One source attributes the following poem to a poet in Texas, who claims he wrote it 20 years ago. Recently it has made its way across the Internet as a story about a crabby old man who died in a hospital or nursing home and left this poem behind. That’s how some urban legends grow.

Wherever lies the truth, the poem should speak to all of us working in the healthcare industry — we impact the lives of real people and should be darned proud of reaching out and making life better for every patient.

There’s a real person inside each of us — even the crabby, feeble and sometimes irritating ones!

What do you see nurses?  What do you see?
What are you thinking  . . .  when you’re looking at me?
A crabby old man . . . not very wise,
Uncertain of habit . . . with faraway eyes?

Who dribbles his food . . . and makes no reply
When you say in a loud voice . . .  ‘I do wish you’d try!
Who seems not to notice . . .  the things that you do
And forever is losing . . . A sock or shoe?

Who, resisting or not   . . .  lets you do as you will
With bathing and feeding . . . The long day to fill?
Is that what you’re thinking? . . .   Is that what you see?
Then open your eyes, nurse . . . you’re not looking at me

I’ll tell you who I am . . .  As I sit here so still
As I do at your bidding  . . . as I eat at your will
I’m a small child of Ten . . . with a father and mother
Brothers and sisters . . .  who love one another

A young boy of Sixteen . . . with wings on his feet
Dreaming that soon now . . .  a lover he’ll meet
A groom soon at Twenty . . . my heart gives a leap
Remembering, the vows . . . that I promised to keep

At Twenty-Five, now . . .  I have young of my own
Who need me to guide . . . .And a secure happy home
A man of Thirty . . . My young now grown fast
Bound to each other . . . With ties that should last

At Forty, my young sons . . . have grown and are gone
But my woman’s beside me . . . to see I don’t mourn
At Fifty, once more . .  . Babies play ’round my knee
Again, we know children . . . My loved one and me .

Dark days are upon me . . . My wife is now dead
I look at the future . . .  I shudder with dread
For my young are all rearing . . . young of their own
And I think of the years . . . And the love that I’ve known

I’m now an old man . . . . . . . . . and nature is cruel
Tis jest to make old age . . . .. . . .look like a fool
The body, it crumbles . . . grace and vigor, depart
There is now a stone . . . where I once had a heart

But inside this old carcass . . . A young guy still dwells
And now and again . . . my battered heart swells
I remember the joys . .  . I remember the pain
And I’m loving and living . . . life over again

I think of the years . all too few . . . gone too fast
And accept the stark fact . . . that nothing can last
So open your eyes, people . . . open and see
Not a crabby old man . . .   Look closer . . . see ME!

You could find yourself in a very embarrassing spotlight that negates years of advertising, millions spent on upgraded facilities and more millions on attracting physicians, nurses and specialists to deliver care.

I just happens that we have a recent case history for how to destroy a hospital’s reputation.

Talk show host Glenn Beck was, according to his story, actually ignored by the front office staff when he came to the hospital in severe pain. He decided to do a short video about the way he was treated — not by the doctors but by the administrative staff. His video was picked up by the Drudge Report, posted on the front page of AOL.com, and now over 600,000 people have seen it on YouTube and CNN.

GLEN BECK VIDEO

Beck from the Dead

At the hospital, I was treated more like a number than a patient. At times, staff members literally turned their back on my cries of pain and pleas for help. In one case a nurse even stood by tapping his fingers as if he was bored while my tiny wife struggled to lift me off a waiting room couch.

I’ve now seen our system at its very best and I’ve also experienced it at its very worst. But in each case, the difference had nothing to do with whether the hospital had the latest equipment or whether it looked like the Taj Mahal. It had to do with compassion. It had to do with respect. It had to do with treating people the way you’d want to be treated when going through something unfamiliar and frightening.

