Comments

I would suggest that she make sure that all people coming into a patient room that are not duty nurses and doctors be fully apprised of the patient's condition.

When I was in the hospital, there were some awkward moments with the person who brought me breakfast and the tech who came to give me a sponge bath. Neither person was informed that I had had surgery on my thyroid, right through the front of the throat, and thus could not move my head or speak. i couldn't even move my mouth enough to produce a decipherable whisper. Fortunately my companion was there to help explain things to the person who gave me the bath, but I'm afraid the person who brought me breakfast must have thought me very rude.

Nothing is more important in the hospital setting than communication but not every patient is able to do so verbally. A pen and paper should be in every room and all people with patient contact should be made aware if a particular patient needs to use non-verbal means to communicate.

Posted by Constance Reader at June 26, 2007 1:30 PM

My suggestion is for the Chief Experience Officer to spend 60% of her time every week doing nothing but listening to the story of patients and their family care givers. Everything will become clear about where the improvements are needed in the system. 30% of her week should be spent listening to front line staff. The other 10% should be spent telling managers the good reasons why it would be a good idea for them to do the same, rather than spending 95% of their week writing reports that no one reads and inventing crap procedures designed to make life more difficult for front line staff who engage directly with patients.

Posted by Trevor Gay at June 26, 2007 1:32 PM

simple...spend as much time on patient care as you do on billing. I absolutely abhor the corporate mentality in healthcare. First do no harm has become first check the profit analysis.

Posted by Mike Neiss at June 26, 2007 5:19 PM

Think "wellness" 24/7 from CEO to janitor... Then commit fully to the following five simple steps:

1) Dismiss "the sick role" from everyone's mind and commit totally to making people as "well" as they can possibly be...

2) Prepare patients for a "wellness regime" the likes they have never experienced before they came to this clinic.

Seth Godin taught us about the power of "permission marketing" - here is a perfect example of where we can use it - market this "new experience" to patients before they arrive.

3) Fully expect that after 6 months of this new regime the patients will do most of the marketing by "word of mouth". If this is not happening then fix the persisting problems with the "experience".

4) Prepare for growth. More and more people will want to use this facility. Do not compromise "the new experience" to better handle growth.

5) Make sure everyone from the CEO down becomes a "patient's advocate" for "wellness". Costs will decrease instantly. Patient care will increase. Insurance costs will go down. Profitability will increase.

Good luck with it and welcome to the wonderful new world of work.

Richard.

Posted by Richard Lipscombe at June 26, 2007 6:17 PM

Simple.

Spend one week in the hospital as a patient. Somewhere where they DON'T know you.

Feel what it's like on that side of the bed.

Posted by Walt Kania at June 26, 2007 8:33 PM

The comments previously have been from the patient side of the equation which is important. It is also important to understand the other side - the healthcare professional and/or worker. From their perspective, watching good people die, seeing children with horrific diseases, in order to make it through the day, one must separate from compassionate involvement with everyone to what appears to be a jaded indifference. I have been on both sides of the fence. It's tough.

This, in no way, excuses rudeness or other incompetencies of the hospital employees, including the physician staff. Everyone still has to remember that patients coming to the hospital are their customers. And everyone needs to treat the "customers" as they would like to be treated. This should be the focus of the cXo. The difficulty for the cXo will be getting buy-in from the physician staff, but without it she will fail.

I truly wish her the best of luck for success.

Posted by Fred Peter at June 26, 2007 10:44 PM

1. Spend 2 weeks in a top class spa (or some such luxury retreat) - not just any spa but the most awesome spa around. Understand every little detail that goes into making her stay at the spa a memorable one. Every little detail.
2. Reproduce as much of that experience at the hospital as she can (she may not be able to build a mud bath massage room!!)- every little detail - the initial greeting, the assistance in filling the form, check-in attitude (I hate that you have to stand behind a monstrous counter, and deal with a really bored financial clerk to check in - why cant we have a warm, welcoming, receptionist with a beaming smile - like in the SPA) the flowers, the wall colours, the fruit, the linen (as allowable), the cable channels, the location of the TV (dont you just hate the way they put the TV close to the roof) and so on and so forth.
3. Train everyone (non-medical) who comes into contact with the patient and the patient's family in 'warmness (I made up the word) and compassion'.
4. Always be available when the patient is arriving and leaving.
5. Get birthday, anniversary, etc details. So she can send "I hope all is well cards" on these special days.

And so on and so forth.

