(This missive is somewhat long—this is where my mind goes when I run.)
Ever watch the show “This old House”? Something magical happens to a man when he watches somebody single-handedly rebuild a 6,000 year old home in a 30 minute program. After that no task seems too complex. As a normal male the first rule of thumb is to remember that having a master’s degree from a reputable university qualifies you for about anything short of brain surgery. The true Type A will often carry that step further by reminding himself that given another week or two of study that even neurosurgery would not be that difficult.
I did a project in one of my prior homes. It involved the simple task of rearranging bedroom furniture one Sunday afternoon; 15 minute project, total cost—nothing. After all, how difficult could that be? The truth is the actual moving of furniture involved nothing more than I’d planned. Only when I thought I was done did I notice that the television set was now located a good 20 feet away from the cable television outlet. The obvious solution would be to simply move the furniture back to its original position.
Can’t do that. To move the furniture back to the original position is either admitting defeat, or admitting I wasn’t bright enough to realize that the cable outlet and the television would be on opposite ends of the planet by the time I finished. Besides, my wife had already seen the new arrangement and if I moved it back to its original position I would have to explain why.
So when she enters the room and asks why (and she will ask why—that’s her job) there is now a 25 foot piece of black coaxial cable snaking its way diagonally across her bedroom carpeting I had better be prepared to answer. Sometimes if you’re quick, real quick, you can try and bluff your way around the problem with a technical answer. You can try and explain that all of the static electricity that was created by sliding furniture across the carpet has caused the sonic membrane surrounding the fiber optical transponders in the coax to be 6 ohms off the medium allowable temperature variation for the building codes in your neighborhood. It is called stalling, allowing for a brief period of self-correction.
The truth, having failed me, the only other option left was to try something close to the truth. I’m forced to say I knew the cable would be at opposite ends of the room before I moved the furniture. My plan all along was to call the cable company and ask them to come to the house to install another outlet on the correct wall.
It’s my wife’s job to inquire how much it will cost—she did not fail me. This is a clear case of me answering her question without bothering to think. It is important to have a clear understanding of the underlying issues before trying to resolve the problem. I mentioned it should cost forty dollars, and we will only need to leave the cable strewn across her bedroom floor for a few days. It’s then her job to say if we put the furniture back where it was we can solve both problems in twenty minutes. Besides, the cable technician left a mess the last time they did some work, and she wasn’t going to spend more money for poor service. Stay with me here, this is how it becomes her fault, and how it relates to the topic of Patient Experience Management (PEM).
Once her issues were out in the open was a simple matter to devise a solution to address them. The solution needed to be implemented quickly and it needed to be free. My answer came quickly—too quickly. Eighty percent of the problem could be handled by simply running the cable along the floor board, and then under the bed. That only left five feet of cable between me and a happy marriage. Unfortunately, the five feet in question is from the foot of the bed to the television and runs across the major walkway of the room, looking all the while like an undernourished blacksnake. Did I mention she hates snakes?
Undaunted, I asked for a little assistance to move the bed. This accomplished, I headed for the garage to find exactly the proper tools for the proper job. I returned five minutes later, tools in hand. I was surprised to see the look of dismay on her face. As it turns out, her dismay resulted from the razor blade knife clutched in my hand. After twenty minutes of the best Boolean logic I could muster, I convinced her, or at least myself, that it would be a simple matter to cut a small hole in the carpet and force the cable underneath. After all, the bed would hide the hole.
The only other tool I thought I would require was a roll of duct tape and a 4’11″ broom handle. Women know we are confused about how to proceed the moment they see men rely on the duct tape gene. Most men, when cornered believe enough duct tape, properly applied, can serve as a panacea for anything up to and including world hunger.
You’ll note I specified the exact length of the broom handle. It’s only after having attempted the project that I’m able to relate the length of the handle. Most men on a project, especially those being watched by their wife, wouldn’t bother to measure a length any more than they would ask directions while driving across Borneo with half a tank of gas.
As it turns out, I should’ve measured both the distance the cable had to travel under the carpet and the length of the broom handle prior to taping the cable to the handle and shoving a 4’11″ broom handle under a five-foot expanse of wall-to-wall carpet. The fact the carpeting was wall-to-wall is key to understanding what lay ahead. Let’s make certain the situation is spelled out clearly; the new carpet in our new home had a hole in it, a broom handle was now nicely buried under the carpet, and my wife was perched on top of the bed like one of Macbeth’s three witches waiting to see what I would do next.
