Pre-Arrival: Building Loyalty Before They Even Get There

There are certainly a lot of factors that go into patient loyalty: convenience, location, friendliness, clinical outcomes, but one area that is often overlooked is that of pre-arrival. I saw a study this morning about how pre-arrival is becoming more important to patients than the admission process when answering the question “How likely are you to recommend this hospital?”

This really surprised me, given all the energy we’ve spent trying to reduce wait times, hire friendly staff, simplify the admission questions, and generally make the process go as quickly and smoothly as possible.

As is often the case in healthcare, I actually realized just how valuable pre-arrival was through my experience with another industry. This past summer, my daughter and I started visiting college campuses. We were planning a trip out west from Chicago and decided to hit four colleges in a week. With plane tickets, hotel stays, rental cars, and mapping everything out online, there was a lot to do and the whole thing was a bit of a blur.

One college really stood out, however. While all of them gave step-by-step directions from the nearest airport to their front door, one had a video. It was shot from the passenger seat of a car and it showed exactly what it looked like while you were heading their way. They zoomed in on the exit signs, let you see just how quickly that right turn that most people miss comes up, showed you where the parking garage was, and then which direction to walk to find the correct building to check in for the tour. It was wonderful.

A few days later while I was driving there, I was comfortable and relaxed. It felt familiar, like I had been there before, even though I hadn’t. With all the money hospitals are spending on interior and exterior signage, it’s astounding to me that they aren’t shooting a video and showing patients what it looks like when you get near their site.

We’ve become accustomed to using our car’s GPS to find a hospital, but what a huge dis-satisfier to then have no idea where to park, which door to go in, and how to find the registration area. How many front desk receptionists would be delighted to not have to spend the first few minutes dealing with angry, frustrated patients and apologizing for the lack of helpful signs or clear directions?

I’m sure more will come out about pre-arrival factors and how they contribute to patient loyalty. This one seems like a good start to me.

What is your hospital doing to make pre-arrival easier for patients?

Manage Up

One of my pet peeves (and it appears I have a lot of them) is being led to an exam room by a receptionist who puts me in exam room 4 saying, “Someone will be with you shortly.”

Someone? Someone who? Who will be with me shortly? I sit and I wait. For someone.

It would be so much nicer if the receptionist said, “Okay you’re going to be right here in exam room 4. Tom will be your medical assistant today and he’ll be in to take care of you in just a few minutes. Tom is great. He’s one of the best we have here and patients love him. You’re in good hands.”

Three great things come from those simple words.

  1. A nervous patient starts to relax. She has heard that this other care provider is good at his job and is good with patients. She feels better already.
  2. Employees actually do a better job after a set of expectations has been set. I step up my game when I know someone has heard that I’m good at my job. If someone says I’m warm and friendly, I am turning up the warm and friendly for sure.
  3. Co-workers get along better when they get into the habit of speaking well of one another. Less gossip and more praise mean higher morale. And by the way, patients pick up on that, too.

But what are you supposed to do if you’re handing a patient off to Tom and you don’t like Tom? Do you lie and make something up so the patient feels better? Of course not. Find out a little something about Tom, like how long he’s worked here or how many years of experience he has.

Maybe patients like Tom just fine, even if you don’t. Try this, “Okay, here we are in room 4. Tom is going to be your medical assistant today. He’s been with us for about three years now and patients love him. I’m sure you’re going to love him. He will be here in just a few minutes.”

That wasn’t so hard, was it?

And you know, there’s a very good chance that after hearing you say nice things about him every day, Tom might actually become easier to work with. You might start to genuinely like him. You’ll like coming to work, patients will pick up on the energy and collegiality around the office, and nervous patients aren’t so nervous anymore.

All because you managed up.

What’s stopping you?

Just Show Up

I saw a video a couple of weeks ago from one my very favorite authors, Brene Brown.  She was talking about sympathy and empathy and something she said really stuck with me:

“When someone shares something really painful, maybe the best response is, ‘I don’t even know what to say right now, I’m just so glad you told me.’ Because the truth is, rarely can a response make something better. What makes something better is connection.”

I’ve been in many painful situations and some of my worst memories aren’t of the situation, itself, but of the thoughtless things well-meaning people say when they think they’re being helpful.

  • Don’t worry, there’s light at the end of the tunnel
  • You won’t be given more than you can handle
  • You’re strong, you can get through this
  • You think this is bad, I know someone who has it way worse than you

People can say some incredibly idiotic things when they’re trying to help but I tend to cut them some slack because I know they don’t know any better.

For many of us, the more difficult situation is the one in which we are with someone who is suffering and we don’t know what to say. We struggle for just the right words that will make that person feel better. We can’t bear the uncomfortable silence so we say something, anything, hoping it’ll be better than nothing.

The truth is, just simply being with another person can make all the difference.

When a person is suffering, he or she feels alone. It’s not the kind of alone like ‘no one understands what I’m going through or how I’m feeling.’ The truth is, no two painful events are the same and no one can truly know how you feel, whether they’ve been through it or not. It’s the kind of alone like ‘no one wants to walk with me while I go through this.’

