Have some availability in your schedule. I was delighted at how easy it was to get an appointment so quickly.

·       Make your office easy to find. This was one issue I had the day of my appointment. My car’s GPS told me I had arrived, but there was no doctor office around. I called and told them I couldn’t find them and the receptionist’s directions got me there perfectly. Next time I’ll know, but it wasn’t obvious to someone unfamiliar with the area.

·       Have an easy check-in process. Again, front desk staff was great, even with the pile of paperwork to complete.

·       Make sure your medical assistant introduces herself and tells you what’s going to happen next. This was textbook perfect. She told me her name, title, every step of the process, which room we were going to, and what she was going to do next.

·       Great bonus – the medical assistant ‘managed up’ the physician. “You’re seeing Dr. M__ today. She is awesome. You’ll love her.” That was the perfect thing to say to help me relax.

·       Hire physicians who appear to really care about their patients. Not only did this doctor take time to find out what was important to me, she asked that I sit in the comfy chair – not the exam table – so she could look at me and I at her while she was entering all my information into the computer. Nice touch!

·       Leave on a high note. The physician walked me back out to the front desk, where I made another appointment and got the paperwork for some lab work. The person there gave clear instructions about where to go to get those labs drawn and how quickly I’d get my results. Everyone there thanked me for choosing them and I was on my way.

You never get a second chance to make a first impression and this office did a great job. Have you taken the time to really examine your touch points through the eyes of a brand new patient?

Ask someone completely unfamiliar with your hospital or physician office to tell you what their impressions were. You might be surprised at what you take for granted.

PX Mastermind

This past week, I was invited to lead a Patient Experience Mastermind webinar on Best Practices and Lessons Learned.

I love that there is a vibrant and passionate community of PX professionals who are continuously learning and sharing their experiences with one another. I was honored to share what I know but even more excited at the idea of discussing and learning from the others on the call.

This was a huge topic so I broke it down into three major categories: Leadership, Data, and Originality. The first two are things I hear being brought up all the time. Culture change doesn’t happen without a firm commitment from leaders and a shared vision across the organization. And there are many more sources of data than simply the H-CAHPS scores. We spoke about all the ways patients and their families tell us about their experiences, yet we only seem to focus on a single number reported monthly.

That third category, originality, is where I spent the most time. There are all kinds of new innovations out there, new tech designed to deliver the ultimate patient experience, new philosophies about doing WITH our patients instead of doing TO or FOR them, and even a new money back guarantee if you’re unhappy with your service. There are new ways of executing old ideas: rounding with an iPad instead of paper and pen, putting your patient and family advisory council members on hospital committees, and moving physicians from ‘on-board’ to actively leading your PX efforts.

The other piece of originality is you. Your personal and professional experiences, along with your natural talents and abilities, all inform your approach to this kind of work. While I love that we can share and learn from each other, we need to bring our authentic selves and not rely on scripting or a cookie cutter formula to success.

Let’s continue to talk about best practices and share our ideas. Let’s talk about approaches that worked and those that didn’t work. And let’s not forget who we are, what we bring, how we feel, and why we do this. Our patients and their families will love us for it.

The Beauty of Making Mistakes

Last Sunday, the Grammy Awards show was on. I didn’t see the whole thing, but I did see pop superstar Adele begin a tribute to the late George Michael, stop her performance, and start over. Having worked as a singer myself for a number of years, I couldn’t imagine stopping in the middle of a song and asking everyone to please begin again. Lord knows I’ve wanted to.

This made me think about the tolerance we have for mistakes. In healthcare, it’s practically zero. When there’s a wrong-site surgery, an unexpected outcome, or even an unlikely but known risk factor, we do a root cause analysis, counsel those involved, suspend or even fire staff, and patients often sue.

I’ve worked in places where it wasn’t safe to make a mistake. You got yelled at, embarrassed in front of your peers, pulled off a project, or let go. Did that make us more careful? Did we perform better? Nope.

