When does it end?

In reviewing Paul Borawski's brief comment about quality at Ford, I was intrigued by one concept mentioned by Mr. Fowler of Ford:  quality must focus on the entire customer experience.  To paraphrase another sage, "It ain't over 'till it's over."  Now there's a new concept for much of healthcare.  How do patients get to your office?  Is it easy to find?  On a public transportation route?  We once surveyed patients coming to a clinic in our building, and 85% said it was difficult to impossible to find. At one time, there was a sign at the main entrance, "Hard hat area.  Do not enter."  The response of our executive officer was, "We have signs!  What's the matter with those patients that they can't read signs."

Beyond directions, how about instructions.  What to bring.  What to eat/drink.  Does this work?  Do you know?  Is the process of getting into your system so easy that it never fails?

Some other thoughts from my surgery center days: 

What about the experience within your system?  How do your customers feel about that?  Don't forget that family members are customers also.  Are they kept informed? An analysis of calls coming in to the pre-op area showed over 95% were looking for a patient.  "Is Mrs. Smith there?"  With computer screens everywhere, it didn't take much to create a patient locator system so any employee could find any patient, tell when they arrived at that location, and how long they were likely to stay.  The calls stopped.

And the exit.  Which way to turn out of the parking lot.  When my wife had cataract surgery, the center gave chits for 2 hours of free parking.  Unfortunately, the procedure took 2 hours and 20 minutes.  Somehow, I found that extra $5 for 20 annoying.  The center had no idea and was not at all interested.
I received a thank-you note from a family once because our maintenance employee changed a tire for them so they wouldn't be delayed going home.  How did he know?  Are employees tuned to signals of a need in patients or families?

How was the trip home?  Did you know there is a high incidence of vomiting in children when the car turns the first corner on the way home? 
In some ways, ambulatory surgery foists the burden of post op care on the family rather than hospital nurses.  Sometimes, the family needs guidance in what to expect and how to deal with it.  Take pain pills before the pain starts.  How long will it take to recover?  Go back to work?  Managed expectations.  Surgeons frequently have an overly optimistic view of the post op period.  Collect data.


The biggest hurdle to managing total customer experience is taking responsibility.  Make it your job.  If providing care is not part of your mission, be there to provide resources or inform those responsible.  Learn from the Ford experience; it ain't over 'till it's over.