The holiday season finally allows some time to tidy the office, collect thoughts, reflect on the hectic year and plan for a rip-snorting 1997.
The pause to refresh also provides an opportunity to read some of the books, studies and articles that were temporarily cast aside to the "Get to Later" pile. This barrage of information convinces me that customer service and patient focus must become the platform for healthcare delivery during the last years of the 20th century.
Those providers who intend to succeed in the new millennium must tune their organizations to hum the do-re-mi of consumerism: value, quality and service. But instead of viewing patient-focused care as a marketing gimmick, a touchy-feely staff-motivation tool or the backbone of some squirrelly TQM program, it's time for pure commitment to customer relations.
Lou Holtz, the departing football coach at the University of Notre Dame, aptly summarized past attempts at patient-focused care. "When all is said and done," Holtz mused, "more is said than done."
But now healthcare futurist Russ Coile sees a consumer revolution brewing in healthcare, one driven by choice, information and quality outcomes. And once the price-driven market shakeout winds down, providers will be left to compete on quality of care and customer service. That's when consumerism will take root.
As leaders of the healthcare enterprise, you are the guardian of the values and the master of the mission. In the book Turned On, authors Roger Dow and Susan Cook identify eight insights to energize staff, customers and the bottom line. The book (HarperCollins Publishers, New York, $25) inspires with anecdotes, some of them from enlightened hospital-based organizations.
There's nothing magical about the eight ideas, other than together they form a framework for leadership. They are:
1. Build a strong foundation.
2. Make every customer feel special.
3. Have the courage to set bold goals.
4. Simplify, simplify, simplify.
5. Make technology your servant.
6. Measure well, act fast.
7. Unleash the power of people.
8. Lead with care.
Let's bring that to your world. In building a strong foundation, Mark Scott, chief executive officer of Mid-Columbia Medical Center, The Dalles, Ore., starts with a simple premise: "What's wrong with hospitals is that the people in charge don't think (about) what it's like to be a patient in that bed."
Take that a step further. In the past 12 months, have you spent more time on (a) information systems, (b) network integration, (c) managed care or (d) what it's like to be a patient in your institution?
Mid-Columbia's Scott addressed the challenge by creating a clear mission statement: Humanize, personalize and demystify healthcare.
Harbor Hospital Center in Baltimore has revamped its admitting process by addressing one of the most frequently asked questions in healthcare: Why do physicians care more about the patient's insurance company than about the patient? Harbor admits patients on any patient floor (or even bedside) and has cut the normal processing time in half.
Harbor's investments in technology, facilities, strategic planning and staff training are centered around building a human-centered organization. Nurse Michelle Pitter-Jones told Dow and Cook that before the changes, "I had to cut myself up into so many pieces I could never give all of me to one person." Now that she is assigned as a primary contact to only a few patients, "I know them as human beings; I learn what special things I can do to get them well and home to their families faster."
Poor communication skills have plagued many a physician. But a poor bedside manner and failure to listen to the patient won't cut it in the new age of consumerism. Some medical groups and health systems have even taken to sending physicians to media training courses where they are videotaped in role-playing exercises with patients.
Saint Louis Park-based HealthSystem Minnesota has put 220 of its physicians and caregivers through a one-day workshop, and another 300 will participate in the first half of 1997. The system later will train some of its clinicians to lead the workshops and will launch a provider-patient communications newsletter.
But once physicians are finished with charm school and the staff is focused on the patient, the healthcare delivery network will still require a business strategy.
Harvard Business School professor Regina E. Herzlinger offers some thoughtful advice in her new book, Market-Driven Health Care, which will be published next month (Addison Wesley Longman, Reading, Mass., $25). Herzlinger is convinced the transformation of healthcare will be based on convenience, choice, competition and open access to information.
Her idea of focus is to "throw out the general purpose, everything-for-everybody model" that has driven the acute-care hospital industry in the past 20 years. Instead, she suggests healthcare organizations concentrate on the things they do best and "design the integrated operating system that will lower the costs and optimize the quality of the focused factory."
It's this concept of the focused factory that aroused my interest. Focused factories, she insists, must be built around the requirements of patients, not the specialties of physicians.
"Traditionally in hospitals, teams of people are drawn from the various specialties to care for a particular case as needed," Herzlinger said. "These made-to-order teams are like sports teams assembled for a pick-up game; a focused factory's team, in contrast, is like the well-seasoned Chicago Bulls."
Organizing these focused factories into integrated delivery networks or virtual systems and offering comprehensive choices to patients could well determine the fate of managed care and healthcare delivery in the 21st century.