The patient satisfaction movement continues to attract volunteers in the form of consultants and other businesses. A recent posting to a LinkedIn group listed “Seven Ways to Improve Patient Satisfaction”. It is not a bad list, but in the spirit of the sevens tradition, here are seven questions about its prescriptions.
1. Is the idea behind this backwards? The poster says, “Happy patients create successful practices.” This seems to be based on the theory that how patients feel about treatment is more important than the correctness of the treatment itself, but isn’t that a questionable way to look at it? Might it not be better to act on the principle that if patients are given good treatment the practice will succeed?
2. Do happy buttons work? The first item is “Smile” – an example of what could be called the “happy button” approach to management. But you can’t make people, whether employees or patients, better just by smiling at them. If people are not feeling good, the attempt to produce smiles may make things worse. Some people are just not natural smilers, nor does smiling always indicate positive feelings. The negative consequences of forced smiling have been shown in Arie Russell Hochschild’s important work The Managed Heart.
3. Is management propaganda effective? One can almost see the posters in the workplace displaying this list of seven. But management by advertising is not the answer. When organizations launch a campaign and commodify a change process, it will not secure the intrinsic motivation and support that is needed, as Glenn Allen explains in his book Nameless Organizational Change.
4. How should communication be improved? One of the agenda items is about communication. It combines two issues: “80% of serious medical errors involve miscommunication between caregivers” and “the $238,000,000,000 problem of low health literacy in America”. No source is cited, but the first comes from a Joint Commission report while the second is the high end figure in a Census Bureau estimate. But, however accurate the figures, both patients and healthcare workers already know that communication needs to be improved – the question is how. Certainly not by posters of seven steps!
5. How do organizations make employees happy? Number six on the list arguably ought to number one: “keep staff happy”. It is not only plausible and logical that if employees are satisfied that will lead to patients being satisfied, but there is considerable research evidence supporting this “contented cows” theory. Still, to say that employees should be made happy is not really very helpful in the absences of specifics as to how that end should be achieved. Interestingly, Fast Company and Inc. have each published a list of seven ways to do just that!
6. Why ask just patients? The final item listed suggests asking patients about their treatment. Given the role of HCAHPS these days, that suggestion seems almost superfluous, though it is a good one. But, as we have noted here before, why question only patients? Why not ask doctors, nurses and other healthcare workers how they think patients are being and should be treated?
7. Why only top-down communication? One way not to make employees happy is to deluge with them lists of seven things they have to do! Indeed, top-down communication cannot solve organizational problems by itself: there needs to be an equal stream of bottom-up communication. So, instead making a list of seven steps and promulgating it to employees, why not have a contest soliciting their ideas for improving patient satisfaction and choose the seven best?
–Jim Murphy has a solo consulting practice called Management 3000, focusing on organizational development and change management. Formerly he led the Massachusetts Bay Organizational Development Learning Group, was Human Resources Director for the City of Boston Assessing Department, and served as a consultant with the Boston Management Consortium. His consulting practice includes management coaching as well as research and writing on employee relationships, leadership, healthcare and collaborative practices. Having produced newsletters for several organizations and being a frequent content writer for the”Confident Voices in Healthcare” blog, he is interested in writing and research opportunities, as we all consulting and coaching. www.manage2001.com email@example.com