That’s why I don’t want to hear anymore about universal health care or HMOs or the evils of insurance companies until each and every hospital in this country can look me in the eye and tell me that they their staff is full of truly compassionate people who treat their visitors like patients, not products. Hire and train the right people, and then and only then come talk to me about everything else you need.

Beck from the Dead is Not the Norm

Now, to be sure, most healthcare professionals do wonderful things, miraculous things every day. I’ve worked with many hospitals over my career in marketing and saw the compassion. I watched car accident victims who could not walk or talk brought back to life by compassionate people. I’ve watched burn victims, and leukemia victims, and crippled children all get incredible care. I hear the compassion in the voices of the nurses and therapists. I’ve even seen nurses cry at the plight of their patients and scream for joy at the birth of a new child. I believe in my heart that this is the way it is in most hospitals.

But it is the weakest link that will break any organization.

Kari Kemper’s experience in the blog posting just below this one is not as dramatic as Glenn Beck’s, but it is an example of a staff person just not centered in on the customer’s experience. There is an indifference exhibited in the way she was being admitted to receive care. Equally clear, this staff person was not equipped with the technology to deliver a great customer experience (or to accelerate the hospital’s cash flow). But she also may not have been trained and certainly did not show the compassion you would expect in a place of healing and care.

Glenn Beck’s rant started as he entered the hospital lobby and reached millions of people. Kari’s was not as dramatic and did not make YouTube. But neither example should have happened … not in a hospital.

Avoid the Rants and Complaints

So if you want to stay off national television with horror stories, there can be no weak links. Your patient access staff are the front door to your hospital. Yes, I know … it is hard just to keep these positions filled. I see the huge number of help wanted positions for patient access staff all over the Internet. But this position is in some ways, the most important at establishing from the get-go an experience that will cause each patient to brag about how well they were treated.

A Great Patient Experience …

… must be delivered consistently by every single person who touches the patient’s visit to the hospital.

Finding caring people to handle patient registration might be difficult. Training them should not be. And surrounding them with a culture that propels everyone to be compassionate and professional should be a priority. And equipping these people so that they can deliver a great experience during registration should be given serious consideration so that this great experience is done with speed and accuracy.

These are simple steps to keep your hospital off YouTube. More yet, they are at least one step to counter the negativity now being dredged up by the Glenn Beck’s of the world. This one experience at one hospital is all over the media … Beck’s saying from his sick bed that “I have stories that will melt your brain and it is a time for a wake up call.”

From the time I was an orderly (I think they’re called transporters these days) at a hospital while in college studying pre-med, to all the years spent with physicians and staff at hospitals in the midwest to help them with marketing and PR to tell their wonderful stories, I have seen the good and the bad … but mostly the good. That’s the story I want to see on YouTube. And it all starts when the patient is registering to get care. This should be a good experience, delivered with compassion.

She was astounded at apparent inept systems at the hospital where she was getting chemo. Mind you, she’s been in this routine for weeks but upon entering the hospital for the now-routine therapy, here’s what she experienced:

We were able to make it to the hospital which I was scheduled to get my chemo around 5 pm. First they made us wait at the lobby. Then I had to go and do the new patient registration .. oh c’mon I thought don’t you guys have a central database that they could pull from the oncologists office ? After all it is the same hospital !

The hospital had its rules and systems, even if they required the patient to register all over again due to the installation of the new registration system. That might be necessary. And the patient went along with the ordeal. But her blog shows just how far apart were her expectations from the actual experience.

It points to yet another opportunity for technology to do a better job of making the patient experience (read that as customer experience) more in line with expectations. Is it unreasonable to expect a doctor who works within the hospital to have his patient registration system aligned/integrated with the hospital’s patient access systems?

Toby Bloomberg at Diva Marketing has a great profile on why Windber Medical Center’s CEO Nicholas Jacob took the risk of blogging out in the public. What’s so remarkable to me is the honest candor that ripples through Nick’s postings … it almost makes me want to hug him for being so forthright.