We threw each other under the bus. We didn’t contribute new ideas. We didn’t speak up if we saw something that didn’t look right. We worked long hours. We missed our kids’ concerts and soccer games. We took our stress out on our spouses. We didn’t sleep enough. We worked straight through lunch and came home too tired to eat dinner.

People will tell you they didn’t learn nearly as much from their successes as they did from their mistakes. So why do so many companies rush to assign blame instead of looking at ways to make improvements?

Well for one, it’s certainly easier to blame a person instead of a process. Holding the system accountable means that changes need to be made, often expensive ones, and many people don’t want to admit they may have made a mistake when they designed the system.  

Certainly, if there is a willful, deliberate action taken that causes harm, people need to be held accountable. But so often, mistakes are just that – mistakes. It makes sense to look at the bigger picture and see what could have been done differently both from an individual and systems perspective.

But it has to be safe, not punitive.

Adele felt safe enough in her star-power to stop an entire orchestra on live TV and ask them to start again. Whether the problem was in not getting her starting pitch because of a bad earpiece or simply due to nerves, she demonstrated that it’s better to speak up, go back and do the job right, even if it means suffering a little embarrassment. The public doesn’t seem to be holding it against her. Let’s hope more organizations take the same approach.

 

Going Platinum, part 2

Last week, I wrote about the Platinum Rule – doing to others as they want, not as we want. It’s not an easy thing; you have to invest a little energy and ask a person what he or she prefers. Many of us don’t feel we have the time, or we assume that others want the same as we do.

I had a friend in college who wanted to do something really wonderful for my birthday so she organized a surprise party for me; secretly invited all my friends, got a big cake, lots of balloons, and many of the foods she’d seen me enjoy. She really did surprise me, too. I had no idea any of it was going on. It was great to see so many people there, all having fun and celebrating. When it came time to blow out the candles, I couldn’t believe my eyes. My friend had gotten a chocolate cake. Everyone loves chocolate cake, right?

Not this girl.

I was gracious, smiled, and didn’t say anything about it except ‘Thank you’, but many of my friends gasped when they saw it. “Oh my God, Kate hates chocolate!”

The party went on; I wasn’t going to let a little thing like cake ruin it, but was a perfect example of how we make assumptions about all kinds of things.

We in healthcare do it all the time. This is especially troubling given all we know about a person’s ability to heal and get well.

If I were to ask 6 different people to tell me the three most important things during their hospital stay, I’d get many different answers. “Manage my pain” “Call me Bill, not William” “Call me Mr. Jones, not Bill” “Please leave the shades closed” “Please always open the shades” “Get me out of here as soon as possible.” “Don’t send me home before I’m ready” “Communicate with my primary care doctor” and on and on.

We have the perfect opportunity to collect that information. In fact, we have two. There’s the admission form when patients first arrive and the white board in their rooms. By simply taking a moment to ask, we can find out what matters most to them. By paying attention to it, we help them get better faster. What better way to demonstrate care and concern that to look at the white board and say, “How are we doing managing your pain today, Mr. Jones? Here, let me open those shades for you.”

That simple act, using the Platinum Rule, lets the patient know that we are taking his needs into account. We are personalizing his care. How he feels, what he wants, matters to us.

You don’t think you have the time? Believe me, the hospital on the other side of town has already figured this out. They’re doing it. They’ve hardwired it into the behaviors of all the employees who interact with their patients. And patients are noticing. More importantly, they’re noticing when it ISN’T happening at your hospital.

Take a few moments to use the Platinum Rule. And please don’t bake me a chocolate cake.

The Platinum Rule

I, like many of you, was brought up with the Golden Rule: Do unto others as you would have them do unto you or treat others as you would like to be treated.

There’s certainly a lot of good in that rule but I now try to do even better. I try to live by The Platinum Rule: Do unto others as they would like to have done unto them.

