Patient Satisfaction: When you are in a hole, stop digging

I awoke this morning to a text message sent from my eleven year old son’s iPhone last night.  The message read, “My two girdles are killing each other.”

I was flummoxed until I spoke with my wife.  It was two gerbils that were killing each other.  Two gerbils, five dollars.  Autocomplete, priceless.

Having left my reading glasses at the hotel this morning I inquired of one of a my-gen coworker where I could buy another pair.  Judging by her stare, I do not think the twenty-something was any more familiar with the term ‘reading glasses’ than some people are with my epistles about patient satisfaction.

“Do you have trouble reading Dude, or are you looking for those Google glasses that read for you?”  She did not use the term Dude, I threw that in for effect.

I told her I did not have trouble reading and that I am able to read two years above my age level—bada boom bada bing.

I was thinking about the time I was teaching rappelling in the Rockies during the summer between my two years of graduate school.  Each one week camp was for high school students of varying backgrounds and their counselors.  On more than one occasion, the person on the other end of my rope, the person being rappelled, would freeze up from fear and I would either have to talk them down safely or rappel down or help them.

Late one day, a thunderstorm broke quickly over the mountain, causing the counselor on the end of my rope to panic.  No amount of talking was going to get her to move either up or down, so it was up to me to rescue her.  I may have mentioned in a prior post that my total amount of rappelling experience was probably no more than a few more hours than hers.  Nonetheless, I went off belay, and within seconds, I was shoulder to shoulder with her.  We were both perpendicular to the face of the cliff and some fifty feet from the bottom.

The sky blackened, and the wind howled, raining bits of rock on us.  I remember that only after I locked her harness to mine did she begin to relax.  She needed to know that she didn’t have to go this alone, and she took comfort knowing someone was willing to help her.

That episode reminds me of a story I heard about a man who fell in a hole—if you know how this turns out, don’t tell the others.  The man in the hole continues to struggle but can’t find a way out.  A CFO walks by.  When the man pleads for help the CFO writes a check and drops it in the hole.  A while later an applications vendor walks by—I know this isn’t the real story, but it’s my blog and I’ll tell it any way I want.  Where were we?  The vendor.  The man pleads for help and the vendor pulls out the contract, reads it, circles some obscure item in the fine print, tosses it in the hole, and walks on.

I walk by and see the man in the hole.  “What are you doing there?”  I asked.

“I fell in the hole and don’t know how to get out.”

I felt sorry for the man—I’m naturally empathetic—so I hopped into the hole.  “Why did you do that?”  He asked.  “Now we’re both stuck.”

“I’ve been down here before,” I said, “And I know the way out.”

I know it is a little sappy and self-serving.  However, before you decide it’s more comfortable to stay in the hole and hope nobody notices, why not see if there’s someone who knows the way out?

John Steinbeck’s novel Of Mice and Men included the statement, ‘The best laid plans of mice and men often go astray.’  My take on it; the reason the best-laid plans of mice and men often go astray is not the because of the plan; it is the mice and men. 

The problem is mice and men have a history with the organization.  They are constrained by phrases like ‘We’ve never done it that way’ and ‘that cannot be done.’  I believe most things people think cannot be done can be done, but then I have been accused of trying to believe in as many as six impossible things before breakfast.

One of the impossible things I believe is that there are simple ways to dramatically improve patient satisfaction for all patients by creating a remarkable experience for every patient every time.  Every time a patient or prospective patient interacts with the hospital they do so in one of three ways; they call, they go to the web, or they do so in person.

Each person is either satisfied or unsatisfied from every call, web visit, and visit.  The health system needs to get these interactions right one hundred percent of the time.  What does it mean to ‘get it right’?

If I go to the web to schedule a follow up appointment and I am given a number to call rather than an appointment, the hospital failed me.  If I call the hospital to understand Medicare billing and am told to call back during normal hours, the hospital failed me.

Finally, suppose using my Bluetooth headset on Dragon I use my iPad, and with voice commands navigate to the link on the hospital’s website showing me how to retrieve a copy of my medical records.  When I get there, having used every possible form of technology, I am instructed to click a link to open a form to request my records.  I then must print the form, complete it, find an envelope and a stamp, and post my request via snail mail.  Over the next few weeks the hospital will reverse the process and eventually I will receive my records.  My satisfaction dropped?  Why?  Because the link implied I could click something and get my records; the fulfillment process was out of date and under-delivered.

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