Finding the bad in the good

For years, we’ve been advocating for the power of a superior patient experience in building a leading hospital brand. Probably the most difficult component of that experience to change is customer service and the interaction of staff with patients. The positive connections physicians, nurses and staff can make with patients so often is the penultimate piece of the experience, and a caring encounter or warm gesture will override so many other negatives. But of course, the flip side is also true, and I had an experience this week that illustrates how difficult it can be for hospital providers to deliver a consistently positive service experience.

I have a condition that requires a three-hour IV infusion every couple of months. I’ve been having the treatment at the same hospital in the Twin Cities for four years, and probably have numerous stories – good and bad – I could tell. Overall, I’ve been very pleased with the care I’ve received at this system, and feel somewhat loyal to the people who care for me. Nevertheless, this week I received my treatment at the hospital’s brand new, multi-million dollar facility, which just recently opened. The center is gorgeous, with numerous amenities, private rooms, flat screen TVs – a wonderful environment. What struck me was that from the moment I arrived, the staff I encountered seemed to talk only of the negatives. They were still working out the kinks, the TV’s were the wrong kind, the private rooms led patients to bemoan the loss of community, there were no clocks in the rooms, nurses couldn’t interact with each other as easily now, volunteers were complaining about the additional space they had to cover, and on and on. Some of this was conveyed to me directly, but most of the comments were made between staff members in my presence, mostly right in my room. To be sure, one of the nurses pointed out some of the features such as the heated chairs and the wireless Internet access. Another showed how the view would soon include a wilderness area and walking bridge. But these positive comments were far outnumbered and definitely overshadowed in my mind by the negative.

The experience reminded me of how hard it is to change mindsets and attitudes, or to demonstrate the power of an off-hand comment. Of course, staff should never bitch in front of patients, yet it happens all the time. But I kept wondering: why, with this obviously first-class facility, would the staff focus so much on the negative? One thought: is this Midwestern modesty? Could the folks who work here be embarrassed by their “riches,” and use the cutting commentary as a way to ensure the proper perspective? Was it what one of my MBA instructors called the Monkey Tree Theory of Management in action? (This says that if an organization was a tree full of monkeys, the leaders at the top would look down at employees and see a bunch of monkeys, and the employees on the bottom would look up at leadership and see a bunch of monkey’s asses.) Was it staff conveying the popular “they don’t get it” mantra about administration, even with a beautiful new facility? Our director of design, Adam Meyer, postulates that hospital staff are so used to being around patients that they forget the impact they can have with what they’re saying. So they talk to each other about the bad computer system two feet from my chair because to them, I’m just part of the room, another patient in a long line of patients. Or perhaps it’s their way of connecting with patients, developing a kind of “us vs. them” bond, or trying to relate on a more down-to-earth, “real” level.

Here’s the deal – the people who cared for me that day were good people, caring people, and, no doubt, great at what they do. One of the nurses conducted one of the best IV installs I’ve ever had (not only no pain, I didn’t feel a thing!) Let me tell you, I’d trade a no-pain IV for negative commentary any day of the week. So on one hand, I hesitate to criticize any of them – they have a difficult job, there’s no doubt.

On the other hand, I tell this story to demonstrate that no matter what the reason behind it, comments like I heard do have an impact on my experience. I can only guess as to why they let these negative comments slip, and I certainly don’t have the answer on how to change that behavior. All I know was that, either inadvertently or intentionally, the negativity took the luster off a beautiful new facility. And that seems like a shame.