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LEADER’S GUIDE TO THE CRM VIDEO

GENERAL HOSPITABLEKeeping Your Patients Satisfied(And Just Plain Keeping Them!)

20 minutes, colorVideo Discussion Segments, 17 minutes

Videoscript Written by Bob SilbergLeader’s Guide prepared by Jane Gould

CONTENTS

INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

SYNOPSIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

CUSTOMER SERVICE IN HEALTHCARE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

SUGGESTED TRAINING DESIGNS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

TRAINING OBJECTIVES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

TRAINING DESIGN 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

TRAINING DESIGN 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

TRAINING DESIGN 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

WORKSHEET I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

WORKSHEET II. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

WORKSHEET III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

WORKSHEET IV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

WORKSHEET V . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

RECOMMENDED RESOURCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

COMPANION VIDEOS FROM CRM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

CLOSED CAPTIONED BY THE NATIONAL CAPTIONING INSTITUTE. USED WITH PERMISSION.COPYRIGHT © MCMXCIX, CRM FILMS, L.P.

VIDEO DISCUSSION SEGMENTS

Leader’s Guide GENERAL HOSPITABLE

At the conclusion of GENERAL HOSPITABLE: Keeping Patients Satisfied (AndJust Plain Keeping Them!), CRM has provided a number of open-ended videosegments. These are designed to be used in a stop-and-go, interactive format to elicitadditional in-depth follow-up discussion of the customer service issues explored in thevideo.

Please refer to the Training Designs in this Leader’s Guide for more information onhow to utilize these Video Discussion Segments in your training program.

INTRODUCTION

Some time ago, CRM introduced its first exclusively healthcare-relatedtraining video, IT’S A DOG’S WORLD, to wildly-enthusiastic responsefrom caregivers everywhere. That award-winning video told the deceptivelysimple story of an unwitting, soon-to-be patient who, along with his faithfuldog, falls into a construction pit while out walking one day. Both go theirrespective healthcare ways, the dog to the veterinarian, the man to his localout-patient care clinic, to drastically different results. As those who have seenthe video know, the dog is happily home watching TV on the couch longbefore his master has had time to so much as fill out the paperwork at theclinic!

As a tale of healthcare customer service gone hopelessly awry, the video sostruck a nerve in healthcare training that DOG’S WORLD has since becomea classic milestone in training for improved customer and patient service atcountless hospitals, healthcare centers and clinics.

Now, CRM is pleased to introduce GENERAL HOSPITABLE: KeepingYour Patients Satisfied (And Just Plain Keeping Them!), which follows upon that customer service message in a truly engaging way with specific, real-world skills that will help any caregiver — nurse, nurse’s aide, receptionist,or doctor — to dramatically improve their customer service, leading to greaterpatient satisfaction and improved outcomes.

How important is customer service to patient outcomes in healthcare? Well,a recent study indicates that a patient’s encounter with the receptionist is abetter predictor of the patient’s level of satisfaction with the quality of theirhealthcare than their encounter with the nurses, the staff, even the doctor! Ata time when many public relations-conscious healthcare organizations aretouting the sophistication of their expensive technology, it’s perhapsworthwhile to underscore the obvious point: good customer service costs littleor nothing over service that is only adequate, and its importance is oftendownplayed or overlooked entirely.

For those who have trained with the previous video, G E N E R A LHOSPITABLE is a natural follow-up for in-depth training, and even includesthe familiar patient from the earlier video acting this time as your Host. For

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Leader’s GuideGENERAL HOSPITABLE

those who are new to CRM’s healthcare training video library, the video iscompletely self-standing, and utilizes proven customer service techniquesthat, when used in conjunction with the activities and exercises in thisLeader’s Guide, will provide a comprehensive course in how to addresspatients’psychological and emotional needs as well as their physical ones.

Kirby Timmons, Creative Director for CRM FILMS

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INTRODUCTION(continued)

SYNOPSIS

It’s the typical opening of a TV hospital drama. We see a surgeon comingconfidently out of the operating room; a nurse rushing a patient into ane m e rgency room; and a customer service representative talkingcompassionately with a patient. Wait a minute — a “customer servicerepresentative,” in a TV drama...?

We see now that the TV drama is playing on a TV set in a hospital waitingroom. Among the people in the room is the Host, who helps us follow Gladysas she goes up to the reception desk and is embarrassed to be asked questionsabout her age and medical procedure in front of others in the waiting room.She then has the further anxiety of waiting to hear whether her insurance hasapproved the procedure.

Our Host points out that Gladys’ encounter is fairly standard, but shouldn’tbe. With the use of a “special” remote, he replays the same scene on thewaiting room TV to show how it could be done better. This time Gladys’information has already been taken over the phone and she’s reassured thatthe receptionist will take care of the insurance authorization. All Gladys hasto do is sign a form, while waiting comfortably for her appointment.

Next, we see Gladys enter an elevator where she overhears a nurse and anaide speaking negatively about a doctor and then discussing the condition ofanother patient. Naturally, Gladys is unsettled by this. The Host plays arevised version of the scene in which the staff members properly restrict theirgossip to a staff lounge.

