Bedside Manners : Competitive Pressure Leads Medical Center to Prescribe Staff Training on Fine Points of Putting Patients at Ease

The blinds are drawn and the lights are dimmed. Twenty-four hospital workers, some munching jellybeans, sit studiously watching a videotape about a mythical “Rose Whister” being wheeled down a corridor on her way to surgery.

Scene One: Suddenly, her gurney is accidentally pushed into the path of a passer-by. Bump! No one is hurt, but as the narrator explains, Rose already is worried about her upcoming operation, so the relatively minor incident is all the more unsettling.

The hospital workers take careful note.

Scene Two: Weeks later, after her recovery, Rose encounters a friend at the supermarket and explains that her operation “was a breeze, but . .

The hospital workers laugh.

Line Brings True-to-Life Flavor

The line is funny only because these workers are employed at St. Mary Medical Center, which has come to view its most visible rival in this city’s highly competitive health-care industry as 998-bed Memorial Medical Center of Long Beach. While the name of the hospital portrayed in the video is only coincidental, it brings a true-to-life flavor to an intensive new training program designed to make 500-bed St. Mary all the more competitive.

Like many other hospitals here and around the country, St. Mary has come to realize that all of its expensive medical equipment and expanding technology makes less of an impression on today’s consumers than the attitudes of the people who treat and take care of them. The surly billing clerks, brusque doctors and sour Nurse Ratcheds of the world, as a result, have been branded bad for business.

Built on Videotapes, Lectures

Although St. Mary has had various kinds of customer communications training for more than a year, this month, it launched a new level of instruction built around a series of videotapes and lectures entitled “When The Patient Comes First.” By summer, officials say, each of the hospital’s 1,800 employees--from nurses to accounting clerks to switchboard operators--will undergo four hours of instruction in what amounts to a hefty dose of simple bedside manners.

Memorial has a similar program, which has been in operation since 1984, and a number of other hospital have their own plans to improve hospital-patient relations.

“Cold professionalism can sometimes be misinterpreted as not caring,” explained St. Mary’s program leader Gerrie Schipske, a 36-year-old nurse practitioner who apparently is the only

full-time community relations coordinator employed by a hospital in the Long Beach area.

“It’s not that we haven’t been doing this all along,” Schipske said. For years, St. Mary has had a written set of Standards of Patient Service.

‘The Golden Rule’

But the new training re-emphasizes the hospital’s commitment, Schipske said, because sometimes “in the myriad of things we do every day, we lose sight of it. There’s nothing magical, there’s nothing mystical” about what the program teaches. “It’s really the golden rule, to be trite. It’s treating people like you would want to be treated.”

St. Mary’s inaugural class, early on a recent Monday, brought together employees from two dozen departments. Although some of the workers have little or no direct contact with patients, officials want everyone on the staff to consider themselves front-line representatives of the hospital. “Because you work here,” Schipske told them, “people view you as experts in the health care field.”

The group was fueled with coffee, doughnuts and colorful jellybeans that set an upbeat tone. Schipske explained that no one had been singled out because their demeanor was necessarily bad, only because everyone can benefit from a little brushing up.

First, they played a game, similar to Monopoly but designed to make the workers feel some of the frustrations that patients can encounter in the form of long delays, cold meals or medical mumbo-jumbo uttered by experts who consider themselves too busy to explain things in understandable terms.

Calming Angry Patients

Then came tips on how to calm an angry patient by recognizing his “hostility curve”--the way a typical temper heats up and cools down--and interjecting soothing words at just the right moment. (“Don’t deny the patient’s or visitor’s anger or tell them to ‘calm down.’. . . Sit down with patients and visitors (if you need to calm yourself, lean forward on something, for example, an armrest or table) . . .. Support patients and visitors when their anger slows down without necessarily agreeing with them . . .. Don’t get caught up in the hysteria by raising your voice to match that of the hostile person.”)

The videotapes showed that workers can do little things, like smile at the right time or tell someone “I understand,” to avoid or deal with troubles, such as in Rose Whister’s corridor collision.

“Memorial Hospital seems to be on the lips on everyone at the supermarket today,” the video narrator says. “So what happened? One little incident that had nothing to do with the excellent medical attention Rose Whister received has inadvertently fueled the rumor mill.

“On average, one dissatisfied patient will complain to 20 other people. And along the way the story will be distorted and exaggerated. For hospitals whose reputation and image is so strongly influenced by word-of-mouth reports from patients and employees, a little bad news can become a big problem.”

Personal Responses

Of every 10 unhappy patients, Schipske said, only one will follow through with a formal complaint. The others usually fear they will be labeled as troublemakers if they speak out, and their care will suffer, she said.

Whenever St. Mary receives a complaint, Schipske said, both she and Sister Mary Lucille Desmond, the hospital’s administrator, write a personal response to assure the patient that they are being taken seriously. Studies also show that patients who have been treated kindly are less inclined to file malpractice suits if problems later arise from their clinical treatment, she said.

So far, St. Mary’s training program has been well-received by employees, Schipske said. It’s too early to tell whether it will bring the hospital more business, she said, as past customers return or recommend the hospital to others in need of treatment. But several other hospitals have called for advice and guidance regarding the program, among them 200-bed Pacific Hospital of Long Beach.

“I don’t think any hospital would have survived even in the past without a real caring attitude on the part of its employees,” said Pacific Administrator Gerald S. Goldberg. “We have had a longstanding commitment in this hospital to customer relations.”

Consumer Awareness Cited

But because “there has been so much emphasis on it,” Goldberg said, Pacific is considering a more formal program like the one at St. Mary.

“Customer relations definitely does have a bottom-line impact,” he said. “The only reason it might be more important today is that consumers are making more of their health care decisions” instead of blindly following the recommendations of their doctor.

At rival Memorial Medical Center, a similar training program called “That Extra Measure of Care” has been in operation for almost two years, said Dr. Gil Taylor, director of human resources development. That program was designed by nationally recognized consultant Kristi Peterson and then passed on to about 60 members of the Memorial staff. In turn, those employees have trained nearly 2,000 of their 3,500 co-workers.

“Hospitals for a long time have relied on their clinical expertise” to draw patients, Taylor said. “But suddenly we’ve realized that people can go to pretty much any hospital they want . . . and what they remember is not the clinical care, they take that for granted . . ..

‘A Human Touch’

“What they really remember is whether the nurses and the admissions people and the accounting people took the time to explain things to them and evidenced that they’re really concerned about that patient’s recovery.”

Aside from the fact that good customer relations can bring a hospital more business, Taylor said, there is evidence that patients recover faster when they are given care that lends “a human touch.”

He said Memorial plans to develop a reward system for staff members who show the best customer relations. And the hospital will emphasize those same skills when screening new employees, Taylor said.

Taylor said the hospital may even conduct a telephone poll of past patients to seek their comments and to demonstrate in another way that the hospital is trying to be sensitive to its customers.