I’m not sure who coined the expression, but I first heard it when I was working in Physician Relations at a very large suburban Chicago hospital. None of us in the department was a physician, but we all worked very closely with them and had to continuously find ways to keep them happy, engaged, and admitting their patients to our hospital instead of our competitor down the street.

We all approached the task from our own perspective; what would I want, what would make me happy. A few times we got it right, but if we were going to truly be effective, we had to start seeing things from the physicians’ point of view. What would they want?

I didn’t realize it at the time, but it became a very valuable life lesson for me. I started approaching a lot of things with the Platinum Rule and it’s one of my key points when I’m delivering Patient Experience training.

One of my favorite examples is what to call people. My name, as it appears on my medical chart, is Katherine. But I’ve found that most people, for some reason, love to use nicknames when they see a long name like Katherine. They call me Kathy. It drives me crazy.

Don’t get me wrong, Kathy is a perfectly fine name, it’s just not my name and I hate when people assume it’s okay to call me that.

Funny thing is, there are Jennifers out there who don’t mind being called Jen or Jenny, and Margarets who take it in stride if someone calls them Maggie. These people can’t understand why I get so bent out of shape when someone calls me Kathy.

They don’t have to understand why. They just have to understand that it does.

So how are you supposed to know? Simple. Ask.

The key to connecting with patients isn’t in giving them everything that would make you happy and comfortable if you were in their shoes.  We need to ask them what they want.

How many of us actually have a question like that on our admission forms? Or our white boards in patient rooms? We have a perfect opportunity to find out exactly what we can do to make patients’ stays with us a little better (and improve our H-CAHPS scores, by the way) and we consistently miss it.

Individualized, personalized care matters. We can’t keep going with what we think is important. We have to ask our patients what matters to them and then do it.

It’s better than gold; it’s platinum.

Uhhhhmmmm Hello?

Shortly after I went to work for a large, multispecialty medical group, I did a little mystery shopping. This group had many locations around town and it was obvious that there was no organization-wide standard for service. Depending on which office you were in, you may be treated beautifully or like an annoyance.

There was one office in particular I’ll never forget. I walked up to the reception desk where a woman was sitting and looking down at some papers.  I got to the desk. She looked up at me and didn’t say anything. I smiled politely. She raised both eyebrows, made her eyes really big and stuck her neck out a little. I looked at her for another moment before I realized that this was her greeting. She wasn’t going to say hello or how can I help you today. Her idea of a proper greeting in a physician’s office was big eyes and a forward neck thrust.

As a perfectly healthy person who was just there to mystery shop and see what was what, I was completely put off. I can only imagine how someone who didn’t feel good and hates to go to doctors’ offices would react to that kind of first impression.

I don’t know what was going on in that woman’s life that day, if she’d had a really tough morning and just couldn’t force one more smile, if she’d gotten some horrible news, was battling some kind of illness, was thisclose to quitting…

And I didn’t care.

Whether we want to admit it or not, healthcare is a service industry. That person behind the desk is an ambassador, a greeter, a tone-setter, a first impression maker, and her personal life cannot affect her professional one.

One of the best offices I ever visited had a front desk person who looked genuinely delighted to see every person who came in. Her warm smile and an, “Oh good, it’s you!” kind of greeting made everyone feel truly welcome and comfortable. Whether she meant it or not didn’t matter. We all believed she did.

Wouldn’t you love to be greeted that way?

 

 

An Attitude of Gratitude with Your Coworkers

Something I’ve been reading a lot about lately is gratitude. Maybe the universe is trying to send me a message, because everywhere I look, I’m seeing something about having an attitude of gratitude.

I used to think gratitude was about being thankful for what you have. It is, of course, but I’ve come to think of it as much more. Instead of merely looking at it from a material possessions perspective, I’m starting to be grateful for all kinds of other things.

I’m grateful for the busy days when there are a million things to do; those days fly by quickly and before I know it, it’s time to go home. I’m grateful for the slow days when there isn’t a lot happening; I can get caught up on things I’d been meaning to do but never had the time.