Before returning to Gladys, we spend some time with Mr. Reynolds, whocomplains to a technician about how his blood work has been handled. Mr.Reynolds points out the large bruise he got from the procedure. Thetechnician shows no particular interest in the patient’s problem. Once again,the Host replays the scene to show the correct way to handle such complaints.This time the technician sympathizes with Mr. Reynolds and apologizes forthe poor job, even though it wasn’t his fault. Then he phones a nurse so shecan look at the bruise to relieve some of Mr. Reynolds’’s anxiety.

Gladys, now dressed in a hospital gown, is waiting in an exam room. Atechnician enters without knocking, referring to Gladys as “the endoscopy.”A nurse corrects him by telling him Gladys is “the colonoscopy workup.”

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Despite Gladys’ embarrassment, the technician leaves without an apology.Soon after, Dr. Marshall enters the room, also without knocking. He studiesher chart, barely looking at Gladys or noticing that she’s having troublehearing him. When he does give her information about her procedure, he usesso much medical jargon that she can’t understand him.

The Host explains that while Dr. Marshall is a competent physician, he’s notcommunicating any caring or respect for the patient. The Host replays thescene on the TV set. Now Dr. Marshall knocks on the door, and when heenters, smiles and introduces himself. After seating himself at Gladys’level,he gives her the opportunity to ask questions, which he answers simply butcompletely.

Later, while Gladys and her son wait, a nurse asks Gladys to sign a consentform. Without any additional information from the nurse, Gladys and her sonare bewildered. In the revised version of the scene, the nurse has Dr. Marshallanswer Gladys’ and her son’s questions. The nurse also provides a bookletthat provides additional information about the procedure. Both Gladys andher son seem reassured and now understand better what Gladys is actuallyconsenting to.

We return to Mr. Reynolds to find him recovering from minor eye surgery. Anurse doesn’t seem to notice that he seems uncomfortable, even though hesays he’s “fine.” When the Host re-runs the scene, the nurse isn’t so easilysatisfied. When Mr. Reynolds says he’s “not too bad,” she probes further,encouraging him to complain. Finally, he admits that he’s a little cold, andthe nurse gets him an extra blanket to make him more comfortable.

When it’s time for Mr. Reynolds to leave the hospital, the nurse gives him andhis wife confusing instructions about his medication. In the replayed version,the nurse clearly demonstrates how to give Mr. Reynolds his medication, aswell as giving him a sheet of instructions and an appointment reminder card.Unlike the first scenario, Mr. and Mrs. Reynolds look more confident andrelaxed.

The medical show that we were watching in the beginning is now finishingup. Back in the waiting area, Gladys is watching the caring professionals onTV and asks her son, “Why can’t my healthcare be like that?!” She decidesto take a good hard look at her health plan when she returns home. To Gladys’amazement, the doctor, nurse, and customer service representative on thescreen encourage her to do just that, as the Host leads us into a full recap.

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SYNOPSIS(continued)

CUSTOMER SERVICE IN HEALTHCARE

How do you choose a restaurant? Often you go to one based on friends’opinions or a review by a critic. Once you go, you decide whether it meetsyour expectations: were the surroundings inviting? the food consistently well-prepared? the service friendly and efficient? the prices reasonable? If it meetsyour expectations or exceeds them, you’ll recommend the restaurant to morefriends. If it doesn’t, you’ll be sure to tell that to people as well.

Although healthcare is a much more serious issue, people have basically thesame expectations. They want competent, personalized service, a staff that isknowledgeable and consistent, pleasant surroundings, and minimal worriesabout payment. If they’re satisfied by their provider, they will not only staywith that healthcare provider, but they’ll also refer others. Word of mouth isusually the most effective way of attracting long-term customers.

Many people claim to be satisfied with their healthcare provider, however oncloser inspection, they may have a lot of unaddressed concerns. Unlike arestaurant, where customers feel comfortable deciding what they want,people don’t always feel they have a say in their healthcare needs. They’reoften intimidated about asking questions; they accept what they’re told to do;and they feel confused by inconsistencies in the system. It’s like going to arestaurant and being told by the waiter what you are going to order, thengetting something you don’t recognize and being told to enjoy it!

WHAT PATIENTS WANT

In 1998, the American Hospital Association and The Picker Institute issuedthe first in a series of “Eye on Patient” studies which evaluated publicperception of healthcare and hospitals. They found that patients’ personalexperiences had led to major concerns about the way the health system works— or fails to work — and that many decisions about their care were not beingmade in their best interest.

Patient groups and surveys kept bringing up common needs that weren’tbeing met: more personalized care; easy access to reliable information; andbeing actively involved in decisions about the treatment process. Afteraccessing a broad range of patients and healthcare facilities, The PickerInstitute identified eight categories that are of most concern to patients.

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Each of these categories represents expectations that patients have of theircaregiver. They also present opportunities for “Moments of Truth,” whichmanagement expert and educator Susan Keane Baker defines as “the momentwhen your patient decides whether or not you are what you say you are.”