Simply having someone next to you, to hold your hand, sit with you, just be there… that’s one of the most meaningful gifts you can give a person.

Don’t worry about what to say. Silence and Presence may be all you need. Just show up.

 

 

I Did My Job

Lately, I’ve been part of some skills training that focuses a lot on checklists. I think there’s a lot to be said for being very specific when you’re trying to teach someone how to interact professionally and compassionately with people. For many, these are skills that don’t come naturally and we need to show some concrete actions that demonstrate warmth and caring. Simply telling someone to be nice often isn’t very helpful. Everyone thinks they’re nice.

There’s no shortage of checklists out there for behavioral standards and ways to make patients feel more comfortable, but what if you do all the things on the checklist and patients are still unhappy?

I had a coaching session with someone for this very thing. He couldn’t understand why, after doing everything he was taught to do, patients still complained about him. He made sure he said hello, introduced himself and his role, he explained how long the tests would take and what was going to happen. He even said thank you at the end of every patient encounter. His manager was having a very difficult time giving him some helpful feedback because he was doing everything on the checklist and still not getting very good survey scores from patients.

To me, the answer was obvious. He wasn’t connecting.

I was looking at a perfectly competent employee with very good technical skills who was simply going through the motions without any sincerity. He was focused on his to-do list, there to do a job and complete a series of tasks, doing just enough to not get fired.

When we put the focus solely on ourselves and our actions, we forget that experience is a two-way street. Simply doing the items on a checklist doesn’t guarantee that the other person understands what we’ve said or interprets those things as helpful. It takes a genuine connection, even if it’s brief, to demonstrate caring to a patient.

Simply saying hello doesn’t convey a warm greeting but “Say Hello” was an item on the checklist. Should we have written “Sincerely and warmly greet every person with whom you come in contact”? Well, if that’s what you want, then that’s what you need to write if you’re going to use a checklist.

A better way is to hire people for whom this comes naturally. Warmth is tough to teach.

Thankfully, my coaching story does have a happy ending. This employee used to display warmth and sincerity with patients, but over time, he got jaded, bored, and burned-out. All it took was a little reminder from me about why he went into this field and he was able to reconnect with that part of himself he’d let go dormant. For those that never had it to begin with, I wonder if you can teach it. I’d rather spend my training budget helping people with the right kind of interpersonal skills and a desire to get even better.

What kinds of criteria are you using to hire your employees?

Patient-Centeredness

A few weeks ago, I got a phone call from an administrative assistant in one of our imaging offices. She asked about the courtesy van that the hospital provides to those who are in need of transportation but are unable to afford cab or bus fare.  A patient who had been in the day before said she had no way to get home but had used that service previously and found it very helpful. This administrative assistant didn’t have the voucher she needed and starting hunting one down.

The hospital had recently changed its policy about which departments were authorized to give these vouchers out to patients. Apparently, people were taking advantage of them. Funny, I thought the whole idea of the program was for people to take advantage of it…

She called another department – one that was authorized – and asked if she could have a voucher for patient who was here and needed to get home. The director responded with, “I don’t know, will I get in trouble if I give this to you?”

She had been in a meeting where the senior leadership team was ranting about how much money it costs us every time someone uses this service. She got the message loud and clear that anyone caught giving the service to someone who didn’t really need it would be in a whole lot of trouble. It was clear that managing the budget was more important than meeting a patient’s needs.

I had to ask myself, what kind of a hospital is this? What do we truly value? The buck kept being passed until someone decided that helping this patient get home was more important than potentially getting yelled at by an executive.

Thankfully, this all happened behind the scenes; the patient had no idea there was such a scramble to find a simple voucher, but as I was listening to this story it became crystal clear to me that we have sent our employees the wrong message. All this talk about patient experience and putting the patient first… it’s just talk.

Until employees – all employees – are empowered to take action that helps patients, you do not have a patient-centered organization.

Your patient experience efforts will go nowhere. And your patients will go elsewhere.

Other People

Other People

I’ve been talking about creating this blog for a long time but I grew up with parents who, while generally supportive and encouraging, always had a way of making me feel like there was a limit on how far I could go. They encouraged me to do my best at school but let me know that getting a B was still really good. They were excited to see me audition for the high school musical and, while I really wanted the lead, they were quick to say, “Well that supporting character would be a good part.”

When I was 10, there were auditions for the musical “Annie” at the Chicago Theatre. I relentlessly hounded my parents to take me and I remember very clearly them saying, “Honey, we don’t do things like that. That’s for other people.”

Other people.

“Don’t try to be the boss, just be a really great employee. Being the boss is for other people.”

“Other people become professional singers. You just keep singing in the church choir.”

“Everybody has an opinion. What makes yours so special? Let the experts create a website called ‘I Am The Patient Experience.'”

The hardest part about starting this blog was convincing myself that I had something to contribute: that my voice, my experience, my perspective mattered.

If you’re wondering if you should take that leap and do something that you think only other people do, remember: no one else has your background, your style, your personality, your accomplishments. Don’t underestimate what you can bring to the conversation.

Next time we’ll talk Patient Experience.