Some Things You Would Do Differently Fred Lee Some Things You Would Do Differently Fred Lee.
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Transcript of Some Things You Would Do Differently Fred Lee Some Things You Would Do Differently Fred Lee.
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Some Things You Would Do Some Things You Would Do DifferentlyDifferently
Fred Lee
Some Things You Would Do Some Things You Would Do DifferentlyDifferently
Fred Lee
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3 Key Premises
We have reached the ceiling in how much we can improve patient satisfaction scores with our current approach.
We cannot go from good to great in patient perceptions by copying and deploying what they do at service companies like Ritz-Carlton or Nordstrom’s.
Culture is driven by management systems, not workers or values.
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Table of Contents
1. Focus on What Can’t be Measured2. Make Courtesy More Important Than Efficiency3. Regard Patient Satisfaction as Fool’s Gold4. Measure to Improve, not to Impress5. Decentralize the Authority to Say “yes”6. Change the Concept of Work from Service to Theater7. Harness the Motivating Power of Imagination8. Create a Climate of Dissatisfaction9. Cease Using Competitive Rewards to Motivate People10. Close the Gap Between Knowing and Doing
If Disney ran your hospital you would…
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If DisneyRan Your
Hospital You Would...
1.1.Focus on What Can’t Be Focus on What Can’t Be
MeasuredMeasured
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On Measurement
“Not all that can be counted, counts. And not all that
counts can be counted.” -- Albert Einstein
“The most important figures one needs for management
are unknown and unknowable…(invisible also used)…
What is the value, for instance, of the multiplying effect of
a happy customer and the opposite effect from an
unhappy customer…(or the) Loss from inhibitors to pride
of workmanship?”
-- W. Edwards Deming, Out of the Crisis, p. 122
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Measurement
Outcomes Perceptions
Clinical Financial Satisfied Loyal fanGood to Great
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PERFORMANCE IMPROVES
Total Quality
Reputation improves
Place of choice
Productivity improves
Customers sing our praises
Costs go down
Processes improve
Outcomes
Perceptio
ns
Impact of PI on Total Quality
AnalyticalSkills
EmotionalSkills
Talent
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You can’t manage perceptions in the same way you manage outcomes.
Objective, MeasurableCreated by teamsMap and study process stepsImprove technical competence“Zero defects” thinking
Based on what you doEliminate carelessness
Subjective, ImpressionsCreated by individualsTake action -- just do it!Inspire attitudes and behaviors“Best possible” thinking
Based on what you sayEliminate avoidance
Outcomes (left brain) Perceptions (right brain)
80% of our PI scores 80% of our PS scores
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If DisneyRan Your
Hospital You Would...
2.2.Make Courtesy MoreMake Courtesy More
Important Than Important Than EfficiencyEfficiency
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1. Safety2. Courtesy3. Show4. Efficiency
Disney’s Quality Priorities
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PERSONAL EXAMPLES
Personal efficiency vs. Accessibility
Job efficiency vs.Saying “yes”
Process efficiency vs.Responsiveness
How do you make courtesy more important than efficiency?
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Paradox: Customer First is More Efficient
Results in overall organizationalinefficiency
Results in overall organizational
efficiency & teamwork
unit efficiency first courtesy first
internal focus
unresponsive
compete for resources
external focus
responsive
share resources
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If DisneyRan Your
Hospital You Would...
3.3.Consider Patient Consider Patient
Satisfaction Fool’s Satisfaction Fool’s GoldGold
Wilderness Lodge
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In Commercial BusinessesResearch on satisfaction shows…
On a scale of 1 to 5, people who mark a 4 are six times more likely to defect to the competition than those who mark a 5.
Harvard Business Review, Nov-Dec, 1995
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Why is it so hard to raise our scores?
+2+1
0 -1 -2 -3
4
Meeting expectations = 0
Satisfied = 0
Satisfied patients have no story to tell
Hampton Inn, huddle
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It’s the same as zero!Neither good nor bad.
Patient satisfaction is a fool’s gold.