#1 — ACCESS

Patients want easy access to healthcare and are often frustrated byimpediments they encounter. These can range from telephone voice mailsystems to long waits, to getting insurance approval. Sometimes the healthorganization can eliminate the problems by changing phone policies orgetting pre-approval for treatment. Long waits can be eliminated by makingaccurate assessments of doctors’ scheduling. And unavoidable delays orfrustrating policies can be made bearable by a sympathetic, responsive staffand open communication.

#2 — RESPECT

There’s often a loss of identity in hospitals or clinics, where patients may beviewed as an illness or treatment, rather than a person. Acknowledgingpatients by name and respecting their privacy are important. They also feelrecognized and less anxious if they are given the information they need toparticipate in their own care.

#3 — COORDINATION

Patients’ perception of the quality of care they are receiving isn’t necessarilybased on the competency of their doctors. They’ll often judge the quality oftheir healthcare on the efficiency and coordination of support services and“front line” care, such as receptionists or technicians. Since navigating amanaged health system can be difficult, patients depend on the help of aknowledgeable staff. These individuals will usually make the first impressionon a patient and also be the first ones they come to with a problem orcomplaint.

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CUSTOMER SERVICEIN HEALTH CARE

(continued)

#4 — INFORMATION & COMMUNICATION

Patients often fear that they’re not getting the information they need abouttheir illness, treatment and prognosis. Many feel unprepared to manage ontheir own after they return home. They need a supportive environment wherethey feel free to ask questions and expect clear, complete explanations. It’simportant to listen to patients without interrupting them and to respond in amanner that makes them feel comfortable and involved in their medicalprocess.

#5 — PHYSICAL COMFORT

Illness makes people acutely aware of physical discomfort, and attending tothis is one of the most important services healthcare providers must give.Pain or disability can be heightened by long waits and cold, frightening, orunpleasant surroundings. Even healthy patients will experience more stressand anxiety in an uncomfortable environment. Caretakers should be sensitiveto verbal and nonverbal signs that a patient is distressed, then respond to theproblem.

#6 — EMOTIONAL SUPPORT

When people are ill, they’re more prone to fear and anxiety. Impersonalhospital environments, frightening treatments, and worries about managedcare or insurance policies all add to the stress. Again, healthcare personnelneed to be empathetic and watch for signs of anxiety or discomfort frompatients. Sometimes all people need is a sympathetic ear or a clearexplanation of what’s happening and what they can expect.

#7 — INVOLVEMENT OF FAMILY, FRIENDS

Since patients often rely on family or friends for support in decision makingor caregiving, they might have to be included in the patient’s medical care.This includes providing the family with information, involving them indecisions, and making visits with patients easy and stress-free. Though notphysically ill themselves, these people can still be very affected by thepatient’s illness.

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#8 — TRANSITION AND CONTINUITY

When patients return to their homes or begin outpatient treatment, they maybe confused or frightened by the changes and new responsibilities they face.They need clearly presented information so they can manage by themselves,and they need easy access to information if they have questions later on. And,like all aspects of healthcare, patients deserve a personal approach when theyleave a facility, including a warm, sincere good-bye and follow-up calls tocheck their progress.

Moments of Truth are opportunities to make loyal customers of your patients,and it’s clear that communication is the vital element in easing patientconcerns and increasing their satisfaction. Susan Baker explains that “Everytime you communicate with a patient, even if it is just for a few seconds, yougive him an opportunity to evaluate how well you are meeting hisexpectations.”

Communication doesn’t necessarily have to be verbal, or even betweenpeople. If parking is difficult, if the waiting room isn’t kept up, if there’s noone around to answer questions, your organization is sending a negativemessage about who you are. During a Moment of Truth, a patient is mentallymeasuring your appearance, your reliability, your responsiveness, your abilityto inspire confidence, and even the extent to which you empathize with his orher needs.

THE LIFETIME VALUE OF A PATIENT

What’s the cost of falling short of patient expectations? It could beconsiderable. When dissatisfied patients have a choice, they’ll go elsewhere.And, according to Baker, the value of a patient isn’t just based on the price ofan exam or a blood test. Losing a patient means losing the revenue generatedby all the years that patient could be expected to stay with the practice, alongwith the revenue of other patients referred by that individual.

Most patients want to maintain a long-term relationship with their caregivers,and retaining such patients is even more important than attracting new ones.When you lose customers, you not only lose their revenue, but you have theadditional expense and inconvenience of replacing them. New patients needto be solicited, introduced to the practice, have new medical records set upand information loaded into the computer system.

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(continued)

And what about the patients themselves? What are they losing when they feelthey need to leave their caregiver or health plan? For one thing, they mustsacrifice continuity. Not only will they have to explain health concerns to anew set of people, but they also have to learn how to navigate through thepolicies of new systems.

EXCEEDING PATIENT EXPECTATIONS

Healthcare workers may fail to meet patient needs because they’re oftenoverworked or distracted by other organizational demands. Sometimesthey’ve fallen into monotonous routines that turn them into automatons. Andeven the most pleasant person could lose his or her patience when confrontedby a demanding, angry patient.

