hospital impact

Indeed we can learn from Disney!

You wrote some great articles about this great book. On my own weblog I've published some thoughts about what I've read here.

Thanks for giving a inside look in the book of Fred Lee.

The idea that Disney has anything to teach us about how to run hosptials is a stretch, at best, and a more likely a counterproductive fantasy. A hospital is not a luxury resort, an operating room is not a ride, a surgeon is not a cute tour guide in a uniform. Nobody dies if they can't afford to go to Disney World. There is a lot that can be improved in our hospitals and our healthcare system, but I hope we can find better role models than the Walt Disney Corporation.

One thing Disney and hospitals DO have in common: overcharging for EVERYTHING!

I think what people need to understand is that no one is looking to run a hospital like an amusement park. If you have never been to Disney to see their Customer Service, then you cannot comment. I would love to see Customer Service in hospital's run like Disney would portray. These are the hospital's customers and they generate the revenue. We need to taker a hard look at this area.

I work in a hospital and I really feel that all hospital have something in comman with Disney Land. I went to a Fred Lee seminar and I really enjoyed it, he explained how Disney Land and a hospital have similar things, you have to have Customer Service in both area's. Cause if you are a patient and you are coming in to pay a bill, I would hope that you would want the person taking your money have good Customer Service skills and to have courtesy and compassion for you. Also when the patient was here for the stay and the nurse and the doctors they also have to have good Customer Service skills, so if you where at Disney Land the employees their have to also be courtesy and friendly, cause if not then you will probably not want to visit either one again.
Thanks,
shannon

What a brilliant idea for a book. I'm going to purchase it.

People choose to go to Disney for vacation and fun. Patients ususally do not go to the hospital for either of the above reasons. There in lies the inherent major difference .

Even if your a not for profit hospital, your hospital is still a business. The hospital has to make money in order to stay in business. If you don't like the service at your local coffee shop, you'd go somewhere else wouldn't you? If there are several hospitals in your area, you need to draw your customers (guests) from the area. A good experience will bring them back, if your competitors aren't doing the job, you need to do it better.

Whether it's Disneyland or some major hospital, superior customer service skills apply and learning to build rapports with our patients should be a # 1 priority. I like the saying, "If you're not smiling....You're not doing it right."

It appears that we can continue to learn from the Mouse!
No, people do not come to hospitals anticipating "fun", as they do at Disney. However, they can have a positive, memorable experience, no matter what brought them in to us. As we each expect excellant customer service no matter where we go, so too should they expect and recieve the same from us.
As Health Care Providers, there is a tendancy to think that our time is somehow more important than thiers, thus justifying curtness, if not downright rudeness, in our interactions with our patients and thier families. It is imperative for each of us to hold in our minds the fact that if it were not for our patients, we would have no reason to be what we are. As well we should be aware of the honor they do us, trusting us with what is thier most precious possesion: thier health, sometimes thier very lives.
Ad Disney is aware, the public has choice. We need to make them want to select us.

Compare:
Hospital: Long waits, uniformed staff, Things costing much more than they should, Bad food, security personnel, Hope that the ride your on doesn't kill you.

Disney: Same as above.

Disney does customer service like nobody else, having experienced it myself in '04. Our comfort was their priority. Nothing seemed beyond consideration, and each employee made us feel welcome. "Disney Hospital" patients would feel safe, appreciated, respected, and more at ease. They would rest better, eat better, heal faster, perhaps even leave sooner. How much better things would be if we truly treated them as our guests rather than as interruptions, or a room number needing meds. I've seen it too often. Are we too proud to provide this level of service?

I blogged earlier about a team of physicians going to a Toyota plant to obtain lessons for hospitals. After leaving the plant, one physician said, "they treat their cars better than we treat our patients."

I have read this book along with all of the other department directors in our hospital. The CEO of my hospital had already read it along with the other affiliate CEOs in our hospital system. We sat down together after reading the book and discussed how our patients need to be related to as customers. It was very interesting to see how our hospital business is so musch like Disney World in the customer service area. We must make our patients feel like we are there for them instead of the bucks.

I work in a hospital and I would just like to see my place of work as clean as Disneyworld.

I haven't read the book but intend to after reading the comments. As an RN of 30 years who does not recommend nursing as a profession, I wonder, does the book address how Disney treats and motivates their employees? What is their turnover rate, how much time and effort go into training them? I grew up in So. Cal and at the time, a job at Disneyland was one of the best to be found for a young person.
It's great to talk about customer service, but that is just "cosmetics" if you are not taking care of the people who are providing the service, especially in an organization as inherently stressful as a hospital.

