PATIENT AND FAMILY SATISFACTION Dr. James Stallcup, M.D.
PREMISE In medicine we tend to focus on the clinical care delivered, not the patient s perception of the care delivered. In a trauma this is acceptable End of life issues are the most sensitive subject a family will ever deal with, therefore we must focus on how we deliver care
TWO MOTIVATIONS Our ultimate goal is to deliver the best possible care. Best clinical care Highest patient satisfaction These are in no way the same We depend heavily on word of mouth marketing This should always be seen as a plus, as it is the best form of marketing available
FACTS Only 4% of dissatisfied customers will complain For every one complaint filed, 25 bad experiences occurred It takes 12 positive experiences to make up for one bad one. Depending on the experience it may be impossible to make up for the bad one. A negative experience will reach twice as many ears as a positive one http://www.helpscout.net/75-customer-service-facts-quotes-statistics/
FACTS We must never treat the patient or family as a third party. Compare our business to that of a plastic surgeon, ophthalmologist, or cosmetic dentist. This is all based on personal motivation Those that do the bare minimum will always fail Those that go above and beyond will change lives
NO COMPLAINTS The allowable number of complaints is zero How I handled complaints at Nowata Typically the care provider is aware that a complaint will happen Upon review, very frequently the provider did nothing to mitigate that complaint All complaints should be handled before they escalate
WHY IS CUSTOMER SERVICE POOR? Our responsibility is to the patient. FALSE: Our responsibility is to everyone who has stake in the patient s care Many health professionals are great at their job, they just get complaints. FALSE: Customer service is a part of the job. We are too busy to spend time on this. FALSE: This is a crucial part of the job we make time for.
WHAT CAN WE DO TO IMPROVE? 1. Clean appearance 2. Always on time 3. Proper communication technique (no hurry) 4. Proper communication content 5. No signs of indifference
1. CLEAN APPEARANCE 1. Multiple lab coats so if one gets dirty you have another Never wear a dirty lab coat Always have a spare folded in your car 2. Stop smelling like smoke Although you may think people can t smell it, trust me they can. About 12 hours is probably a safe window
1. CLEAN APPEARANCE Nothing makes a doctor or nurse appear more incompetent than smoking.
2. ALWAYS ON TIME I start every office visit out with an apology for the wait If they waited, the apology is nice If they did not, they know I value their time Always give a reasonable estimate of arrival. If you are running behind, that is fine, but always call to correct your arrival time. And apologize!
3A. PROPER COMMUNICATION TECHNIQUE Always smile and introduce yourself politely I always add that I am happy to see them You can introduce yourself nicely to a somnolent patient No matter how rushed you are: a great introduction takes only a few seconds and can go a long way Within a few moments people will form a first impression
3B. PROPER COMMUNICATION TECHNIQUE Sit down Eye contact Clear terms Do you think I explained that well enough? I want to make sure I answer all of your questions. If a patient or family cannot think of a question, always encourage them to make a list to go over at your next visit Listen without interrupting. Shows concern Combats indifference
4. PROPER COMMUNICATION CONTENT People do not understand drug classes or types, but can easily learn very complex medical scenarios if you explain it well. When you explain something well it makes the patient and family more active in the care, which is our ultimate goal.
4. PROPER COMMUNICATION CONTENT The doctor wants to switch him to a longer-acting opioid called oxycontin Instead of going up and down with pain control all day, the doctor wants us to try a long lasting pain medicine. That way we can try to get all-day pain relief.
4. PROPER COMMUNICATION CONTENT There aren t any scientific studies saying that oxygen will help this Our doctors don t like to prescribe oxygen Oxygen is VERY expensive! See this number? (applies pulse oximetry) The oxygen level is 90 which is just fine. The illness is making him breathe like that and pain medication may help. The blood has plenty of oxygen so we don t need to add more.
4. PROPER COMMUNICATION CONTENT You are never too busy to think about what you are going to say before you say it. Take a moment to compose your thoughts before you speak, there is nothing wrong with it. It is not a vascular surgery where seconds count. Take your time.
4. PROPER COMMUNICATION CONTENT *FOCUS* Take time to focus on exactly what you want to communicate. Clear your mind and focus intently during the conversation No throwaway comments Hmm that usually works Yep! This is a mess No teacher comments: you are on a team with the family and patient, so act like it Do not sound like you are lecturing
4. PROPER COMMUNICATION CONTENT YOU ARE ON A TEAM! One thing we could try is a fan blowing air on the face You need to put a fan to blow air on his face The doctor will have to OK that Let me call the doctor, I know she would want to know if the pain medicine is not working.
5. INDIFFERENCE IS THE CANCER OF OUR BUSINESS It is both natural and hurtful. Nothing is more memorable to a family. Empathy is conditioned out. You have to work to pick empathy over indifference, and it can be hard. Disagreement amongst family Awful quality of life Availability bias in cognitive heuristics
QUESTIONS? Twitter @dieselcmio jwstallcup@gmail.com