I visited a friend of mine recently in a local private hospital close to where I work (I do not practice in this hospital).  She had just had an operation and I saw her on the morning after her surgery.

It was 10am and the nurse was with her and she had obviously been crying.  The nurse was explaining how busy they had been that morning as they were discharging a patient who lived a long way away.

It turns out that she had been pressing her call button since 7am because she was in pain and was uncomfortable in the bed, but no one had responded – FOR 3 HOURS!

It was a real eye-opener for me, to see the other side of the story.

As a Consultant, my contact with my patients while they are in hospital is usually through short visits to check that all is well.

The majority of a patient’s hospital stay is managed by the nursing staff and the other members of staff on the ward.

In my friend’s case, it was actually one of the catering staff who had been kind enough to take an interest in her, that had finally resulted in a nurse attending to her.

There was not any emergency problem or complication, she simply needed a sympathetic ear and some painkillers.

She wasn’t going to complain, so her Consultant would never get to hear about the event.

How often does this happen without us knowing?

Now that I have my own clinic, I work hard to put in to place systems and processes that ensure that every patient is treated like a VIP.

I am constantly looking for more ways that I can add to the experience that they receive when they come to see me because I want everyone to feel like they have had the best treatment possible.

Doctors will often baulk at the idea of systems and processes, because they say you need the ‘human touch’ and you don’t want it to feel like they are being treated by a machine.

But they have got it wrong.

It is essential to have robust systems and processes to ensure that you can consistently deliver an excellent service.

You cannot build any business on scale which relies on the whims of whether or not an individual chooses to go the extra mile or not.

I went to a meeting last year about how Disney manages to deliver a consistently magical experience for the millions of visitors despite having a huge workforce, which often consists of students and other temporary workers.

They have very clear and robust systems and processes that are drilled in to the workforce when they arrive and reinforced by daily meetings.

There is a hierarchy of priorities.

For instance, ‘show’ is one priority, which means it is important to put on a good show and always make sure that you are ‘in character’.

However, ‘safety’ is another priority and ‘safety’ is more important than ‘show’.

This means that if you are dressed as Buzz Lightyear and you see a trip hazard or you notice someone who might hurt themselves, you can go in to the Prehistoric section to help because although you will be breaching the ‘show’ priority, you will be fulfilling the ‘safety’ priority.

Remember ‘safety’ trumps ‘show’.

You would think that this wouldn’t be needed in a hospital because clinical need should always come over making sure someone is discharged on time, but in an environment where there may be a lot of agency and temporary staff – maybe they need to make this more explicit.

Maybe they need clear priorities which are drilled in to everyone when they start and at each daily meeting, so they all know where they stand.

‘Clinical need’ trumps ‘timely discharge’.

If there is a patient who is day 1 post op whose buzzer is going – then that needs to be attended to before the patient who lives far away is discharged.

I am glad that I only have 4 members of staff in my clinic because it is a lot easier to instil the values and ethos in to everyone.

I don’t envy the hospitals, but if Disney can do it, then so can they.

Systems and processes are essential and without them, we are at the mercy of individuals using their own discretion, which in a large institution can be dangerous.

Please let me know if you want to find out more about my Consulting Class where I work with a small number of Consultants to build and grow their private practice so that it is more efficient, delivers a better service and is worth something when you retire.

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