Assistant Librarian, Leeds Teaching Hospitals NHS Trust
If I say “Disney” to you, I doubt you’d think of hospitals. Yet in 2004, Fred Lee, the then Vice President of Florida Hospital and a former Disney employee, stunned a lot of his fellow hospital executives by writing a book that proposed that their chronic patient satisfaction scores might be cured by a certain Dr. M. Mouse.
Any comparison between theme parks and hospitals seems absurd. After all, they serve completely different ‘customers’, surely? Yet, when hospital managers read his words, their cynicism rapidly dissipated. Lee’s advice doesn’t pull any punches; there’s no ‘spoonful of sugar’ to help his medicine go down, but its tonic effect extends into all aspects of hospital activity, including our own.
Lee’s first point is this. We strive to improve our ‘services’, but customers barely even notice them. Patients wheeled into an operating theatre assume that their surgeon won’t slip with the scalpel. For the most part, they’d be right. ‘Never events’ happen, but increasingly rarely, and we all know our hospitals expend considerable time and effort measuring and improving through them. Yet, how much effort goes into measuring and improving the part of being in hospital that the patient REALLY notices: their actual ‘experience’ of being in a strange place surrounded by people they don’t know, and often at a time when they feel the most vulnerable? How do hospital managers take their baseline of good ‘service’ (operating safely on patients) to include good ‘experience’, which is what the patient REALLY wants (reassuring them they’ll be safe, comfortable and cared for?).
Lee’s second point seems to defy the logic of many other management texts, but it’s valuable. Because our clinical colleagues focus on ‘service provision’ and ‘service improvement’, they build systems that make work more efficient… for them. They constantly watch the clock to see more patients in less time, measure the increase in efficiency and then pat themselves on the back for it, without measuring what impact this has on their patient’s ‘experience’. Lest we get smug, how many of us have hung a ‘do not disturb’ sign on the door to get on with project work and congratulated ourselves on being efficient without thinking how our priorities might look from the library user’s perspective?
And here Dr. Mouse nods sagely and hands us his prescription: a generous dose of imagination. Disney employees use the power of imagination to put themselves in the position of theme park guests, prioritising guest ‘experience’ above every other aspect of their job. Anyone late for a meeting because they were helping a guest is not only excused but actively praised.
So, what does this mean for hospitals? Our clinical colleagues can imagine how it feels to be a patient having curtains pulled around their bed. They are doubtless protecting that patient’s privacy but the patient might ‘experience’ confusion and worry. Imagination empowers them to empathise; to put themselves in the position of the patient. Then, by explaining the reason for their action, the patient’s anxiety can be changed to one of relief and gratitude.
Now let’s consider a literature search training session. Our ‘customer’ is a smart clinician, but they rarely use the electronic tools we’re about to demonstrate. Just like the patient in our first example, they’re in a strange place surrounded by people they don’t know, and at a time when they feel most vulnerable (perhaps recalling negative database experiences as students). We, on the other hand, use these databases and search techniques daily so we blithely deliver their training session like they were just another body on the operating table for a busy surgeon. In other words, we deliver the ‘service’ but don’t think about the ‘experience’ for our customer. By using our imaginations to empathise, we might consider how difficult it might be for a seasoned clinician to admit that they’re feeling anxious and out of their depth. Then, by asking them what experiences they’ve had of research databases in the past, we free them to reveal their anxieties so we can offer them the additional reassurance they need.
Imagination can be used for many other things. It can help with teamwork, allowing us to gain new respect for other members of staff during job-swaps (something encouraged amongst Disney employees), and we can help coach underperforming staff by asking them to imagine themselves in the position of customers to help them choose alternative more empathetic responses, but for the sake of brevity, I’ll skip the detail. Let us merely say that Dr. Mouse’s imagination medicine has many benefits, and all of us, wherever we work in our hospital, may benefit from a healthy dose of it.