If Disney Ran Your Hospital

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If Disney Ran Your Hospital
Some Things You Would Do Differently Fred Lee
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3 Key Premises
We have reached the ceiling in how much we can
improve patient satisfaction scores with our
current approach.
We cannot go from good to great in patient
perceptions by copying and deploying what they do
at service companies like Ritz-Carlton or
Nordstroms.
Culture is driven by management systems, not
workers or values.
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Table of Contents
If Disney ran your hospital you would

• Focus on What Cant be Measured
• Make Courtesy More Important Than Efficiency
• Regard Patient Satisfaction as Fools Gold
• Measure to Improve, not to Impress
• Decentralize the Authority to Say yes
• Change the Concept of Work from Service to
  Theater
• Harness the Motivating Power of Imagination
• Create a Climate of Dissatisfaction
• Cease Using Competitive Rewards to Motivate
  People
• Close the Gap Between Knowing and Doing

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1.Focus on What Cant Be Measured
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On Measurement
Not all that can be counted, counts. And not
all that counts can be counted.
-- Albert Einstein The most important figures
one needs for management are unknown and
unknowable(invisible also used)What is the
value, for instance, of the multiplying effect
of a happy customer and the opposite effect from
an unhappy customer(or the) Loss from inhibitors
to pride of workmanship? -- W. Edwards Deming,
Out of the Crisis, p. 122
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Measurement
Outcomes
Perceptions
Satisfied Loyal fan
Clinical Financial
Good to Great
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Impact of PI on Total Quality
Talent
Perceptions
Emotional Skills
Total Quality
PERFORMANCE IMPROVES
Analytical Skills
Outcomes
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You cant manage perceptions in the same way you
manage outcomes.
Outcomes (left brain)
Perceptions (right brain)
Objective, Measurable Created by teams Map and
study process steps Improve technical
competence Zero defects thinking Based on what
you do Eliminate carelessness
Subjective, Impressions Created by
individuals Take action -- just do it! Inspire
attitudes and behaviors Best possible
thinking Based on what you say Eliminate avoidance
80 of our PI scores
80 of our PS scores
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2.Make Courtesy MoreImportant Than Efficiency
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Disneys Quality Priorities

• 1. Safety
• Courtesy
• Show
• Efficiency

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PERSONAL EXAMPLES
How do you make courtesy more important than
efficiency?
Personal efficiency vs. Accessibility Job
efficiency vs. Saying yes Process efficiency
vs. Responsiveness
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Paradox Customer First is More Efficient
unit efficiency first
courtesy first
internal focus
external focus
unresponsive
responsive
compete for resources
share resources
Results in overall organizational inefficiency
Results in overall organizational efficiency
teamwork
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3.Consider Patient Satisfaction Fools Gold
Wilderness Lodge
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In Commercial BusinessesResearch on satisfaction
shows
On a scale of 1 to 5, people who mark a 4 are six
times more likely to defect to the competition
than those who mark a 5.
Harvard Business Review, Nov-Dec, 1995
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Why is it so hard to raise our scores?
2 1 0 -1 -2 -3
Meeting expectations 0
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Satisfied 0
Satisfied patients have no story to tell
Hampton Inn, huddle
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Patient satisfaction is a fools gold.
Its the same as zero! Neither good nor bad.
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Singing our praises
Caring, Cared, Cares 32 Kind, kindness
24 Compassionate 15 Help, helpfulness
15 Comfort, comforting 13 Friendly
8 Professional 9 Attention, attentive
7 Concerned 6 Listens 4 Loving 3 Sweet
3 Respect 3 Quick 3 Polite 3 Patient 3
Committed Warm Upbeat Generous Softness Pleasant
Supportive Cheerful Informative Competent Efficie
nt Proficient Prompt Hardworking Courteous
Understanding 2 Thoughtful 2 Knowledgeable
2 Smiling 2 Bedside manner 2 Empathy
2 Tender 1 Takes time 1 Sensitive Reassurin
g Selfless Gentle Nice Conscientious
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The Three Levels of Care
Patient Evaluation
Staff Motivation
Staff Performance
Inspire
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Compassion
Require
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Courtesy
Hire
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Competence
1 2
Fire
Judy
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Three enemies of caring
This is about
Enemy is not..
Enemy Is
Compassion
Indifference
Judging
What I Feel
Courtesy
Rudeness
Avoidance
What I Say
Incompetence
Carelessness
Competence
What I Do
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6.Change the Concept of Work from Service to
Theater
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Disney is not a service and neither are we.
Experiences
The progression of economic value
Stage
Services
Deliver
Goods
O V E R T I M E Since 1900
Entertainment?
Make
Commodities
Extract
Joe Pine, The Experience Economy
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Theater is about life comedy and tragedy.
Disney Meeting the emotional needs of a family
to have fun together.
Hospital Meeting the emotional needs of a
family suffering a tragedy together.
A hospital without compassion is like Disney
without fun.
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Focus on the patients experience, not our
service
Companies stage an experience whenever they
engage customers, connecting with them in a
personal, memorable way.
They actually occur with any individual who has
been engaged on an emotional, physical,
intellectual, or even spiritual level. The
result? No two people can have the same
experience period. B. Joseph Pine II, The
Experience Economy
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At the Wilderness Lodge

Think Disney experience, not just department or
hotel service.
Think patient experience, not just department or
hospital service.
Or
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Our Service Or Their Experience?
Depends on the emotional needs of the patient.
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THE DIRECTOR
Borrowing from Theater
Start by describing the experience you want the
guest to have (see, hear, and feel) and how to
make each scene memorable. Cast for the talent to
play the role called for in the guest experience,
rather than just the skills to do a job. Clarify
each persons role in creating a memorable
experience and get their commitment to their role.
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THE ACTOR
Borrowing from Theater
Actors learn how to be real by becoming
emotionally engaged with their character. Actors
rely on sense memory and imagination to become
real in their role.
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Acting is not pretending
Eric Morris, No Acting, Please (first
sentence) Acting is the art of creating genuine
realities on the stage. No matter what the
material, the actors fundamental question is
What is the reality and how can I make it real
to me? Acting must come from a real place.
To paraphrase Care giving is the art of
creating genuine realities on the hospital stage.
No matter what the event, the caregivers
fundamental question is What is the reality of
this patients experience, and how can I make it
real to me? Compassion also must come from a
real place.
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Theater changes the service paradigm
From patient satisfaction to a fan with a
story to tell From just being courteous
to engaging the guest From our service
excellence to their memorable
experience
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Theater changes the service paradigm
From hiring for the skills to do a job to
casting for the talent to play a caring role
in the guest experience From teaching body
language to teaching acting
principles (being real through imagination)
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Knowing how is not the problem
Like losing weight, our problem is not with
knowing how. When we want to enough, we figure
out how and learn by doing. Our problem is with
being committed enough to do what it takes every
day, and do it permanently, not just in short
bursts of inspired energy.
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W. Edwards Deming might add
What is the value of a committed ensemble of care
givers who have become compassionately engaged in
the patients experience?