Yet, healthcare workers themselves can benefit by seeing their jobs from thepoint of view of the patient. Instead of thinking, “I’m just the person whotakes the vitals,” a technician might consider how she’s the one who gets thefirst medical information from patients, who finds out about any problems,who reassures the patients and makes them comfortable before the doctorcomes in.

By providing more personal care, health professionals add to their own jobsatisfaction. They feel more needed, more like a collaborator. Also, a patientwho feels respected, informed, and well-cared for, is going to feel less stressand less need to complain. That also leads to a better work environment forstaff.

There is a lingering perception among patients that managed care meanslower costs at the expense of quality. While the transition to managed carewon’t be easy, patient satisfaction remains primarily in the hands of thecaregivers, regardless of plans or policies. With the right attitude, patientexpectations can be met or exceeded. The key lies in a few simple strategiesthat can be followed by anyone who works for a healthcare organization:

• Treat patients as people. Use their names, be empathetic, respecttheir privacy, and show you care.

• Listen without interrupting. Show you’re sincerely interested andhelp them resolve any problems.

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• Involve patients in their care. Explain what you’re doing and whatthey can expect. Answer their questions clearly. Be knowledgeableabout care options.

• Make patients as comfortable as possible. Have pleasantsurroundings, make sure scheduling is realistic, and be aware ofunspoken needs or concerns.

In this age of computers, patients have more access than ever to medicalinformation, and they expect the best care. Yet, there’s more to healing thanjust the right treatment or medicine. In order to keep patients and attractmore, healthcare providers need to put on a human face and see themselvesfrom the patient’s point of view. They don’t just take care of sick people.They provide reassurance and hope for people who are depending on themduring a difficult time. That’s an important job, and your patients will decideif you’re doing it right.

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(continued)

SUGGESTED TRAINING DESIGNS

The three following Training Designs provide interesting exercises that allowyou to immediately practice the concepts discussed in the video GENERALH O S P I TABLE: Keeping Yo u r Patients Satisfied (And Just PlainKeeping Them!).

Training Design 1 should be useful to individuals who have extensive patientcontact, such as physicians, nurses, aides, technicians, and receptionists.Training Design 2 is aimed at all health service staff, from housekeeping tophysicians to billing services. Training Design 3 can be used as an instructor-led session or as a self-study program by utilizing a series of VideoDiscussion Segments described below.

Choose one that best meets the needs of your group, or create your owntraining session by using any Activities you feel are appropriate.

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At the conclusion of GENERAL HOSPITABLE, CRM has provided aseries of additional Video Discussion Segments for follow-updiscussion. These video segments are designed to be used in a stop-and-go, interactive format to elicit additional in-depth follow-up discussionof the customer service issues explored in the video.

TRAINING OBJECTIVES

After seeing the video GENERALHOSPITABLE: Keeping Your PatientsSatisfied (And Just Plain Keeping Them!) and completing the exercises inthe Training Designs, participants should be able to:

• Recognize “Moments of Truth” and use them to increase patientsatisfaction.

• Be aware of patients’ needs and respond to them appropriately. Thisincludes the need for caring, confidentiality, respect, and information.

• Practice “service recovery”: Listen, apologize, and resolve the problemor refer it someone who can.

• Communicate effectively so that patients have the information they needto make informed decisions about their own healthcare.

• Understand the value of complaints and how to handle them positively.

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TRAINING DESIGN 1

Introduce yourself and the workshop. Give an example of your best andworst experiences as a patient. Then have participants describe their ownbest and worst experiences. Ask the participants to explain the causes forthese experiences, both good and bad. Was it due to the work of oneperson or an organizational policy? Write brief summaries of theirstatements in two columns (Bad/Good) on the flip chart. See if there areany consistent problems or positive experiences that individuals bring up.(10 minutes)

Show the video GENERAL HOSPITABLE: KeepingYo u r Patients Satisfied (And Just Plain KeepingThem!). (20 minutes)

Break participants into groups of 2 or 3, depending on the number ofpeople you have. Have each group make a list of “Moments of Truth”they might experience if they were a patient at your healthcare facility.Have them write them down. They should remember to include thingslike parking, the waiting room, payment, prescriptions, etc.

Reassemble the large group and write down their answers aschronologically as possible. Then go through the list and see which itemsreally would make a difference in how they felt about their healthcare.How does their own facility rate for each of these important Moments ofTruth? (15 minutes)

Have participants complete Worksheet I. Explain what ismeant by defining their jobs from a patient’s point of view.For example, you might define your job as “an instructor oftraining workshops.” However, from participant’s point ofview, your job is “to clearly and interestingly presentinformation that will help them do their jobs better.” See ifanyone else has more to add to that definition. (And, ofcourse, plan to live up to their expectations!)

