Friday, May 11, 2007


"Every little thing she does is magic..." The Police

Dear Reader: Forgive me for wandering off topic in this post.

Saskatoon Health Region's vision is "Healthiest people, healthiest communities, exceptional service." Exceptional service. What does that mean in health care? As a member of the region's patient- and family-centred care steering group, answering that question was my homework last week.

I decided on the literal interpretation of exceptional, that is, "beyond what is expected." A friend of mine who’s a businessman describes exceptional customer service (somewhat cynically) as: "Underpromise, overdeliver."

It shouldn't be hard to "overdeliver" in health care. Let's face it: we've set the bar pretty low. Expectations are so dismal that they're clich├ęs:
  • Check your dignity at the hospital door.
  • It'll be cold.
  • It's going to hurt.
  • Wait to see the busy specialist.
  • You're the doctor.

I was pretty satisfied with my interpretation when I presented it to the group. Two days later though, I discovered I had wasted their time. My understanding was dry and rote-like. At that point, I had no idea of the true power of exceptional service. I was about to learn a lesson no textbook could teach.

My brother called from Calgary. Our father had developed a sudden postoperative complication and had been transferred to the ICU. A short time later, the intensivist called me to explain the situation. I took the next flight out.

I arrived at the Foothills Medical Centre late at night and fumbled around until I found a parkade. There was still a light on in the attendant's office, so I walked over to ask for directions to the hospital entrance. The sign on the door read "Parking office closed". I waved tentatively at the woman seated inside.

Expectation: Scowl, finger jabbed at "Closed" sign.

Actual: She smiled and unlocked the door. "There's another parking lot right across from the hospital entrance - it'll be more convenient for you. I'll open the exit gate so you don't have to pay here."

Wow! Lesson for me: First impressions count. Every impression counts.

I walked through the ER doors and looked for a sign that would lead me to the ICU. Two admitting clerks stood chatting and laughing behind a plexiglass divider. "Excuse me..."

Expectation: Annoyed look, turning reluctantly away from conversation with friend.

Actual: Smile. "Can I help you?"

Lesson: Everyone in the system, not just "care providers," contributes to exceptional service.

I joined my family at my father's bedside. Our experience in the ICU exceeded all expectations. In this hectic, high-tech place, the staff made every effort to make us feel welcome and comfortable. They were truly committed to patient- and family-centred care”
  • "Visit anytime."
  • "If you wake up in the night and are worried about him, just phone and I'll let you know how he's doing."
  • "You can stay right there. I'll work around you."

At one point, late at night, my father took a critical turn and required an emergency procedure.

Expectation: Go back to the waiting room. We'll call you when we're done.

Actual: "You're welcome to stay here. Just have a seat by the nurse's desk."

It must have been nerve-wracking for the staff to carry out the procedure (which proved challenging) with the patient's son, a surgeon, scrutinizing their every move.

Lesson: If you commit to patient- and family-centred care, you're in all the way. No bailing out when the going gets tough.

It wasn't a flawless experience, however. One respiratory tech strolled up to the bedside, munching on a cookie and making glib comments. Petty of me to be bothered by this, perhaps, but that initial experience colored my impression of his ability and professionalism.

Lesson: Consider your words and actions from the point of view of your patient and their family. You are always "on stage."

Two days later, I was taking a walk outside when my cellphone rang. It was my father's surgeon.

"I just wanted to let you know that I'll be out of town for a few days, but I've made arrangements for your father's post-op care when he's transferred to the ward. I've talked to the ICU doctors and he seems to be making very good progress. I'm sorry to leave like this, but my father just passed away and I have to drive down to the States."

Let me repeat that…

The man's father had just died. He had a 15-hour drive ahead of him and a busy surgical practice to rearrange. He took the time to make arrangements for my father's care and then called me personally.

Now that’s exceptional.

I felt humbled by this doctor's commitment to his patients. Could I ever match it? I was overwhelmed.

I hung my head and wept.

P.S. To the staff at Foothills: Thank you for the lessons you taught through your truly exceptional service.


  1. Originally Posted by Geri Geldart (River Valley Health, Fredericton, NB) 5/18/2007 2:39 PM

    Thank you for writing this blog. It’s late in the day, here on the east coast, on the Friday before the long weekend. I'm still in the office. I just read your blog. Your description of the exceptional service at Foothills made me cry. It’s why we do this work every day. Thanks for that "real" moment. And I love what you're doing in your office. There are much better ways to run our system. Thanks for sharing your experience.

  2. Originally posted by Collene Dare Alexander (NNY Rural Health Care Alliance) 5/18/2007 4:13 PM

    Kishore, I am in Karen's IHI Improvement Advisor class and am so glad she gave us the link to your blog. I am going to share it with my project team (a small critical access hospital), but more importantly, with a committee from our community concerned about the quality of health care - especially your blog on May 11th, it was so touching. Thank you for sharing with us your true self - it is inspiring.