Lean on the "always" button

John Taylor: February 06, 20140 Comments

Enter hospital. Observe, and ask one question: “Am I in a social fabric that is safe and caring?” Expected answer, from stressed, overwhelmed patient, “I should be.” From caregiver, “We try to make it that way.”

The search for an absolute hard “Yes” was the driving force in a recent presentation at Clovis Community Medical Center by a physician and best-practices sleuth. Over the course of a four-day stay, a patient will experience 40 to 70 hospital staff, said Dr. Jay Kaplan. The experience will take the form of direct personal contact or just in passing. All it takes, he said, is one bad experience to fray that all-important social fabric.

Among the avenues toward great care – uniformity of behavior and consistency of process.  One of the main reasons good nurses leave hospitals, he said, is that they either don’t get along with their supervisors or members of the medical staff. (In the back of my head, I heard two things: the old Aretha Franklin song “R-E-S-P-E-C-T” and a saying from the philosopher Lao-tzu: “Fail to honor people, they fail to honor you.”

With the Affordable Care Act revolution, a much-needed heightening of circumspection has kicked into healthcare. Kaplan, medical director of the Studer Group and a member of the board of directors of the American College of Emergency Physicians, read it clearly on many levels:

Payment: The old – care equals income. The new – outcome equals income.

Personal involvement: The old -- as witnessed in a hospital employee’s T-shirt (somewhere), “We’re here to save your ass, not to kiss it.” The new – “We’re here to create a memorable patient experience … We hope your visit WOWs you.”

The medical world will soon revolve around measureable health outcomes and measured patient experiences. If the potential answers are never, sometimes, usually and always – unless you provide an “always” experience, you’re in trouble.

“Get behind the patient’s eyes,” Kaplan suggested, see also what they’re smelling and hearing. Are you in a bakery or in a highway gas station bathroom? Congratulate a patient who is making efforts. Sit down when you talk – look in their eyes more than you look at their charts.

His final summary slide said what can’t be restated often enough: “We live in an experience economy. “Satisfy” is not enough. If the other guy’s getting better … Quality gets you in the game. Service helps you win. It’s about the TEAM.”


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