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Materials needed:

Flip chart, mark-ing pens, video ofG E N E R A LH O S P I TA B L E ,photocopies ofWorksheets I, IIand III

2 hours, 10 minutes

After they’ve completed the worksheet, discuss the results. Are theredifferences in how someone in one job perceives the role of someone ina different job? (20 minutes)

Have participants come up with examples illustrating how a patient’sneed for privacy is met. This can range from curtained dressing rooms tolimited access to computer records. Discuss circumstances under whichp a t i e n t s ’ privacy is most likely to be trespassed and write downresponses. What are some precautions a healthcare practice can take toavoid embarrassing the patient? (5 minutes)

Discuss the following among the group:

• Why is it important to provide information to patients? • When are they most likely to need information? • What kinds of information do they expect? • How can you best provide it? • Do you feel like you’re effective when you give information? Why

or why not? • What do you do if you don’t know the answer to a question or

problem?

Have the group come up with suggestions for effective ways to give outinformation and write down their suggestions. (You might mention thePlanetree Model Hospital Unit in San Francisco, where patients weretaught how to read their own charts and allowed to make entriesconcerning their treatment.) (10 minutes)

Divide the group into small groups of 2 or 3. Have themcomplete Worksheet II and discuss the results.(20 minutes)

How do you handle complaints and practice service recovery? See ifanyone can remember the three steps in the video: Listen, Apologize, andResolve the problem.

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TRAINING DESIGNDESIGN 1(continued)

Ask participants to give some examples of effective listening. As theyspeak, look at your watch, tap your fingers, roll your eyes, pretend to beuninterested. Then ask the group if they thought you heard everythingthat was said. Why would your listening be ineffective for servicerecovery? (10 minutes)

Have the group complete Worksheet III. Discuss theirresults. Try to get examples for the different kinds ofresponses. See if people can come up with otherappropriate and inappropriate responses. Have them tellstories about complaints they handled effectively orineffectively, or when they themselves had complaints andhow they were handled. (15 minutes)

Before concluding the workshop, review the key points of the video.Thank participants for coming and remind them to always try to seethings from the patient’s point of view, otherwise the patient may notwant to see them! (5 minutes)

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TRAINING DESIGN 2

Introduce yourself and the workshop. Ask participants how peoplechoose their doctors. Is it often by referral? What are the consequencesif patients don’t like their healthplan or doctor? Write down the answers.How would these possibilities affect participants’ workplaces and theirown jobs? (5 minutes)

Have participants fill out Worksheet IV. (5 minutes)

Show the video GENERAL HOSPITABLE: KeepingYour Patients Satisfied (And Just Plain Keeping Them!)through the scene where Gladys is embarrassed by thereceptionist (or Video Segment 1-A). Then Stop theVideo. Ask participants what they thought the receptionistdid right and what they think she did wrong. Write downtheir answers. (10 minutes)

Now Continue the Video (or show Video Segment 1-B), showing theproper way the receptionist should have treated Gladys. Stop the Video.Ask the group to review the definition of a “Moment of Truth” and writedown their answers. What expectations might patients have when theysign in or wait for an appointment, and how might their expectations bemet? (10 minutes)

Continue the Video as Gladys overhears two staff members makinginappropriate comments on the elevator (or show Video Segment 2-A).Stop the Video. Explain that when researchers rode hospital elevators toobserve discussions, they heard inappropriate comments in 14% of theirtrips, and half of those involved breaches of patient confidentiality. NowContinue the Video, as staff members illustrate the proper way to handlethe situation (or show Video Segment 2-B). Stop the Video, and discuss

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Materials needed:

Flip chart, mark-ing pens, video ofG E N E R A LH O S P I TA B L E,photocopies ofWorksheets IVand V

2 hours, 15 minutesThe following Training Design directs the Trainer to use GENERALHOSPITABLE in a stop-and-go format. If preferred, the Trainer caninstead utilize the Video Discussion Segments described elsewhere inthis Leader’s Guide and provided at the conclusion of the video for justthis purpose.

any differences. (10 minutes)Continue the Video as Mr. Reynolds asks the Technician to look at hisarm (or Video Segment 3-A). Stop the Video. Ask the group whetherthey think the technician acted appropriately. Why or why not? Howwould participants handle this complaint? (10 minutes)

Continue the Video, showing the correct way the technician should havehandled the complaint (or show Video Segment 3-B). Stop the Video.Ask participants how they listen and act effectively when someonecomplains. What are some strategies they use if someone is very angryor won’t calm down? Write down the group’s ideas. (10 minutes)

Continue the Video of Gladys in the examination room up to the pointwhere Dr. Marshall “strikes out” (or show Video Segment 4-A and 5-A).Stop the Video. Review some of the staff behavior that wasinappropriate, rude, or confusing. Write down the answers. A s kparticipants to describe the proper way to handle the situation.(10 minutes)

Continue the Video through the correct version of Gladys’ examination(or show Video Segment 5-B). Stop the Video. Review what went rightthis time, and see if answers correspond to the suggestions the group gavepreviously. Discuss how the doctor listened particularly, and what aregood and bad listening habits. You might mention that:

• 2 minutes sitting at bedside is said to be better than 10 minutesstanding in the doorway or 15 minutes standing with one’s hand onthe doorknob.

• Distractions such as frequent interruptions, time pressures, and pre-conceived judgments or answers are barriers to effective listening.

