TEDxMaastricht - Fred Lee - "Patient Satisfaction or Patient Experience ?"
Summary
TLDRThis transcript explores the shift from service-based industries to an 'experience economy,' emphasizing that emotional experiences can be as impactful as measurable outcomes. Using examples from healthcare and Disney, the speaker highlights how compassion and personal engagement are crucial in creating memorable experiences for patients. They argue that while technical skills are essential, emotional connections and empathy—like those demonstrated by a caring nurse—can significantly improve patient outcomes. The speaker concludes by reflecting on the insights of thought leaders like W. Edwards Deming and Mother Teresa, advocating for compassionate care in healthcare.
Takeaways
- 🤔 Walt Disney seems like the odd one out compared to Deming, Hanel, and Mother Teresa, but innovation connects seemingly unrelated fields.
- 📖 The book 'The Experience Economy' introduced the idea of a fourth sector, beyond commodities, goods, and services, focusing on experiences.
- 🏥 In hospitals, a shift is needed from providing service to creating memorable experiences, similar to how Disney creates emotional experiences for families.
- 🎭 Experiences can be both fun and profound, such as contrasting Tom Hanks in 'Toy Story' with his performance in 'Philadelphia.' It's about emotional impact, not just entertainment.
- 💡 Innovation happens when we make connections others might not see, like applying the 'experience economy' concept to patient care in hospitals.
- ❤️ Compassion in healthcare is like Disney's goal of creating a fun experience; hospitals aim to meet emotional needs during pain and tragedy.
- 📊 W. Edwards Deming emphasized that the most important management figures are often unknown and unmeasurable, such as the impact of patient perceptions.
- 🩺 Personal engagement can change a patient’s experience, as shown by the difference between an ordinary blood draw and one where the caregiver connects personally with the patient.
- 🌟 Emotional care, such as reassuring a patient before a procedure, can reduce anxiety, lower heart rates, and increase pain tolerance.
- 💬 Experiences in healthcare can't be scripted; they must come from genuine compassion, which can even positively affect a patient’s immune system.
Q & A
What is the primary purpose of mentioning Walt Disney in the context of the discussion?
-Walt Disney is used as an example to highlight the concept of providing emotional experiences rather than just services. The speaker contrasts Disney’s focus on delivering memorable experiences in entertainment with the need for healthcare to provide compassionate care that meets the emotional needs of patients and their families.
How does the concept of the 'Experience Economy' apply to healthcare?
-The 'Experience Economy' suggests that people no longer just seek services but emotional and memorable experiences. In healthcare, this translates to moving beyond service excellence to creating meaningful patient experiences, focusing on compassionate care rather than just clinical efficiency.
Why is the interaction between the patient and 'Sherry' used as an example?
-The interaction between the patient and 'Sherry' illustrates the difference between a purely functional service encounter and one that engages the patient emotionally. Sherry's second, more empathetic interaction with the patient demonstrates how small acts of compassion can improve the patient’s overall experience and emotional state.
What is the main criticism of standardized service scripts in healthcare?
-The speaker criticizes standardized service scripts for being impersonal and inadequate in creating meaningful, patient-centered experiences. While they may ensure courtesy and clinical efficiency, they often fail to address the emotional needs of patients, which is crucial for holistic care.
How does Deming’s quote 'the most important figures for management are unknown and unknowable' relate to patient care?
-Deming’s quote highlights the difficulty in measuring the intangible aspects of patient care, such as the emotional impact of compassionate care. While clinical outcomes can be quantified, the emotional and psychological benefits of compassionate care are harder to measure but are essential for improving the patient experience.
What connection is drawn between innovation and making unusual connections?
-The speaker emphasizes that innovation often involves making unexpected or unusual connections between ideas. For instance, applying lessons from the entertainment industry, such as Disney's focus on experiences, to healthcare can lead to innovative approaches in patient care and experience management.
Why does the speaker say that healthcare is not just about entertainment, but still about experiences?
-The speaker clarifies that while healthcare is not in the business of entertainment, it is deeply involved in shaping emotional experiences. These experiences may not be fun but are essential in addressing the pain, fear, and anxiety that patients and families go through during medical treatment.
How does the speaker connect compassion to clinical outcomes?
-The speaker mentions that compassion can reduce patient stress, which can have a positive effect on the immune system and overall recovery. By providing compassionate care, healthcare providers may indirectly improve clinical outcomes by reducing patient anxiety and creating a more healing environment.
What is the significance of 'Gentle Sherry' in the speaker’s narrative?
-'Gentle Sherry' symbolizes a healthcare worker who goes beyond mere clinical competence to create a personal connection with the patient. Her gentle approach reduces the patient's anxiety, illustrating how a compassionate attitude can improve the patient's experience, even in routine procedures like drawing blood.
