Monday, 25 November 2013

Book of the month: If Disney Ran Your Hospital: 9 1/2 things you would do differently by Fred Lee

Before you wonder if you're reading the wrong blog, change the word in the book's title from "Hospital" to "Simulation Centre" and please bear with me for a few more paragraphs. 

About the author

Fred Lee was a senior vice president at Florida Hospital in Orlando before becoming a cast member (as their employees are referred to) at Disney. He helped to develop and facilitate "The Disney Approach to Quality Service for the Healthcare Industry".

Who should read this book?

Lee says: "Although this book was written with hospital managers in mind it should also be appealing to staff at all levels." And he is correct, anybody with an interest in how to improve the experience of the customer/client/participant/patient would benefit from reading this book.

I haven't got time to read a whole book!

The 9 and 1/2 things are listed on the right, however they will provide little insight without reading the chapters. The 10 chapters can be read in chunks and the plain language and personal examples make this book an easy read. 

What's good about this book?

In every chapter Lee provides both the theory behind the thing you would do differently as well as practical applications. A few concepts which  Lee explores, that may influence the way you run your simulation centre are covered below.

1) "Employees leave managers, not organizations" (p.4) Lee quotes work carried out by Buckingham and Coffman for their book "First, Break All the Rules". They argue that an employee's manager has a much greater impact on aspects such as their loyalty, job satisfaction and efficiency than the culture of the company. An employee who does not get on with their manager will not stay in a post because they love the company.

2) "Selling is trying to get people to want what you have. Marketing is trying to have what people want. When you have what people want, it makes selling unnecessary" (p.5) Lee took this quote from Terrance Ryan, a healthcare marketing consultant. A mistake for a simulation centre is for the faculty to sit around and think about what courses they should run. Inevitably this new course will not be radically different from previous courses. Instead what Lee is suggesting is to run the courses that the participants want to come to, i.e. having what people want. This concept may also be applied to timing. At the SCSC we currently don't run any courses after 5pm or on weekends. However, if this is what participants want then shouldn't we be offering it? (Some  sim centres provide 24/7 access.)

3) Most participants are comparing you against the "ideal" sim centre and not another sim centre (p.10) This is part of "redefining your competition" so that you are no longer comparing yourself with other (nearby) sim centres but instead against what you would expect and want from a sim centre which existed to give participants the best possible learning experience.

4) Work on outcomes and perceptions (p.13) Lee argues that both outcomes and perceptions are important, but that outcomes are improved by teams, while perceptions are improved by individuals. At Disney every individual cast member is aware that they represent the brand and that their words and actions reflect on the brand. Lee also argues that you may have fantastic teamwork but that you must show this to participants. How would you do this in a sim centre? Ideas might include referring to the faculty on a first-name basis, wearing badges with first names easily legible, being courteous to the admin and technical staff... The importance of perceptions may also be shown & assessed in a simulation centre by running sessions which include (for example) telling a simulated patient that their operation has been cancelled as the list has run over. Events such as a cancelled op may have a massive effect on the reputation of a hospital and ensuring that these conversations are handled with care and empathy may require some training. 

5) The four Disney priorities are (in order): Safety, Courtesy, Show, Efficiency (p.28). 
Fig. 1: Columns vs Ladder
Lee discusses how a lot of hospitals have graphics showing columns supporting a roof The problem with these graphics is that they do not tell the employees which one of the columns is most important. Lee argues that we should instead have a ladder of priorities which would make it clear to employees that safety is more important than being patient-centred (for example.)

6) Lee says that we must move away from a service to an experience paradigm. Participants at the sim centre do not talk about the service they received but rather the experience they had. We should be focusing on the experience of the participant. What happens when they call or email to book onto a course? Does anyone make them feel welcome when they walk through the door? Are they treated with respect and courtesy? As for your faculty, are the classrooms set up for them, computers & projectors on, kettle on for a cup of tea?

7) Encourage a culture of dissatisfaction. Lee tells us that "being good is the enemy of being great". Your sim centre should constantly be striving for excellence both in the faculty and in the participants. One reason to strive for excellence is because "excellence is fun" (p.212).  Lee means that once you have reached "excellence" you can stop worrying so much about whether what you are doing is right. One of the reasons people are stressed at their jobs is because they feel that they cannot cope with increased acute stress from an emergency. Simulation training can help to alleviate this stress.

8) As a sim centre director/manager, how do you know you're doing a good job? One possible method is to ask your staff what they would want from an excellent director or manager. Then use this template yearly to allow the staff to feedback on your performance.

What's not good about this book?

Very little…. There is no index and the "1/2 thing" does feel a bit gimmicky. (9 1/2 things… probably sounds more interesting than 10 things….)

Final thoughts

Buy this book, read it and keep it for referring back to. Then make some of the changes Lee suggests and see if they improve your sim centre.