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Singing our praises…
Caring, Cared, Cares +32Kind, kindness +24Compassionate +15Help, helpfulness +15Comfort, comforting +13
Friendly +8Professional +9Attention, attentive +7Concerned +6Listens +4
Loving +3Sweet +3Respect +3Quick +3Polite +3Patient +3
CommittedWarmUpbeatGenerousSoftnessPleasantSupportive
CheerfulInformativeCompetentEfficientProficientPromptHardworkingCourteous
Understanding +2Thoughtful +2Knowledgeable +2Smiling +2Bedside manner +2Empathy +2
Tender +1Takes time +1
SensitiveReassuringSelflessGentleNiceConscientious
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Hire
Require
Inspire
4
3
1 & 2
5
Fire
Staff Motivation
PatientEvaluation
Staff Performance
The Three Levels of Care
Judy
Courtesy
Compassion
Competence
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Courtesy
Compassion
CompetenceIncompetence
Rudeness
Indifference
Enemyis not..
This is about
Three enemies of caring
Judging
Avoidance
Carelessness
EnemyIs…
What I Feel
What I Say
What I Do
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If DisneyRan Your
Hospital You Would...
6.6.Change the Concept of Change the Concept of Work from Service to Work from Service to
TheaterTheater
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Disney is not a service and neither are we.
Commodities
Extract
Goods
Make
Services
Deliver
Experiences
Stage
O V
E R
T I
M E
Sinc
e 1
900
Joe Pine, The Experience Economy
The progression of economic value
Entertainment?
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Theater is about life – comedy and tragedy.
Hospital:Meeting the emotional needs of a family suffering a tragedy together.
Disney:Meeting the emotional needs of a family to have fun together.
A hospital without compassion is like Disney without fun.
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Focus on the patient’s experience, not our service…
Companies stage an experience whenever they
engage customers, connecting with them in a personal, memorable way.”
“They actually occur with any individual who has
been engaged on an emotional, physical, intellectual, or even spiritual level. The result? No two people can have the same experience – period.”
B. Joseph Pine II, The Experience Economy
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At the Wilderness Lodge
Think Disney experience, not just department or hotel
service.
Think patient experience, not just
department or hospital service.
Or…Or…
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Our Service Or Their Experience?
High anxiety Pain
No PainLow anxiety
CourtesyWhat you sayNo clinical effect
CompassionWhat you feelClinical effect
Depends on the emotional needs of the patient.
Service paradigm Experience paradigmOR
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THE DIRECTOR:
Start by describing the experience you want the guest
to have (see, hear, and feel) and how to make each
scene memorable.
Cast for the talent to play the role called for in the guest
experience, rather than just the skills to do a job.
Clarify each person’s role in creating a memorable
experience and get their commitment to their role.
Borrowing from Theater
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THE ACTOR:
Actors learn how to be real by becoming emotionally
engaged with their character.
Actors rely on sense memory and imagination to become
real in their role.
Borrowing from Theater
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Acting is not pretending…Eric Morris, No Acting, Please (first sentence)
Acting is the art of creating genuine realities on the stage. No matter what the material, the actor’s fundamental question is: “What is the reality and how can I make it real to me?”
Acting must “come from a real place.”
To paraphrase…
Care giving is the art of creating genuine realities on the hospital stage. No matter what the event, the caregiver’s fundamental question is: “What is the reality of this patient’s experience, and how can I make it real to me?”
Compassion also must “come from a real place.”
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Theater changes the service paradigm…
From patient satisfaction – to a fan with a story to tell
From just being courteous – to engaging the guest
From our service excellence – to their memorable experience
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Theater changes the service paradigm…
From hiring for the skills to do a job – to casting for the talent to play a
caring role in the guest experience
From teaching body language –to teaching acting principles(being real through imagination)
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Knowing how is not the problem…
Like losing weight, our problem is not with knowing how. When we want to enough, we figure out how and learn by doing.
Our problem is with being committed enough to do what it takes every day, and do it permanently, not just in short bursts of inspired energy.
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W. Edwards Deming might add…
What is the value of a committed
ensemble of care givers who have
become compassionately engaged in the
patient’s experience?