The power of the customer is growing and disrupting the health and aged care industry. Not surprising really when you consider that the largest group in our society, the Baby Boomers, are now reaching an age where their health and age is taking up more of their own attention that ever before. This group is such a huge cohort, that they are pretty much dictated how western societies would meet their needs at their various stages in life. From Flower Power to Winnibagos, now they are heading into their sunset years and not looking to give up their self-determination nor the high standards of living they have grown used to.
And so the rise of consumer-directed care, patient-centred care and all the various derivatives. Now one would expect that an industry that is built of people, for people, by people – such as health and aged care, would have no problem responding to this. But lo. This is not always the case. In fact, measuring ‘patient experience’ is a relatively new concept. And the reason is this.
Our focus in health is actually on the lower order needs of Maslow’s Hierarchy – the physiological and safety of the patient, the resident, the client … the person. Meeting these needs must be done with the fewest resources. So, to get the most important work done, nurses work within strict routines, focusing on the tasks that have the highest clinical urgency. In the emergency departments, this is embedded in the Triage system and dictates which patients are seen first. ATS category 1 are to be seen immediately – these people are not usually worried about anything else but their survival. Down the other end, Category 5 patients – well they probably should not even be there and would expect to the seen by anyone for at least 2 hours and in a large ED, many more hours than that. But these people, while they are the “walking worried”, also have other more pressing, non-physiological needs driving them – and have the motivation and means to express these. It is likely most of the complaints received are from these people.
Go back to the Baby Boomers. They are not driven by their lower order needs – these are not in question. They assume that if they are in a hospital, these needs are being met. It is the other higher order needs that drive their levels of satisfaction – the social esteem and even self-actualising needs.
They want to retain their self-determination. They want to be treated with respect and as a valued member of the conversation. They want their own time valued. So there is sometimes a clash of expectations. Nurses need to get the work done which focuses predominantly on patients’ physiological conditions and sometimes forget the ‘care factor’ in patient care. What is a public hospital to do? It is actually designed to deliver great treatment but not necessarily great patient experiences. The solution will likely come from outside of the health and aged are system.
Apple, in an effort to improve its own ‘customer’ experience’ sent its employees to the Carlton Ritz customer training program. They discovered that people who loved high end hotel service experiences especially loved the ‘concierge’ – the person who would meet you at the door and could answer any of your questions. From that idea Apple created the Genius Bar. Recently I interviewed Matui Bush, the Unit Manager of the Outpatient’s at Peter Mac. I wandered into his waiting room thinking it was a cafe and sat down while I was waiting for my next meeting. People were sitting around tables talking, playing with jigsaw puzzles, game boards, reading, drinking cups of tea and coffee. I found out later that these people were complete strangers waiting to be called in for their outpatient oncology appointments. Matui explained to me that he draws his inspiration from Michelin restaurants; focusing on what the customer feels, sees, hears, smells, tastes. With this simple paradigm shift, he transformed this cold, utilitarian waiting area into a social gathering place — a place where people preferred to wait and were disappointed when they were called in to their appointment as it interrupted their social experience!
What could be done in a busy hospital department to meet the patients where they are?
How can the needs of patients and nurses be aligned?