Thursday, September 01, 2005

The Story of Miss Endres; Or, why solving wars 10,000 miles away is easier than 3 ft away; Or the story of Ms. Endres

In my earlier life, I worked in a middle sized metro hospital. Our nursing director was Ms. Endres. She was a larger than life person, with a blazing sense of humor and she had the ability to cut through to the essence of problems. She was heavy set, and at that time in frail health. As a department head, I always loved the meetings that she was present for.

One January, when the hospital was very full, and we were all at peak stress, there was a meeting of the department heads. There was a presentation by a person on a problem occuring in the surgical unit. There were personalities and staffing issues involved. Anyway, after the report, it was time for Ms. Endres to speak.

" Well," she said, "This is really just bull." If we need PR, we can always go to Eric (the PR dept) and have him paper it over, but this is health care, and we need to get to the root of the problem here. Yes, this is about a complaint, but if you look closely at the upper line on each admission to this hospital, you will see the words "Complaint/Diagnosis". So, I don't want to offend all you professionals in any way, but you really are "Complaint specialists" and the day you are not able to respond with sensitivity and speed, is the day you have burned out and need to find a different line of work. In other words, you may work miracles but you need to get through the "complaint" part first. That's the only way to work the miracle."

" So," she went on, "tomorrow I will meet with the physicians involved and with the administrator and the charge nurses involved and we will get to the bottom of this. We can solve it and will. Together as a team we can get it done."

Well, the effect in the room was as though a bolt of lightning had struck. A good bolt of lightning. Not a tornado.

Later that year, I would add the responibility of "Complaint adminstrator" to my list of duties, and had the responsibility of resolving complaints small and large, from the $1.50 pair of slippers to the larger errors. Every complaint was logged and assigned for resolution. There was a standard of 3 days for a billing error. Medical issues were handled stat, which is immediately. Because all complaints, or "concerns" ,large or small,were centrally logged, any administrator could access any concern to find the status. There was never a "I don't know but I will get back to you." There was never telephone tag. That was a route to nowhere.

At the end of the year, I presented a report. It showed that of all the "complaints". 99% were handled in the objective time frame. Less than 1/2 1% were serious and they were resolved.

More importantly, of the small complaints, some system errors were discovered that saved the hospital lots of money and changes were made in how things were done. It got to the point where my staff would ask on the phone if there was any question at all that the patient had about their bill that they did not agree with or understand. By asking and even inviting "concerns", the customers were a lot more satisfied and the process improved very noticibly. I notice many companies on the phone use this technique. They establish that you are satisfied.

Hence, I have always been interested in "Complaint mechanisms". If you click on the post, you will see one of the 1,000,000 search items for this on Yahoo. The central point of almost all these systems is that there is a central log where "concerns" are logged and resolved. Without that key ingrediant, an organization simply is not interested in resolving problems. Organizations without it are simply spinning wheels.

So, I would theorize that it is always easy to expound on how we would solve the wars far away. It is the "wars" close that are more difficult. I urge governments, school districts, and corporations to take grievance resolution seriously and implement systems to make this happen.