• Responding includes maintaining eye contact, showing interest,paraphrasing or asking questions to make sure you understand.(15 minutes)

Ask the group what “informed consent” means. When they sign aconsent form for their own medical treatments do they always know whatthey’re signing? Do their patients? Continue the Video, playing boththe incorrect and correct scenes of Gladys signing a consent form(or show Video Segments 6-A and 6-B). Stop the Video and discuss anydifferences. (10 minutes)

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Ask participants if there are ever times when they want to “encourage”complaints. What do they do if they notice that something is bothering apatient, but the patient isn’t saying anything? Continue the Video asNurse Carter is first oblivious to Mr. Reynolds’ discomfort, then theversion where she notices he has a problem (or show Video Segments 7-A and 7-B). Stop the Video and discuss any differences. (10 minutes)

Continue the Video as Mr. Reynolds is discharged from the hospitalthrough where Nurse Carter demonstrates how to apply eye drops (orshow Video Segments 8-A and 8-B). Stop the Video. Ask participantsto describe sources of information offered to departing patients in theirpractice. It could be brochures, Xeroxed information, appointment cards,a final stop in the doctor’s office, follow-up calls, etc. What otherpossibilities are available that participants may not be using now?(Internet sites, support groups, phone numbers for billing or insurancequestions, etc.) (10 minutes)

Continue the Video through to the end (or show the Video Review).Stop the Vi d e o. Have the group complete Worksheet V. A f t e rparticipants total up their scores, see if there have been any changes intheir scores from their scores on Worksheet IV . Did some have lowerscores, some higher than previously? Why did they change? (If theirscore is between 25-30, their patients should be quite satisfied; between20 and 25, they need to try a little harder; under 20, they’ve got to re-evaluate how they’re treating their patients.)

Go around the room and ask individuals how they first described theirjobs and then how they revised their description from a patient’s point ofview. How did that change their perception of how well they metpatients’ expectations? (15 minutes)

Finish the workshop by having participants come up with“Moments of Truth” from the video and their ownexperiences. Write them down. Explain, again, that everytime they interact with a patient — even if it’s just greetingthem in the hallway, serving them their favorite Jello,adjusting the sound on their TV — they have the potential

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to turn a Moment of Truth into a positive experience.(5 minutes)

TRAINING DESIGN 3

Instructor-Led 2 hours, 50 minutes; Self-Study, 1 day

This Training Design utilizes the series of Video Discussion Segmentslocated at the conclusion of the video. Prior to beginning the trainingsession, cue up Video Discussion Segment 1-A. Or, if conducting as aSelf-Study Program, arrange for participants to view the Vi d e oDiscussion Segments prior to answering the discussion questions.

Explain to participants that they will be viewing a number of healthcarecustomer service interactions, after which they will discuss as a group (orwrite answers to) a series of questions about what they have seen.(5 minutes)

View Video Discussion Segment 1-A. After it has fadedto Black, Pause the Player, as indicated, while you discusswith the participants the following questions:

• What seems to be Gladys’concern throughout the interaction with theAdmissions Clerk? Does the Admissions Clerk notice? Why or whynot?

• What is the Admissions Clerk doing wrong, if anything? How couldshe have done things differently to accommodate Gladys?(10 minutes)

View Video Discussion Segment 1-B. After it has fadedto Black, Pause the Player, as indicated, while you discusswith the participants the following questions:

• Did the Admissions Clerk gain any more, or less, information in thisvignette compared to the previous one? If not, what was the point ofchanging the way she interacted with Gladys?

• How is Gladys’attitude as she goes into her procedure different thanit would have been in the previous vignette? Could this affect herhealthcare outcome? How? (10 minutes)

View Video Discussion Segment 2-A. After it has fadedto Black, Pause the Player, as indicated, while you discuss

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Materials needed:

Video DiscussionS e g m e n t s at theconclusion ofG E N E R A LHOSPITABLE

2 hours, 50 minutes

with the participants the following questions:

• Do the Nurse and Nurse’s Aide mean any real harm when they aregossiping about work conditions in their facility? Do they cause anyreal harm?

• What will Gladys think with regard to any nurses or staff who mayhave access to personal information about her? (10 minutes)

View Video Discussion Segment 2-B. After it has fadedto Black, Pause the Player, as indicated, while youdiscuss with the participants the following questions:

• Is it in some way limiting the healthcare workers’individual freedomto suggest that they restrict their conversation about work issues andpatients to private areas? Why or why not?

• Is such venting about work issues necessary at all? Is it just humannature to need to complain occasionally? (10 minutes)

View Video Discussion Segment 3-A. After it has fadedto Black, Pause the Player, as indicated, while youdiscuss with the participants the following questions:

• What did the Technician say to the patient with regard to the patient’sproblem? What did he communicate to the patient?

• Is it fair to ask staff members to accept some responsibility forproblems initiated by other staff members? Why or why not?(10 minutes)


• Did the Technician accept blame for the patient’s problem? Why orwhy not?

• Was the patient a “complainer”? Did he have a right to complain?

