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Fred Lee | If Disney ran your hospital -- going from good to great in patient expectations


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Hospitals are complex systems operating in a changing and challenging environment. Evidence shows the culture of hospitals is a critical determinant of the quality of healthcare and the patient experience.

Fred Lee, author of 'If Disney ran your hospital: 9 1/2 things you would do differently', presented to the HARC Network in September 2012 on what needs to be done to help hospitals develop cultures that best support effective healthcare and an improved patient experience.

HARC stands for the Hospital Alliance for Research Collaboration. HARC is a collaborative network of researchers, health managers, clinicians and policy makers based in NSW, Australia managed by the Sax Institute.

HARC Forums bring members of the HARC network together to discuss the latest research and analysis about important issues facing our hospitals.

For more information visit

Published in: Health & Medicine
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Fred Lee | If Disney ran your hospital -- going from good to great in patient expectations

  1. 1. Going From Good to Great in Patient Perceptions With Fred Lee Contact: To order books:
  2. 2. Table of ContentsIf Disney ran your hospital you would…1.  Focus on What Can’t be measured2.  Make Courtesy More Important Than Efficiency3.  Regard Patient Satisfaction as Fool’s Gold4.  Measure to Improve, not to Impress5.  Decentralize the Authority to Say “Yes!”6.  Shift From Our Service to the Guest’s Story7.  Harness the Motivating Power of Imagination8.  Create a Climate of Dissatisfaction9.  Cease Using Competitive Rewards to Motivate People10.  Close the Gap Between Knowing and Doing Who Does Not Seem to Belong? W. Edwards Deming Quality Measurement Walt Disney Animation Mother Teresa Compassion Hans Selye, MD Psychoneuroimmunology
  3. 3. Innovation = Making Unusual Connections “We deliver fun (Emotional) and happiness.” Stage Services Deliver Goods Make Tom Hanks Commodities Extract Pine, Gilmore: The Experience Economy We are in the same sector as Disney meeting a different emotional need. Disney: Meeting the emotional needs of a family to have fun together. Hospital: Meeting the emotional needs of a family ______________ __________ together. A hospital without compassion is like Disney without fun.
  4. 4. If Disney Ran Your Hospital You Would... W. Edwards Deming on Things that Cannot Be Measured“The most important figures one needs formanagement are unknown and unknowable…What is the value, for instance, of the multiplyingeffect of a happy customer and the opposite effectfrom an unhappy customer?” (Patient perceptions) Out of the Crisis, pg. 122
  5. 5. Measurement Outcomes Perceptions Clinical Financial Singing our praises…Caring, Cared, Cares +32Kind, kindness +24 Committed Understanding +2Compassionate +15 Warm Thoughtful +2Help, helpfulness +15 Upbeat Knowledgeable +2Comfort, comforting +13 Generous Smiling +2 Bedside manner +2 SoftnessFriendly +8 Pleasant Empathy +2Professional +9 SupportiveAttention, attentive +7 Tender +1Concerned +6 Cheerful Takes time +1Listens +4 Informative Sensitive CompetentLoving +3 Efficient ReassuringSweet +3 Proficient SelflessRespect +3 Prompt GentleQuick +3 Hardworking NicePolite +3 Courteous ConscientiousPatient +3
  6. 6. Hans Selye on Stress and the Immune System “The Einstein of Medicine” Father of PsychoneuroimmunologyStress hormones like cortisol and adrenalin causeshrunken immune tissue, the growth of tumors,and weakening of the body’s ability to heal itself.(Compassion can affect a patient’s immune system.) Stress and Breast Cancer Life Expectancy Reduced stress, measured by daily cortisol levels, can nearly double life expectancy. California Breast Cancer Research Symposium 9/9/2005 Sacramento, CA Linda J. Luecken, Ph.D
  7. 7. Stress and Breast Cancer Life Expectancy“Women with advanced breast cancer who haveabnormal daytime levels of cortisol, a hormone releasedin response to stress, are significantly more likely to diesooner than patients with normal levels of the hormone.” David Spiegel, MD Journal of the National Cancer Institute, June 2000Latest Research Model on Breast Cancer Diagnosis Adaptive Coping ___________ Maladaptive CopingDecreased distress Increased distressDecreased cortisol, Increased cortisol,increased NK and Compassion decreased NK and T-cell activity T-cell activity OncologyDecreased spread, Unit Increased spread,severity, Increased severity, decreased disease-free time Palliative disease-free time and survival Care and survival Hospice
  8. 8. Empathy The Jefferson Scale of Empathy (JSE) is a validated instrument developed in 2001 to measure empathy in the context of patient care. Clinical studies show strong relationship between empathy and better clinical outcomes and LOS in: • Pain Management • Cancer progression • Diabetes control (A1c) • Women’s Health • Psychotherapy • Wound healing Total Quality Management (TQM) Compassion What I Feel Courtesy Courtesy What I Say What I SayCompetence Competence Competence What I Do What I Do What I DoManufacturing Service Hospital Six Sigma Excellence Experience
  9. 9. Mother Teresa on Greatness “We can do no great thing. We can only dosmall things with great love.” Compassion The healing blind spot in… Lean Six Sigma Clinical Pathways Checklists Nursing Competencies Service Excellence Standards