How does the speaker suggest healthcare providers can create memorable patient experiences?
-Healthcare providers can create memorable experiences by engaging patients in a personal and compassionate way, focusing on their emotional needs rather than just performing clinical tasks. The speaker suggests that small, thoughtful actions—like showing empathy and being gentle—can transform routine care into a meaningful experience for the patient.
Outlines
🤔 Connecting Unlikely Innovators
The speaker opens with a 'who' question, examining how various figures like W. Edwards Deming, Walt Disney, Hans Selye (father of psychoneuroimmunology), and Mother Teresa fit into the discussion. While Disney might seem out of place, the speaker explores how innovation is about making unusual connections. They discuss how different sectors—commodities, goods, services, and now, experiences—have evolved, and how the service industry has shifted focus to emotional engagement. Disney’s impact, not just through entertainment but by creating experiences, becomes a central theme for how innovation crosses into healthcare.
🏥 Service vs. Experience in Healthcare
The second paragraph delves into how the service model in hospitals has limitations when compared to emotional experiences. The speaker reflects on how hospitals initially adopted service standards, but began to see that something deeper, beyond service, was missing at the bedside. The speaker suggests that the emotional and human aspects, such as pain, fear, and anxiety, create a different kind of 'experience' in healthcare, much like a trip to Disneyland without fun would feel incomplete. This notion is tied back to Deming’s idea that not everything valuable can be measured.
😰 Patient Perception and Clinical Interaction
Here, the focus shifts to the patient experience during a clinical procedure, specifically a blood draw. The speaker uses personal anecdotes to illustrate how patient perceptions are influenced by interactions with healthcare professionals. Silence during procedures can lead patients to focus on everything that could go wrong, increasing anxiety, heart rate, and pain. The speaker humorously describes common fears during a blood draw, emphasizing how even small actions, like a frown from a nurse, can drastically impact the patient's experience.
💉 The Power of Personal Engagement
In the final paragraph, the speaker contrasts two types of nurses: one who performs her duties robotically and another who engages the patient on a personal level, making the experience more pleasant. They highlight how small acts of personal connection—like a nurse distracting the patient with conversation—can lower anxiety and improve the overall experience. The speaker links this to broader ideas of compassion, referencing Mother Teresa and research suggesting that compassionate care can positively affect a patient's health. The talk concludes by reaffirming that true compassion can't be scripted and must come from the heart.
Mindmap
Keywords
💡Experience Economy
💡Service Economy
💡Innovation
💡Compassion
💡Emotional Experience
💡Patient Perceptions
💡Clinical Measurement
💡W. Edwards Deming
💡Mother Teresa
💡Patient Satisfaction
Highlights
Walt Disney initially appears to be an odd fit in a discussion about clinical measurement, but innovation is about making unusual connections.
Innovation is about making connections that are not logical for most people, but can lead to breakthroughs.
The 'Experience Economy' introduced a new sector of the economy, which focuses on emotional experiences rather than just services.
Hospitals once focused on service excellence, but patient experience has become more critical in recent years.
Experiences are distinct from services, and in healthcare, patient experience can involve pain, anxiety, and fear rather than entertainment.
W. Edwards Deming said, 'The most important figures for management are unknown and unknowable,' challenging the idea that everything can be measured.
A personal experience, such as Tom Hanks' roles in 'Toy Story' and 'Philadelphia,' demonstrates the diverse nature of human experience, from joy to tragedy.
Patient satisfaction and perceptions can have a profound impact on healing, even if changes seem insignificant at first.
Hospitals are in the business of meeting emotional needs during times of pain and fear, similar to how Disney meets emotional needs through entertainment.
Clinically perfect service does not necessarily translate to a great patient experience—human connection and compassion are essential.
Deming emphasized that while some outcomes cannot be easily measured, their impact on patients' perceptions and experiences can be significant.
Anxiety and fear before medical procedures can affect patients' heart rates, blood pressure, and pain thresholds.
Small acts of compassion, like engaging patients in conversation during procedures, can significantly reduce anxiety and improve their experience.
Experiences occur when individuals are engaged in a personal and memorable way, which cannot be achieved through scripts or standardization alone.
Mother Teresa said, 'We can do no great things, only small things with great love,' which applies directly to compassionate patient care.
