Can Mickey Mouse turn your practice around?
Docs head to Disney for customer service advice
Donald Lloyd, FACPE, chief executive officer of the Murfreesboro (TN) Medical Clinic won’t be at all insulted if you say he runs a Mickey Mouse operation. In fact, that oversized mouse and his Goofy friends are exactly the model he has in mind.
Lloyd wants to bring smiles to the faces of his practice’s patients, cater to their needs, and make them feel comfortable and well-treated. That is why he and numerous other medical groups have turned to customer service seminars presented by The Disney Institute in Orlando, FL.
"We’re not only a service industry but a personal service industry," says Lloyd. "I’ve always felt that [customer service] was a great weakness of the medical industry."
By improving customer service, Lloyd hopes patients will feel a stronger loyalty to the practice that will ultimately positively influence payers and employers. "Baby boomers are reaching an age where they want to see customer service in everything," he says. "If they don’t see it, they will vote with their feet and their dollars."
Lloyd received a short version of the Disney program by the Medical Group Management Association in Englewood, CO, last summer at a conference in Orlando, FL. A similar program is available from Marriott in Avon, CT. (For more information, see box, below.)
Lloyd and human resources director Nell Womack revamped job descriptions, created training programs, and developed an orientation video focusing on customer service. "We set a standard and say if you want to work under these conditions, we’ll treat you well," he says. "But we expect you to treat the patient well."
Behind Disney’s smiles and courtesies lies a concept called guestology. "Every guest or patient is a VIP," says Craig Taylor, director of business programs for The Disney Institute. "We mean very individual person.’ Understanding that everyone is an individual and has needs, wants, expectations, and emotions makes a health care organization think more about the experiences the person has when he or she enters the room."
Take a look from the patient’s perspective
Taylor recalls one seminar participant who returned to her hospital and, taking a look from the patient’s perspective, noticed that the plants in the lobby were dying. It was an incongruent image that she soon corrected.
Another participant noticed that patients lying on gurneys before and after surgery were staring at stained ceiling tiles. So the hospital painted a sky mural with clouds and birds to give a more comforting feel.
"We really do encourage [health care providers] to try to understand the experience the patient has," Taylor says. "We have a concept called, Everything speaks.’ The environment speaks to us and says certain things. What do we want the environment to say in the hospital setting? It’s a caregiving place; you’re welcome here.’"
Four basic principles
Disney’s four basic principles can be summed up in four words:
1. safety;
2. courtesy;
3. show;
4. efficiency.
Safety always comes first; courtesy is always expected making eye contact, listening to questions, and responding in a friendly, helpful way.
Murfreesboro Clinic incorporated those concepts in its job descriptions, placing them even above the technical skills that employees are expected to demonstrate. For example, employees are instructed to answer all questions from patients, says Womack. "Never say, I don’t know,’Provide good service with good care
Listening skills, accommodations please patients
Your staff are courteous making eye contact, answering questions, and tending to patients’ needs. But if physicians are having trouble viewing patients as customers, your efforts may fall short.
Managed care has forever changed the way patients view their doctors and health care providers. But some physicians still cling to the old concept that swift diagnosis and treatment are all that matter.
"You don’t have to give bad service to give good care," says Alfredo Czerwinski, MD, principal with Lawson & Associates health care consultants in Sacramento, CA. "On the contrary, good service and good care go hand in hand."
Follow-through counts
For a physician, good service may mean providing timely lab results. Follow-through counts with patients. "If you say, I’ll call you tonight with your test results,’ then do it," he says. "Good service also may involve some outreach to patients, such as sending reminder letters for cholesterol checks or mammograms.
But above all, physicians need to make patients feel they are listening, says Czerwinski, formerly senior vice president for clinical resources at Sutter Health in Sacramento, CA. That doesn’t necessarily mean spending more time with patients, he says.
"A doctor who spends 15 minutes in the exam room but does all the talking is perceived less well than a doctor who made the patient feel they were listened to" even if that visit was shorter, he says.
