Emergency Department Directors Academy Phase II Complaint Management: Deep Dive May 2011
Complaint Management (Case Based Deep Dive) Robert W. Strauss, MD, FACEP ACEP EDDA Phase II The Ultimate Goal: Customer Satisfaction Webster defines a customer: A person who purchases a commodity or service. 1
The Approach Which complaints are real? Who handles the complaints? What is the message? Who? What? Sympathetic and concerned. The imprimatur of leadership: I can fix this. An asset? Your choice Ignore and perpetuate They care enough to complain and allow you to fix the problem Script the interaction This comes at an opportune time 2
Effective listening means hearing it from their perspective What complainers want Changing Perception and Behavior Create early warning system Collect information Get the chart Define the issues, then call Listen, empathize and make a plan Control Damage Retrospectively, do what can be done after the fact Develop prevention strategy Prospectively, examine and change system / behavior Typical Complaints Dr. Zippy Molasses General Hospital Dr. (Mercedes) Benz Dr. Frankenstein Dr. Jerkyll Dr. (Ray) Charles Dr. (Terry) Bradshaw 3
Dr. Zippy He only saw me for 30 seconds At $200, that s $24,000 an hour, no wonder healthcare is so expensive! Time 0 20 40 60 80 100 120 140 160 //// Opener Closer //// // / // Dr. Zippy Since the complainer didn t get time and caring then, give it to them now! Prospective approach Ubiquitous problem If everyone is too busy, improve system efficiency Individual problem Change behavior (scripts, multiple visits, informing. 4
Molasses General Hospital I waited so long... Those party animals I hope they enjoyed their pepperoni pizza, while I was waiting and throwing up Molasses General Hospital Empathize and provide time and caring NOW! Prospective approach Create staff awareness When unable to provide rapid care, provided caring Methods include: sitting, scripting, informing, setting realistic expectation Dr. (Mercedes) Benz Are you people crazy... it cost $275.00 for a sore throat! 5
Dr. (Mercedes) Benz Determine underlying issue. Is it: No money Wrong bill Bad care Can you forgive a bill without: Becoming known as The free ED An Admission of Guilt Dr. (Mercedes) Benz Forgiving (lowering) a bill I understand that you are not satisfied with the bill you received as a result of your visit to our emergency room. Your satisfaction and patronage are important to us at Hospital and for that reason we have decided to decrease your bill to $.00. Thank you for the opportunity to discuss this matter. I hope that in the event that you require emergency services in the future, you will again give us the opportunity to serve you. Dr. (Mercedes) Benz Prospective approach There will always be money complaints Ensure hospital and group cooperate in write-offs Deal effectively with 3 Cs (convenience, caring and care) to decrease the significance of the 4 th C (cost) 6
Dr. Frankenstein (alternative to Dr. Benz) Your charging me what! Even the paramedics said there was no chance! Dr. Frankenstein (alternative to Dr. Benz) Compassion, listening, compromise Prospective approach Institutional decision Consider letter of condolence Avoid implication of wrong-doing Dr. Jerkyll He said I was wasting his time... Well the surgeon who took out my appendix the next day didn t think so! The Beluga Whale 7
Dr. Jerkyll, is it: Rudeness (and bad care) He s sorry that you perceived Is it appropriate for the offender to call Prospective approach Recruit well Set expectations early Provide early and regular feedback Dr. Charles (The missed X-ray) The doctor told me the X-ray was OK and now you re telling me my son has a broken bone! Dr. Charles Ensure appropriate care The system worked! Prospective approach, ensure effective Over-read system Patient discharge education Performance improvement process 8
Dr. Terry Bradshaw The Monday morning quarterback Yeah, well my doctor says that your doctor / nurse screwed up! Dr. Terry Bradshaw The patient listen, empathize, investigate The physician Confront, set expectations Prospective approach Ensure familiarity with system Go to their meetings Close the loop 9