Nick’s words about contextual relevance … what mattered most to patients:

“It was about transforming a hospital into the best of a hotel and the best of a spa. Our philosophy was not just to create something that people would like. We, in fact, were interested only in creating something that people would absolutely love.”

Read Nick’s Blog and you will see for yourself how this medium can transform communications and customer relationships.

Thanks, Toby for getting the bead on this great story.

Reported by Healthcare IT News

The Washington Hospital, a 265-bed hospital in western Pennsylvania, plans to install wireless public Internet service to enhance the patient and guest experience. The not-for-profit, community hospital has signed an agreement with Irving, Texas-based Wayport, Inc., for the technology services.

“We are truly excited about offering our patients and their guests this new service,” said Telford W. Thomas, president and CEO of The Washington Hospital. “Patients and their guests coming to our hospital want to stay connected to family, friends and work at all times. We are delighted that we can help them do so.”

Thomas said hospitals providing guest Internet service must ensure the connection process is fast and simple, yet highly secure. The Washington Hospital will run private side wireless applications and devices and provide guest access on the same Wi-Fi network, while maintaining HIPAA compliance and internal network security.

Wayport will provide 24-hour phone support for anyone who needs assistance connecting to the wireless network while at the hospital, said Kevin McKeand, Wayport‘s vice president and general manager for healthcare. ]]> http://www.better-hospitals.com/2009/02/enhanced-patient-experience-with-in-room-internet-2/feed/ 0 http://www.better-hospitals.com/2009/02/149/ http://www.better-hospitals.com/2009/02/149/#comments Fri, 27 Feb 2009 23:27:54 +0000 Dale Wolf http://www.better-hospitals.com/?p=149 By Dale Wolf

Hospitals are beginning to figure out what hotels have known all along – customer satisfaction is critical to market share and share of wallet. Yes there are nay-sayers who tell us that there is little evidence that customer satisfaction and creating customer advocates has a financial payoff. I see too many examples where companies that are dedicated to customer satisfaction are the best-in-class for growth.

Take Griffin Hospital that was once a struggling institution in the working-class Lower Naugatuck Valley of Connecticut. The board made a commitment to patient experience and now 20-years later – instead of closing their doors as was originally recommended – they are a shining light in the entire medical community. Griffin is financially successful, steadily expanding its programs, its buildings, and — a key metric for hospitals — its market share. It is the only hospital named by Fortune magazine as one of the “100 Best Companies to Work For” in America for seven consecutive years, ranking No. 4 in 2006.

Customer Satisfaction is ALWAYS Delivered by Employees

Research by Press Ganey shows a clear relationship between employee satisfaction, patient satisfaction, and quality of care as an interactive, reinforcing relationship. Not only do satisfied employees deliver better care—which results in better outcomes and higher patient satisfaction— but working for an organization that values patients and delivers quality drives employee satisfaction, retention, and loyalty.

Staff Interaction Leads to Patient Satisfaction

One such Press Ganey survey of 139,380 former patients of 225 hospitals revealed that none of the top 15 patient satisfaction factors had anything to do with the patient’s health outcome. Instead the main factor was staff interaction, and there was a strong correlation between staff interaction and employee satisfaction.

Four Drivers

Analysis of data in the Press Ganey Employee Perspectives database has identified four key drivers of employee satisfaction:

1. Overall organization impression
2. Participation
3. Senior leadership
4. Recognition

Facilities where employees evaluate these dimensions positively experience improvements in employee satisfaction, patient satisfaction, physician satisfaction, clinical quality, and other critical outcomes.

Putting Patients First

According to Susan Frampton, Laura Gilpin and Patrick Charmel in their book: Putting Patients First, listening to patients or answering their questions costs nothing. “It can be argued that negative interactions—alienating patients, being non-responsive to their needs or limiting their sense of control—can be very costly. Angry, frustrated or frightened patients may be combative, withdrawn and less cooperative—requiring far more time than it would have taken to interact with them initially in a positive way.”