Transcripts
I want to start with a who question this
is the who
section who does not seem to belong in
this
group W Edwards Deming the the father of
quality measurement pdca 6
Sigma what about Walt Disney father of
animation and theme
parks what about
hanel the father of psychon
neuroimmunology or Mother Teresa icon of
compassion well if you look at this
group most people would say the odd one
in the group is Walt
Disney these three at least have had
some things to say about clinical
measurement about the immune system and
prevention and of course about healing
when we cannot
cure it's hard to see Walt Disney
fitting into the kind of things we've
talked about
today and there was a time when I would
have said impossible not logical
improbable but you see Innovation is
making connections that are un un usual
connections for most
people two economists wrote a book
called The Experience economy in this
book they said that instead of three
sectors of the economy like we are used
to Commodities goods and
services there's actually four
sectors now of course when I was in the
hospital business in the 1980s we saw
ourselves a new frontier was service
excellence and we were going to learn
from all the service Industries how to
have great service and the way we went
about it of course was to take all of
their scripts and standardize them for
our staff and tell them this is what you
say introduce yourself smile tell the
patient why you're here and what you're
going to do and when you leave the room
you say is there anything else I can do
for you just like a
waitress that was my
thinking but then I read this
book and there was a shift that took
place
because this book said that there's a
whole another sector completely
different than
service and it's when you buy
essentially an emotional experience
nobody comes out of a
movie and talks about the service they
got nobody comes out of Disneyland and
talks about the service they got they
talk about the experience they had and
after today I would say to you nobody
will come out of here talking about the
service service they got but most of us
will talk about the experience we had
that's completely different service is
labor done for me I would otherwise do
for myself clean my own house um uh
paint the house change the oil in my car
cook me some
food but an experience is quite
different and of course in this book
which really grabbed me was Walt Disney
the quintessential example of the
service economy according to the two
economists well I got to thinking about
it and I got to thinking now we're not
in the entertainment business so that
doesn't quite
fit but then it began to dawn on me that
not all all uh
experiences are
fun theater is about not only the things
that make us laugh and have fun what
else is theater about if it's about the
entire Human Experience then it also has
tragedy Tom Hanks as Woody in the movie
Toy Story was certainly
entertaining but Tom Hanks dying of AIDS
in what
movie
Philadelphia that was not
entertaining this e-word is not
entertainment it is experience could I
say that I had a profound
experience watching Tom Tom Hanks with
AIDS yes it's an experience could I also
say I had a great experience watching
Tom Hans or listening to his voice in
the little character Woody in Toy
Story vastly different
experiences but I believe that like
Simon syic said today that in the
80s we were like
this and then we began to diverge into
the service
economy and we thought patient
satisfaction and patient satisfaction
scores and all of those things would
lead us to the same things that service
does in the service
industry and I began to see something is
vastly missing from the service industry
when it comes to the bedside of a
patient and I decided that the
Breakthrough that we talked about
earlier although small some people will
say oh the difference is insignificant
but wait a minute I thought today we
just said that when your routine changes
even
slightly it can have a profound impact
on your thinking on your behaving and
when your thinking and behavior changes
you get a different
world so let's look at this are we in
the same sector as Disney only offering
a different
experience well Disney is in the
business of meeting the emotional needs
of a family to have fun together well
that's not
us but we in
hospitals are
in the rule the job of meeting the
people's needs who are a family
especially who are going through pain
anxiety fear and even tragedy to
together so we could say that a hospital
without compassion that meets the needs
of
those in
pain would be like a trip to Disney that
was no
fun Deming said something that most
people who quote Deming never quote when
most people quote Deming they say if you
can't measure it you can't improve it
and yet Deming also said the most
important figures for
management are unknown and
unknowable and he goes on to give the
example of how do you measure the
multiplying
effect of going from good to great in a
patient's perceptions how do you measure
that multiplying effect of that and yet
that could be the single greatest thing
we could focus on next to SA
safety let's take an
illustration we'll go about this in two
different ways we'll start in the
service
industry I'm in the hospital bed smiling
face comes in the room and says good
morning Mr Lee my name is Sherry I'm
here to draw your blood today we'll
probably be drawing your blood every day
to check on your progress and I say well
good morning Sherry but you see now
she's finished with her script and she
has nothing left to say until she says
is there anything else you need at the
end and so for the next s minutes we
have complete
silence does that begin to feel
awkward well silence is not only awkward
but just before an invasive procedure
and I have deliberately taken the least
invasive least painful least anxiety
producing experience patients could
possibly have and still call it invasive
to make my
point in silence where does the
patient's mind go just before a
procedure that's
invasive to everything that can go wrong
you can't help it if you
try well how many things can go wrong
with a blood draw you say well not that
much well you're all Professionals in
healthc care you can discount this but
when I was 9 years old my mother told me