I am assuming that she doesnt have to really worry about the service delivery of the hospital - I mean the doctors and nurses should know what they are doing at ALL times.

Posted by omer ghani at June 27, 2007 3:07 AM

This is a copy of the text of a slide I use in healthcare talks – says it all methinks.

Bombay Hospital Motto - A patient is the most important person in our hospital. He is not an interruption to our work. He is the purpose of it. He is not an outsider in our hospital; he is a part of it. We are not doing a favour by serving him; he is doing us a favour by giving us an opportunity to do so.' - Mahatma Gandhi

The original copy can be seen on my Simplicity Blog http://www.simplicityitk.blogspot.com/

Fred - I agree with you about staff and like you I have been on both sides of the fence many times. One of my friends is a senior physician (Professor in Oncology). For the last year she has been undergoing treatment for cancer. After many years as a physician she has totally changed her perception of healthcare as a result of her time spent as a patient. She is now a great advocate for greater patient involvement and she regularly writes in high profile national healthcare journals and speaks at healthcare conferences. She says doctors, nurses and all staff in healthcare must focus more on listening to patients and as a result changing our behaviour and services. Amen to that from me.

This applies to managers just as much as front line clinical staff. In fact in my opinion it applies MORE to managers because – sad to say – it would be possible for any manager to go through their entire career in the NHS without ever meeting a patient face to face.

Posted by Trevor Gay at June 27, 2007 3:10 AM

hi val. how about this for quality care:

i have been seeing my doctor since right after i had kidney failure in 2003. he was the nicest man and always took good care of me. he knew i didnt have insurance and so he would always keep that in mind when it came to prescriptions and unnecessary tests. however, i was pretty disappointed this weekend when i received a letter in the mail informing me that he will be leaving the hospital, and passing me along to another doctor. not only did he not sign the letter, it was addressed "Dear Sir/Madam" not "Dear Rachel, my patient of 4 years,". now i understand he probably has alot of patients and signing each letter would be a pain, but come on, at least STAMP it or something! i was just really disappointed to see that the doctor i had loved so much just passed his patients along to another doctor in such a nonchalant way. i wonder if i am the only one of his patients that feels this way.....

oh well! thanks to mitt romney i am now forced to take on another bill that i cannot afford (health insurance) and so i am on the hunt for a new PCP anyway.

and another thing, my grandmother was recently admitted to a nursing home for some rehabilitation after a bad leg infection. the home only has one cordless phone for each patient to share - which i believe is around 100 people. needless to say i have not made contact with my grandmother since she has arrived at the home. i have had other residents hang up on me, obviously confused; people tell me i have the wrong number; and sometimes nobody even answers the phone at all. i have confirmed with family that i do indeed have the right number and they too are having the same results when they call. i just cant fathom how this can be the phone procedure there. It is sad to know that people who are sad and lonely (and most likely ill and possibly about to meet their maker) cant even have their own phone so they can talk with their friends and family. i finally ended up sending her a prepaid cell phone.

so, my suggestions? sign your patient letters and give nursing home residents a telephone in each resident room!!

Posted by rachel at June 27, 2007 9:45 AM

I had a long series of hospital experiences last year (due to a simple gall bladder operation with massive complications). Most of the time I was favorably impressed with the competence and courtesy of the staff. But the last time I was in the hospital, every staff doctor who entered the room concluded that I had yet another potentially deadly affliction. I was at the tail end of a cold and was sniffling, so one doctor decided I had "breathing problems" and prescribed an inhaler (I've never had asthma or sleep apnea in my life). Someone else took an EKG and one of the sensors was defective, so the doctor who looked at the results concluded that I had had a heart attack sometime in the past and needed to get that checked out (of course every other EKG I've ever had has been totally normal). Because of my gall bladder problem, I hadn't been eating well, so another doctor looked at my blood results and came up with all sorts of dreadful scenarios that my slight anemia and mineral deficiencies could signify. I left the hospital as early as I could manage, against the doctors' warnings, because I felt like I was getting sicker the longer I stayed there! Lesson for the CEO: tell these whiz kids to shut up, listen, and look at the patient's TOTAL health picture before they make an off-the-cuff diagnosis.

Posted by Paula at June 27, 2007 6:07 PM

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Fred - you are right this cXo job is all about staff.... It is about efficient and effective staff and systems... It is about zero tolerance for medical rework... It is about good pharmacy practices... It is about accurate patient information and history on admission... It is about good "hand offs" of patient care from one process to another... It is about good "bedside manner" as a positive step in recovery and rehab... It is about good management systems, good management of people, and good management of patient needs....

