An unthinking table saw blade zipped off the end of my friend’s left index finger and shredded the adjoining two, but he was discharged from a Florida hospital with a reattached finger tip and a hope that rehabilitation would give him back his livelihood. He came to two conclusions about his experience: first, under duress, he could keep his sense of humor (“Call me Stubby!”) and second, he was grateful for the physical care he received by experienced medical personnel.
His wife came to a much different conclusion. She remembers the angry clash with a nurse who spoke only jagged English, the interminable waiting without anyone speaking to them, the runarounds for appointments and tests. The agony of bungled decency by the hospital staff was too much for her.
He said, “It wasn’t perfect, but I have my hand back.” She said, “It was an awful experience. I would never go back.” Out of one event came different views of the definition of success.
No one has yet come close to figuring out how to flawlessly, consistently and relentlessly achieve the Holy Trinity of medical care: patients getting better, feeling safe and becoming genuinely pleased throughout the process (or, as marketers say, “having expectations exceeded”). Engineers, bless their efficient hearts, would simply call this “achieving zero-defects.”
We expected that an industry receiving billions of dollars a year to buff us up like new would have reached the Holy Grail of near perfection long ago. It didn’t happen, and as a result, we became indignant; our costs are greater than the value, we said.
I remember the costs, energy and guilt that resulted from trying to better a patient’s journey when I worked in hospitals. So, I promise this to the next generation of hospital staff: If I am admitted to your fine facility, do not worry if there is no valet service, no 24-7 gourmet menu, no 36-inch flat-screen TV for each bed or chair, no ornate entrance with waterfalls. If I am in your emergency department or waiting room, do not worry if I have to wait while others who are sicker than I get care first. If you forget something or even snap at me but it doesn’t affect my outcome, do not worry because a simple apology is all I need. If you screw up, however, and I end up worse off than when I came in, please understand there has to be consequences.
Finally, you do not need to treat me as a “customer” if that means using superficial and costly trappings that have nothing to do with my direct care. The idea of hordes of satisfied and loyal customers suddenly streaming to hospitals because they portray themselves as customer friendly is ludicrous. It doesn’t work that way.
Why am I making such pledges? The bar of hospital care has been lifted too high, and my demand that hospitals continue to reach for it will only force them to redeploy or add costs that are not necessary to my care.
We must change our expectations of health care to reflect those which are most important. Forget the cushy surroundings and expensive marketing. Rather, help us become better off than when we arrived, have exquisitely trained physicians and staff who are friendly often, and then get us out as safely and quickly as possible.
And, please, don’t forget an apology when you make the inevitable mistake; it means so much more than a having a $5,000 hospital bed that does everything but make dark roast coffee.
Michael D. Skinner of Surry worked in hospitals for more than 30 years as a U.S. Army medic, registered nurse, and as a president of a community hospital in Massachusetts. He is now on the faculty of Husson University.