How would you feel if your 7 year old daughter had died from a 3 year battle with cancer, and a week after her death you were asked to complete a customer satisfaction survey from her last visit to the hospital.

Unfortunately this is not an imagined scenario, but exactly what happened to Christchurch mother Sandra Walsh a week after her daughter Bonnie died.

To make matters even worse, the information on the survey was incorrect, stating the visit date as the 19th January, which was the day after Bonnie died at home, and two days after the actual date she visited Christchurch hospital.

Having never experienced a tragedy on this scale, I can’t imagine how Sandra Walsh felt when she received the satisfaction survey,  but I can imagine her feelings might have been anger, disgust, and feeling disrespected at the least.

You can read more about Sandra’s responses she returned to the Canterbury District Health Board (CDHB) in this article by Keith Lynch published in the Christchurch Press.

From my perspective, this situation is completely inexcusable. Death is always going to be a difficult event to respond to from a customer journey perspective, but unfortunately it’s a very reality that should never be ignored or understated.

Many airlines have compassionate policies to help families travel for funerals, but unfortunately some may not make this widely known, and may only offer this service if a customer directly asks for this, and even after that documentation will need to be provided before a ticket will be confirmed – all this in the stressful time of the death of a loved one.

Power companies,  phone companies, and banks also regularly cause grief to spouses when they fail to stop addressing statements to a deceased husband or wife.

In all these situations, these organisations are not doing enough to support people in a time of stress and grief, and there is no excuse. But these is NOTHING in comparison to the event that was caused by CDHB where their core vision is “To promote, enhance and facilitate the health and well-being of the people of the Canterbury District”.

CDHB have publicly apologised stating:

“We would like to assure Bonnie’s family that we will make every endeavour through reviewing our processes that this unfortunate occurrence does not happen to anyone else”.

I’m not satisfied with this response for two reasons. Firstly it’s symptomatic of a reactive culture, where problems are dealt with when they occur rather than actively seeking out negative experiences and catching them before they happen. Secondly, a comment on the same Christchurch Press article suggests that this may not be an isolated event and may have happened at least once before:

“Last year my sister in law received a survey AND a diet sheet for my brother who had died of cancer of the stomach in Christchurch Hospital one week previously. The diet sheet arrived on the morning of my brother’s funeral”.

To me, this event demonstates two problems in heath that I’ve written about before: poor communication, and a lack of an understanding of the holistic patient experience. Bonnie’s father sums it up remarking on the CDHB that:

“…it’s just that a couple of times the left hand doesn’t seem to talk to the right.”

It’s exactly right, because for most patient journeys people will need to interact with a range of different wards and administrative departments, and while each of these wards and departments will be focused on maximsing their own specific goals, there is no one person who is charged with understanding or ensuring a positive patient experience.

So while CDHB may review and perfect their processes, their current segmented organisational structure where different groups focus on specific activities is a barrier to understanding the end-to-end patient experience.

Enough with the critisism, what do I suggest?

A new position on the executive team for a Chief Experience Officer who reports directly to the CEO, and has their own team to professionals to champion all aspects of the patient experience would be ideal, but quite frankly I’m not sure if such an organisational change within CDHB would be possible, so instead I’ll suggest a baby steps approach.

A pair of full time employees (NOT a consultant) are employed who both report directly to all members of the executive team. Their first task would be ethnographic studies of all areas of operation in the hospital: clinical and administrative with outcome being an understanding and documentation of patent journeys from a department-neutral perspective. This pair have a lot of work to do, but I truly believe that by starting somewhere – anywhere – is better than not addressing this problem at all. Where to from there? I can’t predict the results, but when faced with a difficult problem, a tried and tested approach in science is visualisation, so I see a key component of this pairs resseach being a visual model of patient experienes.

Health budgets are always going to be a controversy, but the annual expense of this pair of workers would be little in comparison to other staff costs. I would think that finding a pair of people experienced in customer experience, and with a passion for working in health could easily be found for a salary around $100,000 each.

To put this into perspective, for the year ended June 2008 CHDB employed 466 staff members in salary bands higher than this, and a pair compensated at this expense would have only been 0.04% of the employee operating costs for the year ending 2008 (infomration taken from the CDHB 2008 Annual Report).

Perhaps to help pay for these new staff CDHB could consider using some of the costs associated with delivering customer satisfaction surveys – which as this article rightly points out has a disturbing bias in respondants (with only 35% of surveys sent responded) and a particually concerning under-representation of patients who are of Maori, Pacific Island, or Asian decent.

Man I would love to get my teeth into a job like that!

This entry was posted on Tuesday, February 3rd, 2009 at 11:28 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.