Why is customer service so difficult in the hospital?
Friday, April 29, 2016
On April 20, popular consumer reporter John Stossel wrote an opinion piece on the lack of customer service he received while in the hospital. Stossel was recently diagnosed with lung cancer, for which he was admitted to prestigious New York-Presbyterian Hospital.
Although Stossel acknowledged his medical care was excellent, he could not help but notice the lack of customer care that consumers have grown to expect. He brought up some key issues healthcare workers have been navigating for years.
Stossel noted the lack of timely and easy communication with his physicians. In the age of technology, physicians are still enigmas who arrive when they please and depart just as quickly. The patients and families wait anxiously for the physician to arrive, to only be greeted with a whirlwind of information dropped on them and more questions than answers.
But this is just how it has always been. The current medical model still puts the physician on a pedestal and does not dare challenge them.
As Stossel remarked, there is no easy way for patients and families to communicate with the one person directing most of their care — not even the nurses at the bedside have easy access. This leaves the bedside nurse as the scapegoat for frustrations, yet the system never changes.
In fact, many nurses dread calling physicians for being spoken to poorly or even screamed at for paging them for mundane issues like "the family would like to speak with you."
Stossel takes the stance that most of this is stemming from the third-party payer system that prevails in America, but it generally is not that simple. In the current environment of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) — where the satisfaction of the patient will impact reimbursement — it is quickly becoming apparent that high scores will not necessary indicate good healthcare.
As the manipulation of patient experiences creates new industries, the real solutions remain untouched. While the pool of resources dwindles, something has to give, and that will continue to be the nursing and bedside care staff.
In the pursuit of better patient satisfaction, more pressure is being placed on the bedside staff to be better, quicker and with a smile on their face. Yet the nursing staff continues to have more and more unreasonable expectations placed on them as staff continues to be cut and documentation burdens worsen.
Since the implementation of the electronic medical record, nurses spend anywhere from 19-35 percent of their day in documentation. This equates to less actual time at the bedside performing direct patient care. Any quick walk down a hospital hallway will reveal the staff clicking away at computers and not at the bedside where they belong.
In return, the nursing staff also needs to step up their game. This new environment of patient satisfaction is going nowhere for the time being, so for our institutions to be successful, we have to be part of the solution.
The concept of customer service is a relatively new one in healthcare and therefore not spotlighted in school or even hospital orientations until recently. However, nurses are intrinsic givers, and we need to tap back into the care that inspired us to be nurses in the first place. We need to start treating our patients with kindness and respect and not be fearful to speak up for better care and staffing.
Stossel does hit the nail on the head in discussing that competition in the free market will create change and improvements. Go to any hospital floor that offers elective orthopedic surgery or even obstetric care where the patients actively choose which hospital they go to, and you will quickly see there is merit to his statement.
Most are kept modern and comfortable in appearance, all to draw the patient to their institution. The physicians are catered to in hopes of keeping their steady stream of confirmed payers to their institution.
In a follow-up opinion piece on April 27, Stossel responded to myriad comments he received from his initial article. One point he continued to hold was that if the hospital were more focused on competition, conditions would change. He repeatedly used FedEx as an example of improved efficiency.
The FedEx model is routinely brought up in many healthcare circles of how to better "move patients through your hospital." However, what is frequently forgotten is people are not boxes or parcels.
People are complicated. When moving them through a complex and complicated system, it is not likely to be smooth. Not to mention, being treated like a box is not a typical expectation and will certain affect HCAHPS scores.
Of greater interest is how a consumer reporter was unaware of resources that would actually give him viable data about the healthcare institution at which he was being cared for. As one commenter pointed out, his prestigious hospital was actually lacking in many areas of patient safety according to Leapfrog Group's Hospital Safety Score. Once again, proving that reputation and word of mouth, along with patient satisfaction scores, are not the real indicators of good care.
Although Stossel has stimulated some conversation on many of the most common issues in healthcare, he also uncovers the truth that the solutions are not that simple.
But one thing that can be agreed upon is further regulations and laws have not made the healthcare world move any smoother. On the contrary, it has bogged most down with more layers of bureaucracy, leaving few at the bedside actually caring for patients.
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