In another life and for over ten years, I was a highly trained and very highly regarded Hotel Guest Service Manager (GSM) and eventual General Manager for a major(hospital-ity) chain.
I worked 12-16 hours a day and was on the job six to seven days a week. During one two year stent, I worked an entire year, without a day off.
After five years of this grueling schedule, I suffered what is too commonly diagnosed as "burn out".
Twenty years later and after my immune suppressed husband spent six months of this year hospitalized, due to complications subsequent to hospital aquired infections, I observed, in five separate hospitals, the reality of my my former work day schedule and customer service nightmares had spilled over into the medical field.
I am certain the former RN, who posted above me,could fill a best selling horror novel about the working conditions for hospital employees.
I am also certain, my own book about the working conditions and the lack of customer service training I recently observed and my husband experienced first hand, would run a close race for a second best seller.
John Nesbitt wrote in his book, Megatrends, "whatever is going on locally, is going on nationally". If his and my own observations are true, our nation's hospitals, when viewed as a service industry with failing life threatening implications,are in very serious trouble.
Regarding the "Disney" and "fantasy" book, over fifteen years ago and after my own hospital stay, I wrote a thoughtful letter to a local hospital director regarding the very same service principals discussed by the author of the book and owner of this blog.
Back then, my sincere offerings to write a "train the trainer" course book and my suggestions for hospital (service) improvements), apparently fell on deaf ears.
Both of my letters, my complaint letter and my letter offering to design a professional and hopital specfic basic customer service training course was completely ignored.
I am now a professional artist and a novice political activist.
Too often favorite written historical generalizations about artitic qualities are completely ignored in the business world.
Artists are, whether by nature or by nurture, intuitive, genrally spoken of as being "ahead of their time" or "working against the grain" and they "tend to color outside the lines". After a lifetime of my thoughts, suggestions and ideas about employee/employer and customer relationships and serivce improvements being largely ignored by the corporate business community, I pleaded guilty to all the above and eventually recognized my "talents" belonged elsewhere.
Today, after reading this blog and the above posts, and for a fleeting moment, I wondered if I and other "artistic personality types" had become more the work place activist types and perhaps, less escapists, we could have served our nation's "broken healthcare system" and corporate world better.
My second thought reminded me of an English translation of an ancient chinese symbol. "Chaos-Where brilliant drams are born, before the beginning of great brilliance, there must be chaos. Before a brilliant person begins something great, they must look foolish to the crowd".
The Disney Book may, at first glance, appear as a foolish bandaid to an ailing industry for far too many " expert "industry analysts", "human resource directors" or "corporate mogols" or line level employees.
To this artist and former service industry professional, it is part of the solution and brilliant!
DK, Artist

Having read the comments, but not the book, I am certain that those people with negative comments do not work in a health care setting. It is delightful to hear that some healthcare organizations are finally realizing one of the most basic tenets of business...if your employees are happy, they will give great customer service; but if they're not, watch out! You can take basic business models and apply them to any other business...you just have to be open to see it. In my MBA program, most of the instructors were from manufacturing and were amazed that I could translate the concepts into health care. Business is business, whether it's Disney or your local hospital. We just need Administration to wake up!

How many of Disney's "customers" do not pay for the "experience" they recieve? How many of Disney's "customer's" sue at the end of their stay, not necessarily because the Mouse did something wrong, but because the "customer" didn't like the outcome. As for some of what I've read here about "customers" paying for their "experience"; patients in hospitals don't pay for their healthcare, their insurance companies do. It's often not enough to cover all that they recieve, hence the "overcharging" on the items where cost can be recouped. In order to maximize the amount of mnoney insurance does, eventually, payout; staff is cut to the bare bones to save costs. I wonder if employees at the magic kingdom would be able to deliver such a wonderful "experience" if they were short staffed, overworked, in fear of being sued if someone doesn't like their ride on the Matterhorn, and regulated out the you-know-what by the federal government. In the hospital setting we are continually challenged to serve hamburger steak and make the patient belive it is filet mignon.

I would hope that the people who posted negative comments have actually read the book. It's principles about customer service organizations would be applicable anywhere. Fred Lee's book should be required reading for any Health Services Administration graduate program. Students and professors alike will gain from the experience. I am sure you will enjoy the ride.

