Helen Osborne: Welcome to Health Literacy Out Loud. I’m Helen Osborne, President of Health Literacy Consulting, Founder of Health Literacy Month and your host of Health Literacy Out Loud.
In these podcasts, you get to listen in on my conversations with some really remarkable people—hearing what health literacy is, why it matters and ways all of us can help improve health understanding.
Today, I’m talking with Andres Valencia who is a business leader with more than 10 years of experience as a manager in international hospitality. He has worked at top-end hotels including the Ritz-Carlton.
Andres now brings a wealth of customer service and business best practices from the hotel industry to health care. He currently works at the Patient Experience and Engagement Program at the University of Chicago Medicine.
Andres Valencia: Hi, Helen. Thank you for having me on your podcast.
Helen Osborne: I am really curious. Hotels and healthcare, what in the world do those two have in common? My first thought is being a patient in a hospital and being sick is as opposite as you can get from being a guest at a wonderful facility like the Ritz-Carlton.
Tell us more. How are they alike and how are they different?
Andres Valencia: I hear what you are saying. When you go stay at a hotel you often want to stay at a hotel, and our patients that stay inside the hospital generally do not want to be here.
If we look at the facilities, both buildings would have beds and both our guests and patients need to be fed, so there are definitely similarities in those basic elements.
What is more important to me is that when we go stay at a hotel we want to be there. What we can learn from hospitality in the healthcare industry is how we can make our patients more comfortable, tailor to their needs and anticipate their needs, which is something they do great in hospitality.
Helen Osborne: Give us an example. In the upper-end hotel like the Ritz-Carlton, what kind of a need would you expect somebody has?
Andres Valencia: What you could expect at a Ritz-Carlton is that someone would know your favorite brand of beer and they would remember that. If you compare that to a hospital . . .
Helen Osborne: Brand of beer won’t work, so what is the equivalent?
Andres Valencia: We could make sure that the nurse finds out about what the patient is passionate about, if the patient shares that. I’ll tell you a little story.
Helen Osborne: Please do.
Andres Valencia: One of our patients was very anxious about the procedure that he was going to go through, but the nurse probed a little and found out that he was very passionate about cars, specifically classic cars, and she wrote that on the white board.
The patient was delighted about that because every time someone would come in they would talk about the classic cars. He would light up for just a few minutes and feel like he was in a different world than just the hospital where he was going for some nasty treatment.
Helen Osborne: It’s really about finding out who that individual is and what’s important to that person. Is that one of our commonalities?
Andres Valencia: Absolutely.
Helen Osborne: For that nurse finding out about that classic car, my guess is that it didn’t take very long.
Andres Valencia: Sometimes when we are patients ourselves we forget about a lot of things going on because we’re so worried about the treatment that’s coming up. Sometimes we do have to probe a little bit to make that human connection.
Helen Osborne: It’s that human connection, and that human connection is part of health literacy and good health communication too.
Andres Valencia: Absolutely.
Helen Osborne: What else can we do about that patient experience? That’s what you’re focused on now, patient experience and patient engagement. How does that compare to the hotel experience?
Andres Valencia: If we look at a patient experience, there are so many things that influence that. When we look at our organizations from the hospital they’re often silos. We have the silo of food services, the silo of nurses and the silo of physicians.
For the patient, that doesn’t matter. The patient has one continuous experience and the patient sees one brand and one institution that he’s going to for care.
Helen Osborne: How can you break down those silos within a hospital? We have all of these different people doing all kinds of different work as a team. You talked about how that hotel experience from the guest perspective is all one experience, but in healthcare we’re all doing different types of work. How can we bridge those gaps of all the different work that we do?
Andres Valencia: You’re right. It often is silos, and the key need to bridge those gaps is for all these different individuals to understand how they impact the patient.
The work that we do at University of Chicago is that we organize a patient-experience mapping session. It’s specific to one department and we have all of the key players in the room, which could be the receptionist, the nurses, the technician and the physician. It’s the whole range.
We go through what the patient would go through from the moment that they schedule an appointment to the moment that there’s a follow-up. We identify what that department does really well and then we identify what the gaps are to an ideal state.
