How do we treat the old and vulnerable in our hospitals?
To me, the mark of any civilisation is how we as a society treat the vulnerable. How we treat the vulnerable shows how much we genuinely care for people as human beings rather than economic entities. And when it comes to vulnerability the old folks in hospital are about as vulnerable as you can get – trust me I have spent quite some time observing how these folks and they way they are treated. Which is why I am not at all surprised by how badly these folks are treated in the UK. Here as some highlights from a recent piece in the Guardian newspaper:
- “Nearly half of hospitals are failing to provide good nutrition to elderly patients while 40% do not offer dignified care..”
- “At Alexandra hospital staff told how they sometimes had to prescribe drinking water on medication charts to “ensure people get regular drinks”
- “Inspectors found “meals served and taken to the bedside of people who were asleep or not sitting in the right position to enable them to eat their meal”
- “At Barnsley hospital, one patient whose nutrition was supposed to be monitored ate only a single spoonful of ice cream for lunch before their tray was cleared”
This is what the Chief Executive of the Patients Association says in this article: “Why is it that patients have to be prescribed water? Water and food are not treatments, they are a basic human right. Helping patients with food and water is not a try-to-do, it is a fundamental part of essential care”.
Ask yourself: what kind of system delivers this outcome? Is is simply a question of not enough staff on the ward? Or is it more: a system in which the ‘human touch’ has been driven out and replaced with stuff like targets, tasks, forms, checklists, outsourcing to reduce costs….? Whatever you decide, it is clear that the system is not designed to care for the patient and his/her wellbeing. It is a system in which there as so many players (each player doing his thing) that no single person has the complete picture of the patient nor the feeling of responsibility for the well-being of patients. It is a system where the people at the top claim and possibly believe that they are treating the patient/the customer well. Whilst the people at the coal face only make the targets (set by the people at the top) by not paying attention to the needs of the patients. Does this remind you of many commercial organisations where so many functions/people touch the customer and yet no-one owns the customer experience nor is responsible for the health of the relationship?
Are we using technology to dehumanize (one another) rather than enhance the human touch?
“For all the promise of digital media to bring people together, I still believe that the most sincere, lasting powers of human connection come from looking directly into someone else’s eyes, with no screen in between” [Howard Schultz]
As a society we are in love with technology and we are under the illusion that information technologies can and should replace the human touch. This is not a harmless illusion – it has a real impact on our relationships with each other: between employees; between the people in the business and the customer; between the doctors and their patients… You might have read about the research (and real life horror stories) that show that human babies shrivel up, under develop and even die in the absence of human touch. Is it any different for adults?
Abraham Verghese spells out the importance of human touch and ritual to the well-being of patients in the following video. I urge you to watch it as the story that he shares sheds light on the human condition and provides lessons on how we treat one another.
What are the lessons for Customer Experience?
Just in case you did not watch the video here are some of Abraham Verghese’s words and my commentary on those words:
- “The patient in the bed has almost become an icon for the real patient who is in the computer. I have coined a term for that entity I call it the iPatient. The iPatient has getting wonderful care all across over America, the real patient often wonders where is everyone? When are they going to come by and explain things to me? Who is in charge?” There is world of difference between the real customer and what the customer’s record in the marketing database – too many marketers and organisations confuse the two.
- “There is a real disjunction between the patients perception and our own perceptions as physicians of the best medical care.” We live out of our own worldview and we want to think well of ourselves so we almost always have biassed view on how well we are doing in terms of looking after our customers and the relationships we have with them. Often we confuse convenience and the repeat transactions that it drives with customer loyalty founded on an enduring emotional bond.
- “To often rounds look like this where discussion is taking place in a room far away from the patient. The discussion is all about images on the computer, data, and the one critical piece missing is the patient.” I witness many discussions about customers and/or the voice of the customer and yet I notice that no customers are present and neither is there voice. How many have set-up a dedicated platform to allow customers a voice? How many executives actually spend time with real customers and walking in the shoes of these customers? Numbers, analytics, can never substitute for nor provide access to that which is fundamentally human and which comes alive through human touch. If numbers is your thing and not people then go and run an investment fund not a business: a business is all about people.
A final thought
Would it make any difference to human relationships and the way that we conduct business if we remembered and acted on the following insight:
“You never know what is going on in people’s lives when you serve them. For all you know it could be someone’s last day on earth.” (Onward, p187)
I made a visit to see my doctor today to get his assessment on the results of the blood tests. It was easy enough to see the doctor, he greeted me warmly and had already reviewed the results of the blood test. So far so good. Then he went on to tell me that there is a problem with ….. and that he will prescribe tablets to deal with the issue. He gave me the prescription note and enthusiastically told me that the good thing is “you no longer need to pay for your medicines as you can get an exemption certificate from the dispensing chemists”.
So I wandered out of the doctor’s office wondering what exactly is the issue? What will this medicine do? How long will I have to take it? What are the side effects? And then I wondered why it was that my doctor, a friendly chap who takes his job seriously, did not anticipate and thus address these questions with me.
When I turned up at the chemists I handed over the prescription note and told the lady “My doctor has told me that you will issue me with an exemption certificate as I no longer need to pay for my medicines”. She looked at me puzzled and told me that on the contrary the doctor has to issue, sign and forward the paperwork to the national health service so that an exemption certificate is issued. Nonetheless, she told me that she would issue the prescriptions without charge and advised me to go and see my doctor to get the paperwork done.
So while I was waiting for my medicines to be prepared I made my way to the doctor’s surgery and relayed my conversation with the chemist. The receptionist then pulled out the relevant form and asked me to fill it in – including the medical condition that made me eligible for the exemption. I told her that whilst I could fill in my personal details the doctor would have to fill in the medical part as he is the expert. She accepted that explanation, I filled in the form, signed it and left on the promise that she would take care of it.
As I headed back to the chemist to pick up my medicine I wondered why are people and institutions so inconsiderate. Why had my doctor, a good doctor in so many ways, not:
- Anticipated and answered the normal questions that a layperson is likely to have when you tell him that an important part of himself is not working properly;
- Anticipated and dealt with the concern, the fear that a normal person has when you tell him that as a result of prescribing him this medicine he will no longer have to pay for any medicines;
- Complete the medical exemption certificate for me so that all I had to do was sign it.
So this evening I did the research via the Internet to answer my questions and concerns. It looks like the medicine is a hormone replacement medicine. And that once you start on this medicine you take it for the rest of your life. Perhaps that is why my doctor acted as if I was being prescribed a treat.
Which leaves me asking the question again: why, oh why, do experts (e.g. the Doctor) behave in such an inconsiderate manner towards the lay person? Whilst the normal person (the lady at Lloyds chemists) who has no medical expertise was so helpful and considerate: she told me what I needed to do and she did the right thing by looking at the medicine and checking with the dispensing chemist (another expert) that I was eligible to get my medicine free of charge.