Multidisciplinary Customer Service

from Caring For Our Future, Summer 2005

By Michele Young, BA, Director of Customer Service

When you hear the words “cus tomer service” in a healthcare setting, many different things may come into your mind. You might picture the admissions clerk responsible for greeting and registering patients; you might picture the volunteer clerk in the gift shop assisting families and employees with their purchases; or you might picture the individual who delivers patient meals or the man responsible for valet parking.  Those are often easy places to go when talking about “customer service” because these roles appear to be “service-oriented.” But if we want to be successful in today’s healthcare environment, we’ll need to broaden our focus. Customer Service in healthcare today includes everyone from the environmental services employee to the bedside nurse to the attending physician – and it takes a collaborative effort from each and every one of us to make that experience positive.

This multidisciplinary approach to healthcare service excellence is exactly what has happened at many hospitals across the nation, and the results are impressive. The Studer Group in Florida focuses solely on coaching healthcare organizations toward implementation of a multidisciplinary approach, and hundreds of participants from hospitals and healthcare-related industries across the nation attend these types of three-day training sessions each month.

Hospitals like Children’s Memorial in Chicago and Atlanta Children’s have successfully reached the 90th percentile in family satisfaction ratings by working with the Studer Group and implementing a cross-functional team approach. Baptist Healthcare in Florida has become so skilled at multidisciplinary customer service that they now offer training to other organizations. So what, specifically, are these organizations doing, and what does it mean to take a multidisciplinary approach when taking care of our patients and families?

The first step is to clearly identify and state your goal. The goal of the multidisciplinary approach to customer service is simple: create an environment where nurses and other employees want to come to work, where patients feel truly cared for, and where physicians want to practice medicine. It’s not a program, but rather a culture shift that’s about making your organization a great hospital. Everyone agrees that nursing and nursing leadership are often in the best position to support such initiatives within the organization.

The effort starts by creating service teams that are responsible for increasing patient, physician and employee satisfaction. Service teams are made up of representatives from the various disciplines that impact the experience of an employee, physician, nurse or patient: front-line staff members, admissions clerks, nurses, physicians, technicians, volunteers, social workers, security personnel, environmental services, food services, admissions and parking, for example. Any discipline that has an impact on the organizational environment (and therefore has an impact on the service experienced by both internal and external customers) has representation on the team. All team members are given an equal voice and are asked to make the same commitment: Become a working, contributing member of the team.

During the first few meetings of the service team, the group spends time simply putting things into perspective. The group works together to sculpt a flow chart that accurately represents a family’s (or customer’s) entire experience — from the first phone call or referral to the day the patient or family is discharged (and sometimes beyond!). The same type of chart also is created to map out the typical employee,nurse and physician experience. This in and of itself is quite a process and provides a wonderful opportunity for each member of the group to better understand how various roles and responsibilities contribute to the overall impression of the service received during a patient’s stay or an individual’s interaction with the hospital. The flow chart also helps team members realize how many crucial interaction points the hospital has with its employees, nurses, physicians and patients

These interaction points are referred to as “moments of truth.” Moments of truth are the opportunities every staff member has to impact a customer’s life. These moments may seem insignificant to the individual providing the service, but they aren’t to the person on the receiving end. In fact, they may become the defining moment of how an individual is experiencing the entire environment of care.

Once the teams are up and running, the Studer Group suggests that they focus their work on developing the following characteristics, which are critical to becoming a world-class hospital:

• Creating a friendly, caring environment -Staff members must first and foremost understand that patients and their families often feel vulnerable when they enter a hospital environment. They’re confused about where they’re going, what they’re doing and why. They’re not sure who’s who; they don’t know the language of hospital acronyms, and even finding the restroom can seem daunting. However, there’s one thing patients and families are absolutely clear on: they know when they’re being treated promptly with care, warmth and compassion. While studies continue to show that nurses often have the strongest connection with a patient and the family, all staff members can help create a positive experience by simply making the patients and their families feel more comfortable when they have questions, requests or needs.
• Employing “Key Words at Key Times" - Studer points out that patients and families often feel “in the dark” throughout various stages of their stay. Customer-focused healthcare environments do what’s needed to educate families about every aspect of their child’s care — even those aspects that may seem obvious or insignificant to the staff member. An easy solution can be found by using “Key Words at Key Times.” For example, if a nurse enters a non-private room and pulls the curtain across to divide the room, the parent may think that something is about to happen. Is their child going to have another exam? A test? Something worse? However, if the nurse tells the family what he or she is doing, it can immediately put the family at ease. For example, “Mrs. Montoya, we want to make sure your child has as much privacy as possible during your stay. I’ll pull the curtain to help make that happen.” Key Words at Key Times can be used by other staff members as well. When it’s time to clean the room: “Mrs. Montoya, we like to keep your child’s room as clean as possible during your stay, so I’ll be taking care of that during the next 20 minutes.”
• Regularly communicating credentials -Experience counts! Families like to know they’re in good hands. It’s calming and reassuring to hear a nurse say, “I’m Joanie, and I’ll be your nurse this evening. I’ve been a nurse for more than 15 years; 10 right here at this hospital.” Likewise, other disciplines should be encouraged to share such information: “I’m Greg and I’m the phlebotomist. I’ll be drawing your child’s blood samples today. I’ve been at the hospital for more than five years, and I draw hundreds of samples each month.”
• Communicating the plan of care - Families like to be kept in the loop, and sometimes they need education to understand the “loop.” Explain each and every step of every process, and allow time for questions. The Studer Group suggests that families be asked to organize a communication chain. Every time the physician gives an update to a family member, that person is responsible for passing the information along to everyone else. The communication chain is especially supportive to nursing, since family members often rotate visiting hours and rely on the nurse assigned to the child to update each new visitor.
• Creating a visitor-friendly environment -Lost visitors have an unmistakable look about them, and every staff member from the janitor to the CEO needs to take ownership of helping lost visitors find their way. It starts with an offer to assist, “Can I help you get to where you’re going?” and is followed by physically walking the visitor to the desired destination. No pointing. No maps. No long, drawn-out explanations. Just the simple kindness of getting the visitor to where they want to be.
• Managing wait times -No one likes to wait, and it’s especially frustrating in the Emergency Department. But on those occasions when a patient or family has to wait, periodic updates from a staff member go a long way to showing the family that the hospital cares. Utilizing resources from the multidisciplinary service team can be a key to success in managing wait times. ED nurses often are occupied, and the environment can be extremely chaotic. The cross-functional service team can help identify other members of the staff who could be involved in updating families about wait times, thus alleviating some of the stress for the family, the nurses and the physicians providing the emergency care.
• Making patients feel you’ve got time -When a family or patient needs to talk, we need to listen. A family might have specific questions for the doctor, the nurse or the technician. Or more importantly, they might just need a set of ears that are willing. Great healthcare employees physically sit down when they talk to a patient, and taking a seat pays off. Did you know that when a healthcare employee sits down to chat with a family, the family actually perceives him or her as having been there twice as long?
• Following up after discharge - Families sometimes are confused about how to care for their child after they get home. A follow-up phone call can ease some of the fear and frustration they may be feeling. And if the child is doing great and there are no questions or concerns, families still appreciate the call. Some studies even suggest that keeping in contact with the patient or family can significantly decrease the number of re-admissions. So follow-up phone calls may have a clinical and a customer-service benefit.
• Communicating with, and showing confidence in, one another -Families are comforted by knowing that they’re being cared for by a well-coordinated team. Clear, concise communication between staff members is obvious to the patient and family. Demonstrating confidence in one another creates a sense of trust and can put the family and patient at ease. A simple statement can provide strong reassurance to a family, and it shows professional respect and integrity. The cross-functional customer-service team can encourage good working relationships amongst all disciplines by encouraging employees to practice verbal affirmations and confirmations such as, “Julie is a great nurse! She’ll take very good care of your child tonight.”
• Knowing that well-cared-for employees make for well-cared-for patients -It’s so simple, it’s scary. Happy employees equal happy patients and families. World-class hospitals go to great lengths to keep their employees happy and create a culture that fosters employee satisfaction.

Multidisciplinary customer-service teams can be instrumental in helping create an organizational culture where great nurses want to be, employees want to work, and where patients feel truly cared for. Sustaining such a culture of excellence can’t be achieved by using a “flavor of the month” attitude. Hospital leadership must set measurable goals and emphasize accountability to help transform the culture, and all staff members must believe that being good isn’t good enough.