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(10 minutes)


• Which of the following applies to what the Nurse’s Aide has done:

• Violated patient privacy?• Referred to patient as a procedure instead of as a person?• Breached patient confidentiality?• What should the Nurse’s Aide have done differently? Perhaps

never come into the room at all? (10 minutes)


• As far as you can tell, is the Doctor technically correct in hisinformation and procedure with Gladys?

• What problem does Gladys appear to be having understanding theDoctor? (10 minutes)


• What does the Doctor do differently this time compared topreviously?

• What effect does the Doctor’s behavior have on Gladys in the firstscene compared to the final version? Which interaction took the

page 21


longer amount of the Doctor’s time? (10 minutes)


• What information does the Nurse give Gladys about the consentform?

• What feeling is Gladys left with as she and her son look over theform? (10 minutes)


• Why did the Nurse ask for the Doctor’s help in explaining theconsent form to Gladys and her son?

• Why is it important for patients to understand what they are givingconsent to? Could it have legal implications? Medical ones?(10 minutes)


• Did the Nurse accept Mr. Reynolds’answer that he was “fine” a littletoo quickly?

• Is everything “fine” for Mr. Reynolds as best you can tell?(10 minutes)


• Why wasn’t the Nurse willing to take Mr. Reynolds’ answer that hewas “ok” at face value? What did she learn by not accepting hisanswer?

• Are patients sometimes unwilling to express what’s really bothering

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them? Why? (10 minutes)


• Is the Nurse giving Mr. and Mrs. Reynolds too little or too muchinformation? Why?

• Could the information being dispensed by the Nurse be better givenin a pamphlet or booklet? (10 minutes)


• Who does the Nurse address her instructions to in this scene?

• Are her verbal instructions sufficient for the patient to understandhow to take care of himself at home? Are they really necessary if abooklet is going to be provided anyway? (10 minutes)

View the Video Review. After it has faded to Black, Stop the Player anddiscuss with the participants the following questions:

• Are the caregivers taking significantly longer to deliver superiorpatient care than giving merely adequate service?

• How many of the techniques and skills illustrated are applicable inyour role as a healthcare practitioner? (10 minutes)

Conclude the workshop by reminding participants of the link betweencustomer service and patient retention, and discussing with them waysthat they might implement some or all of the customer service techniques

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MOMENTS OF TRUTH

How would you define your job?__________________________________________________

_____________________________________________________________________________

How would you define your job from a patient’s point of view? _________________________

_____________________________________________________________________________

List 5 Moments of Truth that you frequently experience with patients:

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Choose two Moments of Truth from the list above and answer the following questions abouteach. What are the patient’s expectations? How do you respond to them?

Moment #_____

Patient expectations: ___________________________________________________________

_____________________________________________________________________________

Your response: ________________________________________________________________

_____________________________________________________________________________

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WORKSHEET I

Katie M Simpson


Moment #_____


_____________________________________________________________________________

Your response: ________________________________________________________________

_____________________________________________________________________________

Moment #_____


_____________________________________________________________________________

Your response: ________________________________________________________________

_____________________________________________________________________________

Katie M Simpson


HOW WOULD YOU SAY THIS?

Instead of: “You’re wrong.”

Say: _____________________________________________________________________

_________________________________________________________________________

Instead of: “I don’t know.”

Say: _____________________________________________________________________

_________________________________________________________________________

Instead of: “I can’t.”

Say: _____________________________________________________________________

_________________________________________________________________________

Instead of: “I’m just a nurse’s aide.”

Say: _____________________________________________________________________

WORKSHEET II

How can you rephrase the following statements so that they express respect, caring, and/orcompetence?

EXAMPLE Instead of: “What do you want?”Say: “May I help you?”

Instead of: “No”Say: “I realize you need the test results today, but Dr. Lopez has to give you that

information. I’ll page her and get back to you within the next hour.”

Katie M Simpson


_________________________________________________________________________Instead of: “What is this regarding?”

Say: _____________________________________________________________________

_________________________________________________________________________

Instead of: “We really messed up.”

Say: _____________________________________________________________________

_________________________________________________________________________

Instead of: “I’ll get back to you.”

Say: _____________________________________________________________________

_________________________________________________________________________

Instead of: “If you want an appointment today, you’ll have to be here at 1:00.”

Say: _____________________________________________________________________

_________________________________________________________________________

Instead of: “I’ll see what I can do.”

Say: _____________________________________________________________________

_________________________________________________________________________

Instead of: “It’s crazy here today.”

Say: _____________________________________________________________________

Katie M Simpson


_________________________________________________________________________RESPONDING TO COMPLAINTS

NOTAPPROPRIATE APPROPRIATE

Tell the person to calm down. ❏ ❏

Listen without interrupting. ❏ ❏

Don’t take the anger personally. ❏ ❏

Defend the organization or yourself. ❏ ❏

Scream back. ❏ ❏

Try to steer the person to a more private area. ❏ ❏

Empathize with the person. ❏ ❏

Point out how foolishly the person is behaving. ❏ ❏

Agree to take care of the problem. ❏ ❏

Support the person without necessarily agreeing. ❏ ❏

Try to stay calm. ❏ ❏

Keep an open mind about who’s wrong. ❏ ❏

Ask questions to get more information. ❏ ❏

Apologize, even if it’s not your fault. ❏ ❏

Don’t take any responsibility on yourself. ❏ ❏

If you can’t handle the situation, find someone ❏ ❏who can.