The bottom line: "Behave in a way that makes patients feel heard and respected," says Czerwinski.
Remember to meet the customers’ needs
Physicians should even consider adapting some of the universal basics of customer service to their practice, he says. Namely, meet the customers’ needs. For example, patients may be having difficulty making appointments because the practice doesn’t offer any evening or weekend hours. Over time, some of those patients may drift to practices that accommodate those needs.
Czerwinski suggests including an open-ended request for information in patient surveys to cover such issues, such as, "We would appreciate your suggestions on what we could do to improve our practice." Responses from patients are likely to vary widely. "I would guess there are big demographic and regional differences in what patients would like," says Czerwinski. or act bothered by a question," she tells employees. "Just say that’s a good question; let me find the answer."
Murfreesboro Medical Clinic also has a dress code to ensure that employees project a professional image. "In the modern era, when skirts can be pretty short, we think they ought to be close to the knee, not four or five inches above the knee," Lloyd says. Wild jewelry and jeans are out, too.
Rather than simply printing a list of do’s and don’ts, the issue of appropriate dress is included in a video shown to potential employees. The video, patterned after one shown to Disney employees, was produced in-house with the help of a local television station and cost about $6,000, Lloyd says.
Don’t forget common courtesy
With the video and inservice sessions, the clinic has been re-orienting current staff to the new customer service standards. As the largest medical facility in a community of 55,000, clinic employees and physicians may have taken their patients for granted and "forgotten their manners," Lloyd says. "Whether we like managed care or not, it’s focusing on the fact that we have to be accountable to the patients and employers," he says.
Customer service depends mostly on the daily interaction between numerous clerks, nurses, doctors, technicians, and patients. But Murfreesboro Clinic has added some support systems, as well. A new customer service department of 10 employees including three new positions escorts new patients through the clinic and handles patient complaints.
The department also files insurance claims and sorts through other insurance issues. "The idea is for patients to be able to go to that department and handle any problems they may have," Womack says.
The practice also created a patient care committee of physicians to discuss any patient concerns that arise concerning direct care and to review benchmarks and outcomes. A newly hired trainer provides seminars and orientations both for new employees and long-standing ones.
Womack thinks she has made it clear to employees that the new attitude puts patients first in every way.
"I don’t want you to come in and do your job," she says. "I want you to come in and do everything you can to make the patients happy and comfortable. I want them walk out saying Wow! They were so nice to me.’"
Already, Womack says she feels the practice is more patient-friendly. To better gauge the impact of the customer service efforts, she is holding focus groups with physicians’ wives, employees, and patients, and will conduct a patient satisfaction survey.
"We have made great strides in making patients happy and comfortable, and I really think it’s showed," she says.
The Disney Institute, Orlando, FL. Craig Taylor, Director of Business Programs. Telephone: (407) 828-4411.
Georgetown University Medical Center, Washington, DC. John Cockerham, Associate Professor of Pediatrics and Outcomes Management Consultant. Telephone: (202) 687-2707. E-mail: [email protected].
Murfreesboro (TN) Medical Clinic. Nell Womack, Director of Human Resources. Telephone: (615) 867-7885.
Tallahassee (FL) Ear, Nose & Throat. Tricia Skinner, Nurse Practitioner. Telephone: (850) 877-0101.
A Practical Guide to HEDIS 3.0/1998 Implementation March 30-31, Fort Worth, TX. Sponsored by the National Committee for Quality Assurance, Education Department, 2000 L Street, NW, Suite 500, Washington, DC 20036. Telephone: (202) 955-5697. Fax: (202) 955-3531. E-mail: conference @ncqa.org. World Wide Web: http://www.ncqa.org.
Improving Health Care Quality April 6-8, Boston. Sponsored by the Institute for Healthcare Improvement (IHI), 135 Francis Street, Boston, MA 02215. Telephone: (617) 754-4800. Fax: (617) 754-4848.
Methods and Tools for Breakthrough Improvement April 6-8, Tempe, AZ. Sponsored by the IHI. See contact information, above.
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