I'm also impressed by Fred Lee's imagination and his book is a very good one. His satire and ironic style deserves a lot of appreciation.

About 10 years ago, I worked at an emergency department in an inner city. The Disney organization was paid to come to our facility to "teach" customer care. Needless to say I thought this was ridiculous, how do you compare an emergency dept with Disney World? There is no comparison. The E.R. is a place where emotions run high, life or death situations are a constant and patience by the patients is worn thin, not to mention the many, many people who use the E.R. as their doctor's office. What is the worst thing that can happen at Disney? Can it at all compare to death of a loved one? The Disney people who were recruited to come to our facility could barely speak to one another, never mind our patient clientele, they were in a word, shocked by what they had encountered. The staff at the ER had already been through sensitivity training, and are some of the most caring, compassionate, empathetic people I had the pleasure to work with, not to mention, not easily shocked. People do not need a book or a Disney staff to teach customer care, what they need is to look at how they'd like to be treated, "do onto others as you would yourself."

I have read the book- something that I think many comment leavers have not. It does not tell you to run your hospital like a resort, it is telling you to look at their business model and their measure of success. Sure, a hospital isnt a resort, a vacation, a getaway, but it is a customer service industry...like it or not.
We need customers, we need them to be satisfied and to have the best hospital experience possible. How can we do this amid staffing shortages, malpractice suits, charge backs, writeoffs, and the like? By looking at a different business model, we can be motivated to chnge and to be more productive...THAT is what this book is about. For all you naysayers out there...I'm sorry that organizational inertia has proven fatal to your attitude. For all the rest, this book is awesome and motivating. A must read for ANY hospital employee.

I read this book for one of my graduate courses. This book is an excellent book and should be read by all leaders in the hospital industry. Some hospital employees have forgotten what we are there for: TO PROVIDE COMPASSIONATE CARE TO THE PATIENT, to touch the lives of others. A quote by Adam Gordon-"Life is mostly froth and bubble, two things stand like stone, kindness in another's trouble, courage in your own! This book is GREAT!

Such a delightful title. Worth browsing at the local Barnes and Noble.

I remember my wife and I taking my kids to Disney World. I had given my notice at one well-respected academic medical center to leave for another in another city, and this vacation provided a break in the stress of all the change affecting all and each of us.

I doubt that if I had been moving from one Disney location to another, I would have taken my family to a world-class hospital to relax.

When I was an undergraduate I worked in a consumer electronics business for almosy three years. Part of my job involved home service of their televisions. Like those who believe they learned everything they ever needed to know in kindergarten, I believe I learned enough about customer service from what my parents and other adults taught me. I sure as hell didn't need to pad some writer's pockets back then to learn how to respect a fellow traveler, and I sure as hell don't now.

That said, a number of years ago I surveyed customers of a group I supervised regarding what they expected and appreciated about our services. As I expected, what they appreciated most was our professionalism, but key to that was the expectation of technical expertise. Professionalism, i.e., customer service, was of little value in the absence of competence.

My guess is the expertise involved in portraying a duck, mouse, Snow White, etc, hasn't changed much in recent years. Ditto cooking a hmaburger, managing a ride, picking up trash before it hits the ground, etc. But the rate of change of health care is off the scale and accelerating. When I entered the field, computers were just showing up at the nurses' stations of ICUs. Now there are easily ten or more in the equipment at the bedside of a single patient.

Over the years, those of us in the field have heard how we should adopt 7 Habits, TQM, CQI, and now MIC KEY MOUSE. Every time, when we reply that we need tiome to learn how do it, other than for a pilot project here and there, there is simply no time in which tio fit it in. Why? Because we'd need money for that, and one thing that people will not part with to make health care work is a bigger slice of GNP. The same people who will hop on a plane amd throw thousands of dollars to spend a few days in a Magic Kingdom, the same people who would throw everything they at getting care for a family member suffering with a possibly terminal illness, these same people go nuts when they hear their health care premiums are on the rise.

Here are the choices:

1) Keep spending the same amount of money and treading water as the system continues to devolve under the pressures of accelerating technological and social change

2) Throw the money instead at gurus to teach us to say the equivalent of "Would you like fries with that?" and permit the system to devolve even faster than it is now?