Often by just going through those experiences with the lens of the patient in mind, we really get to understand how certain behaviors or certain processes don’t really benefit the patient experience.
Helen Osborne: I see, and that becomes very vivid with that example. I really do get it. When I’m the patient in the bed it’s all about me and it all seems the same, but I want to make sure my doctor comes on time, my food tastes okay and that people are nice when I walk down the hall. That’s what you’re bringing together.
Andres Valencia: Exactly.
Helen Osborne: How does the staff respond to those kinds of meetings?
Andres Valencia: Often getting that understanding is that very first buy-in to change. It’s really understanding how different processes impact the patient. That’s the first buy-in to change.
What follows after that is some project plans to implement the necessary change or even to identify how the department will change certain things.
Helen Osborne: It’s wonderful to bring that together so we can create our plans in healthcare to make it better next time.
Andres Valencia: Absolutely.
Helen Osborne: Andres, we’re talking about hotels and hospitals and what’s common as far as finding that human connection. What are other lessons learned about what we share or what we don’t share and how we can bridge those gaps?
Andres Valencia: One of the things that we do very well in hospitality is make sure that those guests that come in receive a warm welcome, have a pleasant stay and get a warm goodbye.
Helen Osborne: Warm welcome, pleasant stay and warm goodbye is important in a hotel.
Andres Valencia: Absolutely.
Helen Osborne: That’s important in a hospital too?
Andres Valencia: That’s important in a hospital too.
Helen Osborne: Give us some examples. What would a warm welcome be a hospital? It’s not “you’re here and we’re all going to have a good time.” That’s the wrong affect.
Andres Valencia: That’s correct. Let’s imagine two different scenarios. Let’s say that someone is in line to register for an outpatient clinic and you hear the receptionist say, “Next.” That’s not a warm welcome, is it?
Helen Osborne: No.
Andres Valencia: The other alternative is saying, “Good morning. How are you doing? What’s your name?” I’ve seen both happen. I’ve been on the other end of both examples, and I can assure you that I prefer the one where someone sees me as a person first and then goes through all the steps that are needed to check me in.
Helen Osborne: You talked about that human connection and how important that is. What I’m hearing in that warm welcome is the tone and setting that environment for caring and good communication, which can be conveyed not just in our words. You can say, “Next,” you can say, “Next, can I help you?” or you can say, “Next!” It’s partly our tone.
That’s the warm welcome. How does a pleasant stay translate into healthcare?
Andres Valencia: There are different ways that we can implement that in any healthcare practice. If we go back to the receptionist, they could ask the patient, “Is there anything on your mind that you would like me to pass on to the physician when they see you? Is there anything you really are worried about?”
They can put it as simply as a post-it on the chart so that the physician knows that’s the first thing that the patient wants to talk about.
If you’re getting ready for any type of treatment, such as an x-ray and you have to get undressed and put on your gown, you can say, “Is there anything else I can do to make you feel more comfortable?” and provide those warm blankets. Those are little things that are very meaningful to the patient.
Helen Osborne: It sometimes feels like I’ve worked in healthcare forever. We don’t have much time and we don’t have much money. Can those things be done very quickly, such as bringing in that extra blanket or putting up that post-it note?
Andres Valencia: I’m going to go out on a limb and say that it will actually save time. If we make the patient comfortable, make sure that we have connected and asked the patient, “What is on your mind?” and we can relay that to the physician treating the patient, by taking care of all of the questions that the patient has, we will make sure that the patient adheres to our treatment better because we will connect better with the patient.
Helen Osborne: That’s how we can make that stay, that interaction, that ongoing relationship during the hospital stay more pleasant, and that equates to the hotel one.
What about this warm goodbye? I know discharges in hospitals, or even if it was outpatient, it’s rushed. They say, “Here’s your paperwork and here’s your car.” How can we make that more of a good experience?
Andres Valencia: Let’s add to that that once the patient hears that they’re going to go they want to get out of the hospital. I would have that same feeling, thinking, “Oh I heard that I’m going to be discharged. The sooner the better.”