What Makes this so Hard?

“Perhaps the simplest and most profound of all human interactions is KINDNESS. But if it is so simple, it is surprising how frequently it is absent from our healthcare environments. Many staff members report verbal ‘abuse’ by physicians, managers and coworkers.”

Griffin Hospital — The First Five-Star Hospital

As reported in “Strategy + Business” … While most hospitals are hacking and trimming in desperate efforts to survive, the executives at Griffin and other “five-star hospitals” have taken a different tack. They’re attempting to build health-care centers with the customer-friendliness of Nordstrom, the reliability of FedEx, and the transactional accuracy and simplicity of American Express. They believe that making hospital stays more pleasant will pump up market share and revenues, boost the quality of clinical care, create less stress for the staff, and generally turn their business around. They are transforming themselves to better serve the consumer.

Griffin Makes Radical Change

Griffin’s revolutionary childbirth center opened in 1987. Griffin’s maternity business — a profit center for any hospital — doubled in just four years from fewer than 500 births per year to more than 1,000. An extraordinary one-third of its “customers” came from outside the Naugatuck Valley. Patient and staff satisfaction surveys resulted in perfect scores. Then they rebuilt the medical/surgical patient facilities. They replaced the harsh fluorescent lights with indirect incandescent lamps, installed carpeting to absorb sound, and constructed family rooms and kitchens stocked with snacks. Volunteers came in to bake muffins and cookies for patients and staff, filling the corridors with comforting, homey smells. Musicians were brought in to play live music, and visiting hour restrictions were eliminated.

Griffin’s Efforts are Paying Off

In recent years, inpatient admissions have leaped 25 percent (from 5,866 in 1997 to 7,349 in 2004), and its outpatient services have grown even faster (from 94,567 in 1997 to 160,427 in 2004, an increase of 70 percent). This is three times the average growth rate for the state. Many of Griffin’s doctors have been able to expand their practices, bringing in other doctors.” At the same time, Griffin’s work-force turnover has dropped. “We under-compensate our employees,” CEO Patrick Charmel admits, “and we probably work them harder [than do other hospitals]. But they become much prouder of what they do.” Griffin has also become a model for other institutions. More than 500 medical centers — 10 percent of the hospitals in the U.S. — have sought out Griffin for benchmarking tours. Griffin is no longer everyone’s last choice in health care.

One Last Word from “Putting Patients First”

“There is a misconception that supportive interactions require more staff or more time and are therefore more costly. Although labor costs are a substantial part of any hospital budget, the interactions themselves add nothing to the budget. Kindness is free.   Listening to patients or answering their questions costs nothing. It can be argued that negative interactions—alienating patients, being non-responsive to their needs or limiting their sense of control—can be very costly. … Angry, frustrated or frightened patients may be combative, withdrawn and less cooperative—requiring far more time than it would have taken to interact with them initially in a positive way.”

Living Proof

Fortunately, for me, that’s exactly the kind of hospital I go to. So I am living proof that the research by Press and Ganey and the wisdom in “Putting Patients First” is legitimate. My hospital is Bethesda North in Cincinnati. Every time my family has needed lab work, outpatient services or ER … everytime, the registration process is compassionately handled with speed and accuracy. And the staff that have cared for us after the registration process was over all delivered the same level of kindness. Sure it takes outstanding doctors, nurses and specialists … sure it takes great front-office and clinical technology, but even more, it takes a caring culture.

The incoming administration has plans to fix our healthcare system. It is important to keep patient experience and satisfaction as a factor in this re-invention of the system. Surely, getting increased access to those who now have little or no health insurance is paramount.

But along the way, we want to preserve the features that make our healthcare system one that most patients are satisfied with. Don’t break the positive experience that those with coverage now have with their providers. At the same time, The Consumer Assessment of Healthcare Providers and Systems survey indicates a lower level of delight with payers … so there is room for improving here.

