Mentor Staff to Improve Patient Satisfaction
By Dan Hurley
Elsevier Global Medical News
NEW YORK -- Say what you will about patient satisfaction - it doesn't reflect the real quality of your care, surveys that measure it aren't statistically valid -- but it's time emergency physicians took it seriously, according to a specialist in medical management.
"Good medical care is necessary but not sufficient for good clinical care," said Dr. Thom A. Mayer, chairman of the emergency practice-management company BestPractices Inc. and author of guides on patient and employee satisfaction. The No. 1 reason to get customer service right is not that it's good for the patient (although it is) and not that it's good for market share (although it is) but because it makes physicians' jobs easier, he said at the American College of Emergency Physicians' Advanced Pediatric Emergency Medicine Assembly.
A critical part of offering good customer service, Dr. Mayer said, is to make sure that your emergency department staff is made up primarily of "A Team" members, rather than "B Team" grumblers.
"There are days you walk in your ED, see who's there, and you say, 'Bring it on.' You have your A Team: They're positive, they're proactive, they know how to take care of things, they have a sense of humor."
On other days, Dr. Mayer said, "You walk in and say, 'Just shoot me.' That's when you see your B Team: They're negative, they're reactive, they're confused, they're late. These are your constant complainers. They're always surprised by things you know are predictable."
Rather than just tolerating them, physicians should work with B Team staffers to improve their behavior, Dr. Mayer urged. When providing guidance to them, he said, "Be specific: 'When you do X, it makes others feel Y. Try this other behavior instead.' Give them an A Team mentor. If you pair them with a mentor and they still can't get it together, it's better to let them go."
When dealing with patients and families, he said, the three most important A Team behaviors are as follows:
- Sitting down when talking with a patient or parent. "If you sit down, people think you were in the room seven times longer than you were," Dr. Mayer said. "And don't forget the importance of touch. That's the magic healing of being a physician or nurse in the first place."
- Using active listening and open body language. "The most important thing you can say to a patient or parent is, 'What's your biggest concern?' " Dr. Mayer said. "After they tell you, repeat back to the person what they just said: 'I understand you had this chest pain for about 3 weeks, but it got worse tonight. Is that about right?' And don't sit there with your arms crossed."
- Managing expectations. Finding out what the patient or parent wants, and explaining to that person at the outset what the emergency department is able to provide, will help avoid frustrations later. "Say, 'I understand that's your expectation, but that's not the way it works at this ED or at any ED,' " Dr. Mayer explained.
When parents are upset because of perceived delays in care, he said, "Walk in and say, 'I'm sorry, I take responsibility, we've had a lot of cases today.' ... They'll be 10 times more loyal."
For parents who seem particularly difficult, "Give them all you've got," Dr. Mayer urged. "Sit down, have open body language, use active listening, and manage their expectations from the beginning."
Good customer service doesn't necessarily end once the patient leaves the emergency department, Dr. Mayer said. "One of the most powerful things you can do with kids you admitted to the hospital is go see them upstairs. When you take the time to do that, you're often going to hear the kid, the mom, and the dad say, 'Thanks for coming up. We didn't have time to say thanks in the ED because we were so anxious.' It really helps you understand what a difference you make in their lives."