they could put a bubble up your arm go
right to your heart and kill you
did you ever hear that it could kill you
with a
bubble yeah what else could go wrong did
you know they could blow out your vein
yeah think about that next time they
could blow out your
vein Bleed Out Underneath big big bruise
on there hurts to bend your arm for a
week I know because it happened to my
son you know what they say when they
blow out your vein
oops there's a reassuring word oops and
then they say give me your other
arm I want to say bring me another
FLOTUS well if I'm having all these
thoughts oh by the way how many sticks
there's one that you worry about ow ow
ow ow
ow yeah if I'm having these kind of
thoughts what happens to my heart rate
goes up what happens to my blood
pressure goes up when your heart rate
and blood pressure goes up what happens
to your pain
threshold goes down everything hurts
more than it should so when she puts
that little in that little bicycle inner
tube or whatever it is around my arm and
tights a knot in there she catches some
of my skin and it hurts and I look down
there and I think you know what if you
can't see the skin in the knot how will
you ever find my f
we're talking patient
perceptions I look at her face when
she's looking for a vein it has a frown
on it what does a frown tell you when
somebody's looking for
something well that means they can't
find
it so imagine my surprise when she pulls
up the needle and she starts this thing
and I want to say oh hold it hold it I
could get you a vein let me pump pump
this out for you you know there
quick of course I don't do that it's not
very
manly this is more of the manly pose
help yourself there's my
arm I'm brave I can take anything put
two or three bubbles up there I'll show
you I can take
it blow it out you try that on me I can
take anything 17 Sticks no
problem of course I'm like this and my
pain threat hold his way down here and
when she puts the needle in E how big a
needle is
that
look she got it first sck how lucky was
that now if you draw blood do you want
to be thought of as lucky or
good patient
perceptions nothing about her made me
think that if that she would ever get
that vein except by pure lck of course
I'm
glad she stands up in her SCP STP kicks
in and she says now then Mr Lee is there
anything else I can do for
you and I say no thank you
Sherry do you really have to put me
through this again
tomorrow I'm afraid M you do Mr Lee and
she's out the door and down the
hall in any way you can measure what she
did it was perfect perfect clinically
perfect for service perfect perfect for
Courtesy but was she
great you can't improve on it and you
can't ask the patient how to improve it
cu the patient doesn't
know good morning mustle my name is
Sherry I'm here to draw your blood
today and I say well good morning Sherry
she says by the way do you live around
here or are you from out of town I said
well no I live around here I raised two
kids here you see she sense that I was a
little
tense and she decides to distract me I
don't know what she might say but I tell
her about my two kids a little bit son's
a Macintosh computer technician my
daughter's an artist and while I'm
telling her this she's already put a
tourniquet around my arm and pinched
some of my skin but did I notice not
much I'm trying to tell about my kids
she starts feeling for a vein and I get
focused real
fast my heart rate starts to do this and
I think oh oh here it comes and she
looks up she says by the way you have a
nice vein here Mr Lee I should have no
trouble with this
one what did that do to my heart rate
what did it do to my pain threshold and
then she goes on and said by the way
beginners can be a little rough but I
have done this for 10
years when they're trying to find
somebody that can get a vein they
usually call the lab and say is gentle
Sherry down
there and I say are they they call you
Gentle
Sherry now you see once in while
somebody will go when I say that which
of course means too much Disney for this
group we're not going to call each other
Tinkerbell or gentle Sherry I don't
think so too much Disney or too American
for us but I got that from clinical
trials Gallop reports them in the book
First Break All the Rules they would go
to a hospital ask for the best nurses
they were doing a placebo experiment
with a shot and they would ask for
average nurses best nurses of those
nurses they get lots of compliments from
patients average nurses get no
compliments and no
complaints they each give a subject they
all are randomized so this double blind
study we they ask the subject after each
shot the different subjects and the
different nurses did we get a pain
rating by saying on a scale of 1 to 10
how much did that
hurt after they take away the double
blind they suddenly discover
that your best nurses have lower pain
ratings than your average nurses and you
say well how can that
be there it is on the
videotape the best nurses tend to say
This Might Sting a little bit Mr Lee but
I'll be as gentle as I
can what does the word gentle do to a
person's anxiety a little bit of fear if
I can say this for a blood draw how much
more important would this be for every
other procedure that we
do but it are the passionate
compassionate caring people that do this
because it has to be done from the heart
you can't fake it these authors say that
experiences occur whenever an individual
has been engaged in a
personal or memorable way the difference
between these two sheries is that one
engaged me in a personal memorable way
and when she got up and said is there
anything else I can do for you I will
say not right now but if I have to have
my blood drawn tomorrow will you please
be the one who comes back don't be
sending rough Rudy up
here I want gentle Sherry
again and Deming says that
difference between being perfectly
satisfied and wanting the person back
again cannot be measured scripted
reduced variation or
standardized it comes only from the
heart it can be physical
emotional hrelia pointed out that
compassion can actually affect the
immune system if you believe compassion
can reduce stress in a
patient Mother Teresa said we
cannot we can do no great thing we can
only do great small things with great
love thank you very much
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