Frustration levels too high? Act now, not later

Pre-empt frustration

To avoid making a bad situation worse, your staff should be prepared to smooth things over before an angry patient walks away. This sounds difficult, but can be surprisingly simple.

"First and most importantly, apologize about the situation and that your facility has failed to meet their expectations," says Amy M. Kirkland, CHAA, patient access team leader for the emergency department at Palmetto Health Richland in Columbia, SC. Then she says to follow these steps:

• Get exact details on what the patient is upset about.

After learning this information, try to take immediate action to correct whatever is wrong. Recently, a patient told an access staff member at Palmetto Health Richland that he was in a lot of pain, had been waiting for several hours, and had not been seen yet by a doctor. "We contacted the nurse in our waiting room, who contacted a doctor and got the patient's pain under control until they could get them back," says Kirkland.

Another time, a homeless woman came to the emergency department with no socks or shoes. "When I register the patient, at the end of my process I always ask if there is anything I can do or anything I can get them. This patient asked me for socks," says Kirkland. "I went and got the socks, and the patient was so thankful. She explained how she'd been asking for them for several hours. Everyone told her they would bring some back, but they never did. She was so thankful I brought them right away."

• Determine if you are in a position to resolve the issue personally.

"If you're not, let the patient know you will notify the appropriate person to handle the issue," says Kirkland. However, if you do hand the problem off to someone else, remain involved. Recently, the wife of a trauma patient who was intubated at Palmetto Health Richland became very upset because the man's valuables were locked up. The hospital's policy states that valuables can be released to someone other than the patient only with verbal consent.

"We printed off our policy and showed it to the spouse, but she was still not satisfied," says Kirkland. "She asked to speak to someone in charge that wasn't in the emergency department. We contacted our administrator on duty to take over with the irate family member." Together, the administrator and the patient access representative consulted with the man's wife to explain the policy. "This did not take access out of the picture. If a formal complaint was filed, this involvement would protect access," says Kirkland.

• Thank the patient for bringing the issue to your attention.

"It's important to make the patient feel you are concerned about them personally and you are there to serve them," says Kirkland. "Ask what you can do for the patient in the meantime. If you can't make your patients happy, someone else will."

Give feedback right away

At Brigham & Women's Hospital in Boston, if a patient issue is identified involving a staff member who did not provide customer service in accordance with the department's policy, immediate feedback is given not only to the individual, but the entire department.

"One patient's perception of the manner in which he or she was treated by a staff member is a reflection on the entire department's customer service," says Christine F. Collins, executive director of patient access services. "If even one person says somebody was rude or inattentive, that means there are many more that felt it but didn't take the time to put it down on paper. So we share the negative comment with everyone. And we ask, 'How can we make sure this never happens again?'"

Service recovery can be a powerful tool, if used correctly. "A patient may wait an extended time through no fault of their own, or somebody may be directed to an incorrect location," says Collins. "In that case, we go to wherever they are, apologize, and say, 'Let me give you free parking for the day,' or if they just bought their lunch, we ask them to give us the receipt and we will get them reimbursed."

Recently, access staff mistakenly sent a patient home because a diagnostic test appeared to be cancelled. "We did many things to compensate that particular patient, including calling them at home and apologizing," Collins says.

It's not enough, however, to assuage a patient's frustration after a mistake was made. Collins expects her staff to head off problems before things get to that point. For instance, if a family member is becoming apprehensive while waiting for a loved one to come out of surgery, she wants staff to approach that person, not the other way around. "I tell my staff that if somebody has to ask you a question, then it means you are not staying on top of the situation. You should be one step ahead, because communication is the key," she says. "It is all about the patient and or family, not us."

Remind employees that they may in fact be completely right, but this doesn't mean that the patient shouldn't be apologized to. "You cannot please everybody. And as long as you were courteous, then I am on your side. But that doesn't mean I'm not going to apologize to this patient," says Collins.

Employees at times come forward to tell Collins, "There is just no chemistry here. Can somebody help me?'"

"In that case, the employee can tell the patient, 'Just give me a second, I'll be right back,' and we are able to do a nice handoff," says Collins. "Why would you want to make a bad situation worse?"