WORKSHEET III

Decide which responses are appropriate and which aren’t for handling complaints.

Katie M Simpson


DO YOU MEET PATIENTS’ EXPECTATIONS?

NEEDS ADEQUATE GOOD IMPROVEMENT

I greet them pleasantly. ❏ ❏ ❏

I use their name when possible. ❏ ❏ ❏

I look them in the eye when I speak. ❏ ❏ ❏

I respect their need for privacy. ❏ ❏ ❏

I try to be understanding and caring. ❏ ❏ ❏

I try to make them physically comfortable. ❏ ❏ ❏

I listen to them without interrupting. ❏ ❏ ❏

I try to uncover problems or concerns. ❏ ❏ ❏

I answer all questions as clearly and ❏ ❏ ❏thoroughly as possible.

I respond to their complaints or problems. ❏ ❏ ❏

(Needs Improvement = 1 pt., Adequate = 2 pts., Good = 3 pts.)

TOTAL POINTS: _________

WORKSHEET IV

Complete this worksheet BEFORE viewing the video.

• Describe your job as you perceive it:_______________________________________________

_____________________________________________________________________________

• How would you describe your interactions with patients?

Katie M Simpson


WORKSHEET V

Complete this worksheet AFTER viewing the video.

• Describe your job as you perceive it:________________________________________________

______________________________________________________________________________

• How would you describe your interactions with patients?

DO YOU REALLY MEET PATIENTS’ EXPECTATIONS?

NEEDS ADEQUATE GOODIMPROVEMENT

I greet them pleasantly. ❏ ❏ ❏

I use their name when possible. ❏ ❏ ❏

I look them in the eye when I speak. ❏ ❏ ❏

I respect their need for privacy. ❏ ❏ ❏

I try to be understanding and caring. ❏ ❏ ❏

I try to make them physically comfortable. ❏ ❏ ❏

I listen to them without interrupting. ❏ ❏ ❏

I try to uncover problems or concerns. ❏ ❏ ❏

I answer all questions as clearly and ❏ ❏ ❏thoroughly as possible.

I respond to their complaints or problems. ❏ ❏ ❏

(Needs Improvement = 1 pt., Adequate = 2 pts., Good = 3 pts.)

TOTAL POINTS: _________

Katie M Simpson


depicted in the vignettes in their own roles as caregivers. (5 minutes)

RECOMMENDED RESOURCES

Baker, Susan Keane, Managing Patient Expectations: The Art of Findingand Keeping Loyal Patients. San Francisco: Jossey-Bass Publishers, 1998.

Eye on Patients: A Report from The American Hospital Association and ThePicker Institute. Chicago: American Hospital Association, 1996.

Leebov, W., Afriat,S., and Presha, J., Service Savvy Health Care: One Goalat a Time. Chicago: AHA Press, 1998.

Leebov, W., Scott, G., and Olson, L., Achieving Impressive CustomerService: 7 Strategies for the Health Care Manager. Chicago: AHA Press,


1998.

COMPANION VIDEOS FROM CRM

IT’S A DOG’S WORLDHere’s a painfully funny video with serious lessons about patient satisfaction— or lack thereof. When Max the dog and his owner are injured during aromp in the park, the owner is not the one who receives exemplary medicalattention! Viewers will learn the key points of good patient service and thedire consequences of bad patient service. (13 minutes)

DEALING WITH CONFLICT, HEALTHCARE VERSIONConflict is an inevitable result of people working together in any healthcareorganization. But how team members handle such conflict, and how they tryto resolve it, can have a significant impact upon their ability to deliver highquality care. This video explores 5 Conflict-Handling Modes that can helpteam members to resolve any disagreement effectively while meeting bothparties’ underlying needs. (25 minutes)

TAKING CHARGE OF CHANGE, HEALTHCARE VERSIONThis essential new video offers an important look into how to redefine ourorganizations and ourselves to accommodate current healthcare trends.Viewers learn how to embrace change as opportunity, encourage employeeinvolvement in the change process and create a personal action plan foradapting to change. (19 minutes)

AN INVISIBLE MAN MEETS THE MUMMY, HEALTHCAREVERSIONLearn how to unwrap employees from the red tape that has kept them fromproviding effective, efficient service throughout your organization in thisentertaining new video. All viewers will clearly understand how to recognizeand respond to their customers, the importance of positive attitude, and howto measure progress. (19 minutes)

A PEACOCK IN THE LAND OF PENGUINSThis animated, award-winning video featuring Perry the Peacock and hisexotic feathered friends illustrates employee empowerment and thedevelopment of effective communication and teambuilding skills within thecontext of diversity. Insightful and inspiring. (10 minutes)


FOR MORE INFORMATION ABOUT CRM’SAWARD-WINNING VIDEOS AND OTHER TRAINING PRODUCTS

PLEASE CALL:

Your CRM Distributor

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