Overall survey results from the 2008 CAHPS Health Plan Survey remain consistent with those of previous years. The survey indicates we are happy with the care provided by physicians and with the way in which doctors  communicate with us about healthcare issues:

The majority of survey respondents rate their medical care providers highly. 60% of respondents across all sectors rated their personal doctors and specialists either 9 or 10 on a 10-point scale where 0 is the worst possible and 10 is the best possible. While this is positive … it still points out that 40% of our doctors need an improved bedside manner so even where the system is doing well, we can still get better. Medicare enrollees gave the highest ratings across the sectors, with nearly 75% of Medicare respondents rating their personal doctors either 9 or 10.

Respondents report the most positive experiences for questions related to how well doctors communicate. Nearly 70% or more of all respondents report that their doctors always explain things, listen carefully, and show respect for what they had to say. These positive reports about doctor communication appear to be related to or consistent with the high ratings for personal doctors.

Our disappointment with the healthcare system is focused on how health plans address our needs and how they place barriers to accessing specialists. The plans should be sitting up worried at night at how they are disappointing their customers who generate the revenue that keep these plans in business. The facts show clear indication that the patient experience is way below that of the professionals who actually provide our care. There is a lot of righteous anger falling upon greedy financial services companies and healthcare plan managers should be moving now to improve the experience they provide to their customers.

Take a look at these two facts from the CAHPS survey:

Respondents rate their health plans and overall health care lower than they rate their personal doctors and specialists. Commercial plan enrollees rate their health plans the lowest across the sectors, with only 40% of respondents in 2007 and 36% of respondents in 2008 scoring their plans a 9 or 10. Less than 50% of both Medicaid and Commercial plan enrollees rate their overall health care a “9″ or “10″.  

Respondents report the least positive experiences for questions about getting needed care. Less than half of Medicaid and Commercial plan respondents report that it was always easy getting appointments with specialists they needed to see. Similarly, just over 50% of respondents reported “always” getting the care, tests, and treatments they thought they needed through their health plan. These relatively negative reports appear to be associated with lower health plan ratings.

So while the incoming administration looks at how to make affordable coverage accessible to everyone, they should also be encouraging existing healthcare plan managers to improve the overall customer (patient) experience with the consumers who are increasingly paying more of the bills while not getting the service we all expect in return.

Where is the healthcare system broken? The facts point at the insurers.

Perhaps no industry should be more centered on improving customer experience than healthcare … where the experience has enormous personal implications and where buzz around experiences at hospitals can dramatically impact market share and revenue growth.

At a recent HealthLeaders Media event, it became apparent that C-level managers are catching on fast to the validity of patient experience as something that is directly affected by how management approaches its employee relations.

One example that you could be easily replicated in any organization came from keynote speaker Al Stubblefield, president and CEO of Florida’s Baptist Healthcare Corporation. He talked about the importance of sharing “feel-good moments” with employees. When a friend of a patient wrote to praise hospital employees and departments for the excellent care his friend received while hospitalized, the organization created a video of the man reading the letter and showed it to employees. Accompanying slides highlighted the individuals and departments he mentioned to show, as Stubblefeld noted, that “everybody makes a difference.”

Kate Fenner, CEO of healthcare consulting firm Compass Group, “There are a lot of factors that impact patient satisfaction, with outcomes being the obvious to top the list. But equally important in shaping the patient’s perception of one hospital compared to another include physician satisfaction and employee satisfaction since these drive clinical quality. Hospital leaders must set the environment for exceeding expectations for care outcomes, accessibility, waiting time and how well such factors align with the hospital’s brand promise.”

Fenner added, “In an era where maybe a third of hospitals lost money, patient happiness is crucial for gaining market share and with market share comes the ability to negotiate better payments from payers. Everyone in the organization from patient registration staff to surgeons and nurses to various clinicians and support staff to senior managers — everyone must see delighting the patient as Job One.”