We can make a warm goodbye by better anticipating or preparing the patient for what’s going to happen before discharge.
If the patient hears in the morning that they’re going to be discharged today, the patient hears, “I’m going to be discharged in the next half hour.” Sometimes things have to happen. Labs have to come in or other things have to happen before the patient can get discharged.
It’s setting the stage for the patient and saying, “You’re going to be discharged today, but we have to wait for the labs that will come in at 3:00 p.m. and after that we’ll have to do a few things.” It’s managing those expectations.
Helen Osborne: That’s really important. I’ve heard of so many people saying, “I thought I was going to be discharged and then they made me wait all day.” Set those expectations and put that into context.
I’m just hearing so many parallels between best practices for health communication, health literacy and that human connection and taking care of those little things, setting those expectations and communicating them clearly. I really am seeing those connections. Thanks for all of that.
When I go someplace, such as a hotel or somewhere else, these days I almost always seem to be getting a survey. They ask, “How did you like it? Was everything to your satisfaction, Mrs. Osborne?” Those can be annoying, but hospitals also seem to send out a lot of surveys these days. What do those have in common or not?
Andres Valencia: Those surveys are so important for hospitals.
Helen Osborne: Really?
Andres Valencia: I’m going to take you way back to a few years ago when the Center for Medicare and Medicaid, who takes care of the payment for care of the elderly and the poor in the United States, introduced value-based purchasing.
This means that eventually, in 2017, 2% of the revenue that a hospital gets from CMS will be dependent on good scores on four different categories, and one of those categories is patient satisfaction.
In order to measure that patient satisfaction, hospitals send out surveys. It’s the same survey throughout the United States.
Those surveys are so important. We appreciate each and every survey that we get because it tells us, as an organization and even as a department, what we’re doing well and what the patient is telling us what we need to improve on.
Helen Osborne: You really value those. I honestly tend to blow them off. I blow off the hotel ones. It’s just like I am so swamped with those.
I don’t always have that sense of how they’re really helping you at the other end. I guess I’m jaded with so many of them and I’m thinking, “Here’s just more paperwork and they have to do it.”
Andres Valencia: I understand that.
Helen Osborne: You’re saying that you really learn from it?
Andres Valencia: Absolutely. We value each and every survey that we get because it’s an opportunity for us to improve and to really hear your voice.
What’s even nicer with the surveys that we get is that with some of those you also have the opportunity to write down comments. If there is a nurse or a physician that really went above and beyond and if you write that down, my department makes sure that those people are recognized for the care that they gave.
Helen Osborne: It’s the same thing as a hotel. I might just say that this person really helped me in whatever sticky situation I was in.
Andres Valencia: Absolutely.
Helen Osborne: It’s really interesting to hear what the organization can be doing and what the individual can be doing.
On behalf of our listeners who might be working at outpatient practices, maybe they’re in public health or they’re librarians or educators, how can they bring some of these principles of patient engagement and good customer service to whatever area they’re working in?
Andres Valencia: I think that the three steps, the warm welcome, pleasant stay and a warm goodbye, are applicable to each and every industry.
If you talk about a librarian, he or she can make sure that, when a person comes in to check out a book, you can have those three steps in that one-minute interaction. You can have a pleasant greeting, take care of whatever needs that person has efficiently and then say, “Goodbye. We hope to see you again.”
Helen Osborne: Thank you so much for bridging this gap between these two industries. I’m long a fan of how much we can all learn from each other, and I keep promoting that health literacy is so much bigger than any one person, profession or program. Andres, you have brought that to our listeners, making clear what we can learn from one another.
My warm appreciation, and thank you to you for being a guest on Health Literacy Out Loud.
Andres Valencia: It was my pleasure, Helen. Thank you so much for having me here.
Helen Osborne: As we just heard from Andres Valencia, it is so important to consider the patient experience, but doing so isn’t always easy. For help considering that and communicating your health message in ways people can understand, please visit my Health Literacy Consulting website at www.HealthLiteracy.com.
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Until next time, I’m Helen Osborne.