Employees empowered to handle patient complaints

Disgruntled customers receive flowers, candy

Already immersed in a strong customer-service culture, Morton Plant Mease Health Care in Dunedin, FL, has taken its philosophy a step further with "On The Spot," a program that empowers its staff or team members to handle patient complaints without management intervention.

"On The Spot," or OTS (pronounced Otis), as it's been dubbed, "was created as a way to show customers that we are listening when they address a concern, that we think what they say is important, that it matters, and that their input shows us a way to improve," says Kandy Swanson, manager of patient access services at East Lake Outpatient Center, a division of Morton Plant Mease in Palm Harbor, FL.

The OTS program was devised by Margie Brusseau, director of the medical/surgical nursing team, and piloted with the nursing teams in 1996. Swanson introduced the program in 1997 to the organization's five outpatient centers, she says.

An OTS is an on-the-spot intervention by an employee who has dealt with a complaint but feels that - even though management intervention is not called for - the customer still is displeased or is leaving upset.

That intervention involves filling out an order form for one of several items to be sent to the customer. Those include a flower or fruit basket from a local florist or one of several kinds of containers filled with candies and other treats from a specialty shop, Swanson adds.

The team member encloses a card with a personalized note or standard greeting: "Thank you for helping us to see how we can improve our service. We hope you will let us serve you again." The card is signed with the name and facility of the team member placing the order, she says.

When the program was instituted at the ambulatory care facilities, Swanson led a 45-minute in-service for team members, going over a flowchart showing the sequence of events that might lead to an OTS (see chart, p. 93). She explained when it's appropriate to send an OTS and when it's not. Team members use their own judgment to determine if a manager needs to be involved at any point in the process, she notes.

The OTS program builds on Morton Plant Mease's "Can you take the HEAT?" method of dealing with complaints. HEAT stands for:

o Hear them out;

o Empathize;

o Apologize;

o Take responsibility for action.

"Prior to OTS, we just used HEAT," Swanson adds. "Now we have another step before management intervention. We needed to give empowerment to team members."

After sending a gift, a team member enters the information on a log sheet, giving his or her name and the reason for the intervention. Once a month, Swanson matches the OTS invoices for ambulatory care to the log sheet and pays them. Administration covers the costs, she notes. "They think it's a worthy cause."

She tracks the number of times an OTS is used, looking for trends. "If we're OTS-ing for the same thing over and over again, that's important," Swanson adds. "We identify the reasons so we can put action plans in place."

"A worst-case scenario would be for team members to listen to a complaint, send an OTS, and then have the patient return and see the same problem occurring again," she points out. "We need to stand by what that card says."

In a month's time, Swanson estimates, ambulatory care - which comprises five outpatient centers - sends about 25 OTS's. "Extreme waiting times are one of the main things we are OTS-ing for at this time," she says. To address the issue, the facilities are taking a closer look at how procedures are scheduled and have designed a new card to present to outpatients, she adds.

In addition to giving some background on the facility and explaining how patients can retrieve X-rays or address billing concerns, the card discusses waiting times, she says. "It says that we're making every effort to be on time but asks them to please understand if extra time is needed for the previous patient."

The card also clarifies why a patient who checks in later might be taken to an exam room first, a source of frequent customer irritation, Swanson notes. "We have 10 rooms for different exams, and if a patient is waiting for a mammogram, not a CAT scan, that room might be available first," she adds.

The OTS program has gotten good response from patients, with few exceptions, Swanson says. "It always amazes me to get a'thank-you' for a'thank-you,' but that's what happens. We did get one phone call where the patient said,'This isn't appropriate.' At that point, management follows up."

Team members, she points out, appreciate the fact that they don't need management approval for the program. "OTS was created just to show we truly care. We can't just talk the talk, we have to walk the walk. It's not just management's responsibility to recover an upset patient."