Each patient experience is your brand. Is it consistent? Is it positive? How do know? You ASK and then LISTEN – Scott Stratten, @unbranding
This tweet, or a variation of it, was shared by several attendees at the 2015 Greystone Health Care Internet Conference where Stratten was a keynote speaker. The message resonated with me because of the experiences my mom and I had been having over the last few months. A consistent, positive experience is critical to the brand.
- Is it consistent?
- Has it been positive?
- Have we been asked?
I know Mom will receive a patient satisfaction survey at the end of her treatment but does that really do the patient experience justice? Stratten’s point is that we, in the health care industry, often assume asking after the fact offers the best assessment of patient satisfaction.
Because Mom is having both chemotherapy and radiation, we’ve experienced several aspects of the cancer center: the medical oncology clinic, the radiation oncology clinic and the infusion suites – three separate areas of the clinic that are all vital to Mom’s treatment. Not to mention experiences during a side trip to dermatology for a consultative visit, an ER visit, parking, etc. Has the experience been positive? Yes. Has the experience been consistent? Overall, no. Have we been asked? No.
Using the pain scale used in the clinics, here’s how I’d rank some of the experiences (one meaning no pain, 10 being significant pain):
Radiation Oncology: 1
The majority of our time has been spent in Radiation Oncology. Appointments are managed efficiently. The treatments are quick (we had one appointment in which we left my house and returned in under an hour – a 24-mile round trip). The staff is kind, compassionate, and professional. We were quickly made to feel like we were part of a family – greeted with a smile and our names. Often Mom would be checked in for her treatment before we were even two steps off the stairs. The therapists shared stories and laughter with Mom. The nurses always had time for our questions, asked how the weekend was and what silly thing my daughter had done to make Mom laugh. We always saw the same group of professionals, throughout the entire treatment. This is the way the treatment of a disease like cancer should be, right?
Infusion Suites: 3
Life in the infusion suite is also pretty good. Mom had six chemo treatments that would last three-and-a-half to four hours every Wednesday afternoon. Each afternoon we’d be offered a snack or drink from a volunteer who is stationed in the waiting area of the suite. Most days we’d be there for about 15-20 minutes before being called back to the suite. The nurses in the suite were amazing – at least the four Mom had been. We were fortunate enough to have one nurse for two treatments. It was apparent each of these nurses had started hundreds, if not thousands, of IVs. They knew how to find the vein and make the experience as painless as possible. Again, these nurses quickly learned our names and spent time making sure we understood what treatments would be like, potential side effects, and when to call with questions. At the last treatment, Mom was presented with a certificate signed by all of the nurses in the suite, many with messages requesting she stop back to visit when she returned for follow-up appointments.
The suite is filled with amenities to make the time for both of us more comfortable – a family lounge with computers, TV, puzzles and a fireplace, all the warm blankets Mom needed for an infusion (I think the record was eight), headphones to keep the TV noise private to each infusion suite, and beverages for the patient. The only real complaint we had was the wait for medications before getting started with the infusion. After a couple of treatments, I realized this had nothing to do with the infusion suite or their staff. It was a result of the chain of events started by the medical oncology appointment right before the treatment.
Medical Oncology: 5
No matter how much we liked the physician and staff of the medical oncology clinic, visits to this clinic were always frustrating. There was always a wait involved – a wait that seemed like there should be ways to avoid it given how efficient radiation oncology and the infusion suites were able to run.
After our first day of chemotherapy, I was venting to my husband about how much time was spent sitting in waiting rooms once the radiation treatment was completed. The day is jam-packed – first radiation treatment, then meet with the radiation oncologist, then labs drawn, followed by an appointment with the medical oncologist, then chemo. When the appointments were originally scheduled, we explained to the schedulers that radiation treatment and the subsequent appointment with the physician were slated for 10:45. Based on that information and a general understanding of how long these types of appointments take, the scheduler picked a time for the labs to be drawn and an hour later for the appointment with the oncologist. With all the moving parts to this machine, I expected to spend time in the waiting rooms but not to the degree we experienced.
From the very beginning, we never made those times. And as a result, everything is pushed back the amount of time you miss the lab appointment. For example, one lab appointment time was missed by 20 minutes. That pushed the oncology physician appointment by 20 minutes, which actually meant about 40 minutes and therefore pushed the infusion time frame by at least 40 minutes. We faced this at every appointment to some degree. After two chemo days like this, we asked about having labs drawn the day before so there was no need to build the lab processing time into the already busy, busy Wednesday we faced each week. This helped significantly – but also set us up for more waiting on Tuesday (more on this in a separate blog – there are key points to be made regarding communication and setting expectations).
We never built the relationships with the staff of the medical oncology clinic that we were able to do in radiation oncology and the infusion suite. There are a number of reasons for this – we weren’t there daily like in radiation oncology, we weren’t spending several hours there like in the infusion suite, and we didn’t consistently see the same staff week after week. We saw the same group of schedulers – and finally on the last chemo day, the scheduler welcomed Mom by name. But I could not tell you the names of the schedulers like I can each of those in radiation oncology. During the appointments with the physician, the only constant was the oncologist. We saw a resident two weeks in a row. The last two weeks of treatment we saw a physician assistant. I understand that the oncologist has a nurse assigned to him but we saw her once at the beginning of the treatments and then again in the middle. Our relationship was built with the physician, no one else.
As Mom started to show more side effects from the treatment, relationships became very important. The relationships we had built with radiation oncology and the infusion suite staff made it more comfortable to ask questions about what was going on and how to manage those side effects. We could talk to a nurse easily from either of these two areas. But knowing that many of Mom’s side effects were caused by the chemotherapy, having a relationship built with the medical oncology staff was noticeably absent.
Could I have done more to build this relationship? Of course, but it seemed like work to do that. The relationships in the other areas came so naturally that the comfort level was established. As I reflect on this now that the treatments are done, I feel like we are going to radiation oncology for questions and concerns that might be better directed to medical oncology. Radiation oncology is more than willing and capable of managing these concerns – hopefully not at the expense of someone else (meaning delaying someone else’s appointment or taking time with the staff that should be focused elsewhere). We’ve asked that question – and were assured that all is fine.
Going back to the questions at the beginning of this post:
- Is it consistent? Overall our experience has been consistent.
- Has it been positive? Unfortunately, the consistency doesn’t always mean consistently positive. We know that the experience in medical oncology is going to be consistently the same – wait times longer than any other, unknowns regarding who will be part of the appointment, with the result leading to longer waits in the infusion suite and a longer day overall.
- Have we been asked? While we are asked if there is anything we need, we have not been asked about our experience in the sense of seeking ways to improve the visit. That will happen when the Press Ganey patient satisfaction survey is sent in several weeks — when it is more of a memory than a top-of-mind experience.