Walking to the wall and grasping the carpet as best I could, I pulled up a good 10 feet of it from the tacking, acting all the while like I would have to have done that even had the handle not been one inch too short. Leaning with my one arm on the newly exposed carpet tacks, I solicited help in excising the handle from beneath the rug. That accomplished, and dying the death of a thousand cuts, I looked for another proper tool to complete the task. Walking through the kitchen to the garage I spent a moment wondering if the proper tool could be found in the kitchen. Naturally, it was—one half of a pair of chopsticks or, as it’s now referred to in technical terms, a broom handle extender.
Five minutes later, the broom handle extender and cable was firmly duct taped to the broom handle and once again shoved under the carpet. They both went in, but no cable came out the other side. So, I pulled the handle back out and surveyed the situation. The situation, as it turns out, was that in my hand was a perfectly good broom handle, a piece of coaxial cable, and no broom handle extender. The extender was now smack dab in the middle of the 5 foot expanse I was trying to cross, the problem being it was on the wrong side of the carpet, the underneath side. It was positioned perfectly. It was too far under to be reached from either end. In other words, the chop stick just became a permanent fixture in our bedroom.
Certainly, one small chopstick hidden beneath four hundred square feet of carpeting was not a big problem to me. It was not a problem unless you happen to be walking barefoot across the carpet and you happen not to be the one who put it there. It became not unlike the fable The Princes and the Pea, and my princes found it immediately. In the fable, it was the princes could not sleep. In my case, I knew the non-sleeper in the story would be me for as long as the chopstick remained under the carpet. Keeping my eyes focused firmly on the task at hand, I foolishly believed if I could resolve the cable problem, the matter of the chopstick would resolve itself.
One final trip to the garage led me to return with a second broom handle. The peanut gallery looked on in disbelief in my ability to finish what I had started without having to sell the house at a loss before I was through. The “I told you so’s” were being thought through in most of the major dialects of the Western Hemisphere.
This had ceased to be a project—it was now a quest, no lesser than that of the Holy Grail. A mile of duct tape later, both broom handles were firmly attached to one another. Even if I destroyed every square foot of carpeting in the house, I would not lose this broom handle under the carpet. A minute later the cable emerged exactly where it should have, on the other side of the room. I pulled the out broom handle, attached the cable and turned on the television. Everything worked, just as I had known it would.
Standing in front of the television, admiring my work in the new room arrangement, I noticed I was now a good foot taller than when I began the project. Was this an illusion brought about by my success? As was quickly pointed out by my princess, my enhanced stature was more attributable to the fact that all of the carpet padding that used to lie between the end of the bed and the wall was now nicely compacted into a ball. The ball of padding was located in the same twilight zone the chopstick found, right in the middle of the walkway. Trying to correct the problem only made it worse. Each time I prodded the ball of padding with the broom handle it grew larger underfoot. Within minutes it looked as though I had managed to suck up every inch of padding from every room in the house and placed it between my wife and a good night’s sleep. Resorting to logic once again, I quickly pointed out that she should walk on it because she would no longer be bothered by feeling the chopstick underfoot.
The next day I was on the phone scheduling an appointment with the carpet installation service. The carpet installer had to pull up most of the carpeting in the bedroom to be able to reach what she had affectionately labeled Chopstick Hill. I watched him work and I learned all about carpet padding and the installation of hardwood floors. He explained it was lucky for me that he came over because our padding was not good quality padding and we would not have known that had he not pulled up the carpet. I asked him why, if we would not have known about the padding, we would want to spend $300 for new padding. Without responding, he just kept slamming his knee in the carpet installer, charging one hundred dollars for his efforts and my education.
I was so impressed with his discussion of hardwood floors I almost bought one on the spot to surprise my wife. By now, we both know she wouldn’t have appreciated the surprise. Anybody who did not want to spend forty dollars on the cable repairman would probably have a little more trouble accepting five thousand dollars for a new floor.
However, I walked around with a silent smirk on my face for days knowing had we done it my way from the start, called the cable man, we could’ve saved the hundred dollars and never put a hole in the carpet.
This is what can happen when your patients decide to bypass your customer service because of prior bad experiences they have had trying to solve a problem. It usually comes down to process, bad process. Processes are a lot easier to fix than disappointed patients, and when you disappoint them too often they go to the ED–no appointment needed, no copay, and a great way for them to get their scripts refilled.
It would have been a lot cheaper to the hospital to have just done what the patient needed when they called the hospital or their physician, but many, many hospitals can’t seem to do that.