I’m grateful for coworker who is supportive and upbeat; she makes me feel like I’m not alone in my work. I’m grateful for the coworker who is difficult and moody; she is teaching me how to be patient and she’s making me examine my own behavior and its impact on those around me.

I’m grateful for the patient who truly appreciates the work I do; he makes me feel like what I’m doing really makes a difference. I’m grateful for the patient who appears to be impossible to satisfy; he makes me step up my game, look harder for solutions, and not get complacent.

What I‘m finding is that I used to only be grateful when things were going my way, but anyone can be grateful under happy circumstances.  It’s the people who can be grateful under trying circumstances, difficult circumstances, even miserable circumstances – they’re the ones that truly inspire those around them.

That’s the kind of coworker I want around me. That’s the kind of coworker I want to be.

The next time things at work get a little tough, ask yourself how you can turn it into something to be grateful for. You might be surprised at the impact it has.

Final Impressions

You’ve got a pet peeve, right? That thing that really irritates you. Nothing huge, just something that gets under your skin.

When it comes to doctor appointments, I think my latest pet peeve is not knowing what to do when you think the visit is over.

It used to be (and maybe sometimes still is) that, once you saw the physician and he or she told you what the problem was, a nurse came in, answered any additional questions you might have, and told you to check out at the desk before you left the office.

These days, you see the physician, a nurse comes in afterwards to answer any additional questions and tells you to have a nice day. I always find myself stopping at the desk on my way out to be sure there isn’t something else I need to do before I go. Usually, the person at the desk is very sweet about it and says something like, “You’re all set. Take care!”

Sometimes, though, that person looks really annoyed and says, “Well, did the doctor say you needed something else?” in that condescending tone that screams “I hate my job”. “No,” I reply. “I just wanted to be sure we were good to go,” which is often met with a fake, dismissive smile.

And THAT will be my final – and lasting – impression about my visit.

As a Patient Experience trainer, I spend a lot of time talking about the greeting: that first impression that’s so important to people when they walk in the door. But lately, I’ve started spending just as much time on that final acknowledgment, the last thing patients see and hear before they walk out the door. You can undo a lot of good in those final moments, negate the things that had gone well up to that point. Or you can reaffirm your commitment to patient experience and continue to be helpful and kind, even after the visit is over.

The end is just as important as the beginning. Develop a good exit greeting and make a wonderful final – and lasting – impression.

The Story of Your Patient

We’re storytellers. With every human interaction, we’re telling a story about what we see and hear. Depending on the narrative that we create in our heads, the actions of others can be a mild annoyance or completely exasperating. 

Consider the patient who arrives late to an appointment. Do you immediately assume he is inconsiderate, unreliable, and just plain rude, or do you assume he made every effort to get there on time but circumstances beyond his control got in his way?

Maybe he was involved in an accident. Maybe he stopped to help someone in an accident. That little bit of narrative will absolutely affect your interactions with him and if you choose to be annoyed instead of gracious, he will sense it.

Consider, too, the patient that doesn’t lose any weight even after you’ve counseled her, told her that her health problems are only going to get worse. Every time she’s in your office, her test results are more and more of a concern. Blood pressure, cholesterol, kidney and liver function all headed in the wrong direction. She’s clearly not taking your advice. What story are you telling about her? She’s lazy? She doesn’t care about her health? She just won’t put down the bag of chips or box of cookies?

One or more of these may be true, but have you taken a few moments to find out anything about her living conditions, asked about any unresolved trauma, or learned of any family history of addiction?

It’s true we tend to be much more forgiving and gracious when we learn a little bit of the why, or the story behind the story. And although you may never know the actual truth, you can choose to like your patients more when you choose to tell a different story about their behavior.

They will be more likely to open up to you and be honest about their habits when they aren’t sensing your judgement and distain. And when patients like their doctors and feel that their doctors like them, they are more likely to comply with instructions and advice. They may even get healthier. 

If you want to change your patients, start by changing the story you tell yourself about them. Change you.