When quality trumps service, patients lose out – Healthy Debate.
I wrote the post in the link above for the Healthy Debate blog (click on the link). I’d be thrilled if you read and commented on the site!
Many thanks,
Shawn
Author: Shawn Whatley
Improve Quality, Efficiency, & Communication with Physician Navigators
Emergency physicians spend more time looking for charts, finding lab reports, and checking if treatments are done, than they do caring for patients. After continual interruptions from allied health providers, patients, and other physicians, doctors have little time left for patients.
Some say scribes help. But after trying scribes, we found navigation to be our greatest need, not transcription.
Physician navigators (PNs) do 2 things:
Direct physician-patient traffic
Manage information
They do not:
Make clinical decisions
Give clinical advice
Order clinical care
PNs improve:
Patient experience.
Physician efficiency
Team communication, especially between nurses and physicians.
PNs perform non-medical tasks that MDs do when working without a PN. They do anything doctors do that does not require a medical degree.
We use Physician Navigators to
- Keep informed of patients waiting in all areas of the department
- Find out which patients are waiting to be seen next
- Accept and photocopy patient handover lists from the physician handing over —
- Make sure all these patients are reviewed and looked after by the accepting physician
- Keep track of all the patients the doctor has seen and when patients are ready for reassessment
- Obtain chart for “next available MD to see”
- Access electronic charts; print out reports
- Prepare chart for MD reassessment: blood-work, x-rays…printed and ready to hand to patients at discharge
- Update MD data in the ED information system (tracking board)
- Page and receive specialist phone calls
- Receive and manage other incoming calls
- Hold non-critical calls for MD when MD is with a patient
- Assist RNs locating MD for urgent needs
- Inform patients about wait times and purpose
- Direct patients in and out of examining stations
- Update RNs on MD work plan
- Receive RN requests for patient reassessment
- Work with the team (e.g., RN and RT) to gather equipment for procedures
- Handout patient information sheets and referral forms to patients when instructed by MD
- Assist with paperwork to ensure proper completion
- Create handover list at the end of a shift
Physicians Navigators do this, and more, with good humour, a positive attitude, and in a polite, semi-invisible way. After a few shifts with a PN helping out, physicians never go back.
(photo credit: whatdoesceostandfor.com)
Less Rules = Better Patient Service: 23 Ways Over-Regulation Hurts
WestJet Airlines built their reputation breaking rules to improve customer experience. The Christmas Miracle video went viral showing WestJet staff run around buying Christmas gifts for travellers based on wishes they made as they boarded. Travellers got their wishes when they landed, and WestJet got famous. No rulebook could lay out the performance needed for the Christmas Miracle.
Medicare stands at the other end of the customer service spectrum. Over-regulation makes outstanding customer service all but impossible. Here’s how.
Regulation decreases quality.
Rules stop staff from thinking.
Rules mandate a one-size-fits-all approach to individual patients.
Regulation doesn’t keep pace with progress.
Regulators rarely know the job like front line workers.
Regulation impoverishes decision-making.
Thick rulebooks make staff hesitate, or freeze with indecision.
Rules are open to interpretation.
Rules never account for every possibility.
People can’t remember all the rules.
Rulebooks get long and cumbersome.
Regulation is expensive.
It requires hordes of managers to enforce.
Rules take hours to maintain…at huge cost.
Rules are costly to produce.
Regulation crushes ingenuity and personal effort.
Provider effort withers with command and control rules.
You can’t regulate innovation.
Regulation undermines leadership.
Top-down edicts to front-line workers don’t influence change.
Regulation assumes an air of infallibility and certitude.
Who decides which new regulations to adopt?
Regulations are complicated, but life is complex.
Healthcare should define great customer service, but it never will as long as it’s over-regulated. What can we learn from WestJet about customer service?