3) Examine what we get for each incremental health care dollar and make the tough decisions whether the interventions and services we can provide are worth it. It would be a huge leap forward if we could move the economic discussion from guns-or-butter to health-or-entertainment. But that would require will and discipline that we seem to have lost from the days when we set out to build the health care system capable of what it is doing today. Now it's more "What have you done for me lately?"

Many people in this business know what needs to be done. We've figured out how to treat heart disease, cancer, and stroke among others; we can do this. Just let us know what you really care about by not only telling us what your choices are but putting your money where your mouths are.

The last thing I need is another hospital administrator yapping about the latest book craze. Five dysfunctions, indeed. After thirty years, I've learned it best to view MBA prattling with a Christian perspective: Forgive them, for they know not what they do.

Having worked at Disney for 29 years, lemme just say that the LAST thing you'd want a medical facility to be run like is a Disney theme park.

For example;

1. Perceptions > Reality

Perceptions are greater than Reality? Really? Isn't that what they call in the medical profession the Placebo Effect?

We especially appreciated Fred Lee's explanation of the 90% patient satisfaction survey results. Our hospital has always been in the 90% range on patient satisfaction surveys and we feel Mr. Lee's book helped us tweak our current service objectives. We've incorporated some of his thoughts into the customer service portion of our new hire orientation that educates our employees, from the start, on the quality of customer service we expect, their role and how hospital administration will support their decisions.

It's been a year now since I attended this lecture given by Fred Lee. He has had the most positive impact in my career, even above my medical education because without these principles my practice of medicine falls short. The healing power is not in the pill. When I am tired and overworked and short tempered I still hear his words and press on with quality and compassion.

It was easy for me to dismiss all the emails about my book from people who obviously have not read the book, but are sure they know what the content must be, and are giving a reaction to their notion of Disney’s relevance, instead of an honest reaction to the ideas in the book. One of the great thrills for me in speaking to hospital leadership groups is overcoming this common prejudice in the room before I start talking, and ending up with fans of the ten things you would do differently, instead of detractors.

However, I was finally moved and felt compelled to respond to the short paragraph from a physician who actually said (and this stunned and touched me deeply) that a year after listening to these ideas, it still "had the most positive impact in my career, even above my medical education because without these principles my practice of medicine falls short. The healing power is not in the pill. When I am tired and overworked and short tempered I still hear his words and press on with quality and compassion."

This physician has beautifully articulated the heart of my message, which is compassion, kindness, empathy and caring. These are the words used by patients who have a wonderful story to tell of their experience. Actually these words are all synonyms for the same variable. They are words which I believe capture the essential variable that can take us from good (our service) to great (their experience). This is no small difference. Disney is not a service; it’s an experience. I did not invent this distinction. It has been brilliantly explained by two economists, Pine and Gilmore, in their book, The Experience Economy. People do not come out of Disney talking about the service they got, they speak of the fun they had. Likewise, patients do not come out of a hospital talking about the service they got, they speak of the caring they received, or did not receive. Disney, at its best, meets a family’s emotional needs for fun when they are on vacation. Hospitals at their best, also meet people’s emotional needs, which are for compassion when a family is suffering.

Services do not meet people’s emotional needs. That is why the service paradigm can only take us so far, maybe to “good.” But what takes us all the way to “great” is engaging patients at an emotional level, instead of just at a physical level.

The proper comparison with Disney is not in the glaring difference between their focus on fun and entertainment, and our focus on pain and grief. It is in seeing that we are both dealing with human emotions, which run the full gamut of feelings. Not all movies are entertaining, even though we classify all movies, as entertainment. Tom Hanks as Woody in the movie Toy Story is certainly entertaining, but Tom Hanks as a victim dying of AIDS in the movie, Philadelphia, is as far from entertaining as you can get. Disney is on the Tom Hanks as Woody, end of the emotional spectrum. We are on Tom Hanks dying of AIDS end of the emotional spectrum.

Maybe the best way of saying it is – a hospital without compassion is like Disney without fun.

For those I see who have scorned this book because they assume it must have come from the naive mind of a Disney employee who cannot relate to the stressful, demanding work nurses do, for instance, it might help to know that I have spent 30 years in healthcare (including senior vice president of one of America’s largest hospitals), and only 2 years as a Disney cast member. For nurses it might help to know that I am married to a retired director of nurses and that the book is dedicated to the four most influential women in my life, who are all nurses.