The scope as cXo for doing work that matters, work that serves others, work that changes lives, etc is mind blowing....

As this cXo you will have to unlearn, take risks, break the "institutional care mould", change current mindsets and ways of thinking, change long-term habits, build a culture of discipline, etc.

What an awesome job - where does one apply for the next vacancy?

Finally I note that Cleveland Clinic was ranked the 3rd best Hospital in the USA in 2006... It is almost always those who already excel at what they do who lead us to new ways of thinking about, and of doing, our jobs....

Richard

Posted by Richard Lipscombe at June 28, 2007 1:15 AM

Excellent comments so far. I'd like to fill in from the patient's family side, as sometimes the family has to represent the patient.

My dad has been in a very prestigious hospital in NYC for 3 weeks already, most of it in ICU.

1. Please tell us everything. I understand that most people don't understand the jargon. But please give us a bit more than "fine", "improving" and "stable". My dad wants to know what they are doing to him and why. I need to be able to discuss this with him.

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2. MANY more chairs in the waiting rooms. People should not be forced to stand or sit on the floor all day while a loved one is in surgery or ICU. buy viagra australia generic

3. Hospital food. Ok, this sounds cliche. But the meals are provided by a for-profit third party food service. And it shows. My son's school lunches are more appetizing than this. (And I'm talking about normal diet, not a restricted diet). When you're sick, you need food that smells great so it makes you want to eat it. Families shouldn't have to bring food in from outside because the patient is desperate for something good.

For the record... the staff has been very bright and cheerful, and this helps the experience immensely.

Posted by Gayle at June 28, 2007 8:01 AM

Three simple principles used by some here in the UK to aim for a patient centred service. I am pleased to say things are improving but we still have some way to go.

1 Trust Me I'm a Patient.
2 Tell me the truth.
3 Nothing about me without me.

Posted by Trevor Gay at June 28, 2007 9:50 AM

1) All the non-medical staff need to know how their work cares for the patient- clean floors, clean linen, working plumbing, accurate records etc. One Team- One Goal. A lot of these people have great ideas how to improve service- Listen!

2) Food- the only source of energy and repair the body has. Serve the managers hospital trays every day. Rotate through regular diet, cardiac diet, soft diet- what gets measured gets done.

And what a great idea!

Posted by Lois Gory at June 28, 2007 5:02 PM

I am currently a Leukemia patient who has spent considerable time in the hospital for the last few months fighting cancer. I have been impressed with the level of care that I have received , but my day job (process director at a real estate firm) keeps me focused on how the health care experience is very broken.

If you are the head of customer experience at a hospital - here is what I would focus on.

- Go in as a patient for at least 7 days, preferably enter through and emergency room

- get out and ask your patients about their experience. Hospitals are still set up as small departments and fiefdoms. For example - go to chemotherapy outpatient department and ask a patient how well their home care and hospital care have been coordinated.

- Fix redundant paperwork. I can not tell you how much time is spent telling admissions, the nurses, the doctors about the same history and background each time. I have spent more than 30 days in the hospital in the last 60 days and when I come back in - they know little to know nothing about my case. shouldn't their systems be able to serve the customer and understand me as the patient?

- work on the whole experience - from the janitor to the parking attendant. At my hospital - the worse team of people I have met is the cafeteria staff. They don't smile, they are perturbed you are there and you never get a thanks. Why is this a major customer offense - because the cafteria is the one of the few small breaks people get from dealing with a sick relative or the staff getting a break from the madness. I think everyone needs to be shown examples like Ritz Carlton and how staff at any level can make a huge difference in the experience.

Posted by Glenn Gleason at July 2, 2007 1:04 PM

there are sometimes other options to keep the elderly out of a nursing home. While placing the elderly in a skilled nursing facility is the first thing that pops into our minds for their utmost safety and care, we as caregivers are not always informed and aware that we have other options. Personal Emergency Alarms like ResponseLINK Emergency Alert is one of those options. They provide 24/7 emergency alerts, voice to voice response, meal and prescription reminders and they are more affordable than nursing facilities. Sometimes a little extra peace of mind is all it takes to keep the elderly in their own home or at home with family and out of nursing care. A lot of times the elderly is put in to nursing care too early in age, and can increase in bad health afterwards simply from depression and isolation. These systems are readily available and affordable, if more people were aware, there would be less unjust admittance to these facilities to early. here is the link www.ResponseLINK.com,

Posted by Terry Shaw at April 17, 2008 10:28 AM