I like to think that this is the book Florence Nightingale might have written if she had ever started out as a Disney cast member first. I have read her inspiring tretise, Notes on Nursing, and know how similar our message realy is!

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As an employee of the publisher of Mr. Lee's book, I frequently hear comments from people who have either read it, or are very exited to give it a shot. The stories are too many to list here but suffice it to say that no one has ever asked for a refund. It is personally gratifying for me to work for a business that has a product that is making a positive difference in the lives of so many. I occasionally have the opportunity to speak with Mr. Lee and the passion and dedication for the work he is doing in healthcare is always what I take away from every conversation.

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I must say it was so exciting to read a book that truly embraces the Customer as being #1 and in the case of the almighty healthcare system the patient being #1. When I read the book I imagined myself as the patient and would I look for during my stay. Applying these principles it would clearly be a pleasant experience for me overall if they were followed through with. One part imparticular that rang in my ears was the Lack of Professional Appearance and Inconsistency in Uniform that is promblematic in healthcare organizations today; the free mentality of the 1990's and the dot commers needs to go away as mentioned in the book and get back to a Nurse in White, A Tech in Navy, An MA in Royal and a Unit Secretary not looking at all clinical so there not confused as a nurse by families in need of getting there clinical questions answered. Registration people should look more like a Hotel in Suiting if they are preaching Disney and your Food should emulate a resturant/cafe but be functional to there job role. Housekeeping Men and Women should be the same and not wear clinical apparel because patients will think they are caregivers and ask the wrong questions creating confusion. Trust, First Impressions, A Sense of Teamwork, and Professional Appearance can all be achieved by Mr Fred Lee's concepts on page 168-171 of a Standardized Dress Code with NO CASUAL FRIDAY'S. The Patient Comes first 7 days a week not 6 and it should always be seen and percieved as a Team Oriented Facility just like Disney. In a day when the elderly will be at an all time high and they recognize color what better way to introduce teamwork then giving the seniors what they want; A Nurse Back! Perception is Reality and Patient Satisfaction Scores will reap the benefits of increase with a Consistent Image Program. Mr Lee, Thank you again for reminding us how important perception, image, and professional appearance really are. Amazing Mr Lee, just truly amazing!!! My best... Thomas J Pingitore Regional Sales Rep Cintas Healthcare NJ

I think the book makes a lot of valid points. It is DEFINETELY worth reading. Most of what it says is true, but the critisism come from what it leaves out-- some major issues.

An example involves employee satisfaction, which the book flat out states is overrated. A great employee is never satified, and always tries to improve, other than that satifaction should come from doing a great job. OK. What it does not take into account is that Disney can pretty much train anyone for any job, but hospitals have to have actual registered nurses, respiratory and phsical therapists, speech and occupational therapists, MDs of varying specialties, etc. All of these employees are NOT cast members playing a doctor, or nurse, or therapist, they must have actual licenses. Due to shortages, you cannot always just go get another one when the one you have does not conform to your ideals. Actual firings are pretty much reserved for things like verbal or other abuse, med theft, not showing up for work, etc.

The book also describes "acting" your part, and tries, somewhat unsuccessfully, to suggest acting when interacting with patients does not mean a nurse or caregiver is insincere or unauthentic. No matter how Lee phrased it, I couldn't quite buy it.

Another issue not dealt with is the fact that satifying the patient is not ethical, or in their best interest. Over the course of my career, I have come in contact with many drug addicts wanting narcotics, some quite suspiciously for diversionary tactics (ie selling to third party) They are not satified customers when we say "no".

Also not addressed are the patients that make so many demands that they take away from others needing care. Sometimes you can address the root cause of their actions (such as anxiety), sometimes you can't. Sometimes, you have to gently set limits. Disney may simply hire more employees, as the majority of people entering the park are paying guests, but when you have a lot of people with no insurance, or the very poorly reimburing medicaid, you can't just hire more people. The people available simply have to do as much as they can for as many people they can. The stress of this can make it difficult to keep "acting" the part of the ER RN who loves taking care of patients, even when she truely is an ER RN who loves taking care of patients.

I have read a lot of great reviews on this book. They are all true it IS a great book. But I do feel that many of the biggest challenges of my career are not well represented.

Give me a break with the hospitals run like Disney crap. This is obviously someone who has not seen a patient's butt, dealt first hand with unreasonable and bonoxious family members interfereing with life saving care and whose reality is based behind a desk far far away from the bedside.