Reasonable Rascal
11-02-02, 21:10
Making A Case for Customer Service - Part I
Over the years I have often heard of services that loudly proclaim their version of "customer service." This presumed "service" consists of such as after-service opinions and questionnaires, crews remaining in the ER to "assist" with patient care, or making sure the patient has a pillow under their head once they are deposited at the ER or bedside. Offering stuffed toys to child patients is very common, offering to carry large quantities of flowers and cards and gifts for hospital-stay patients returning to home or care centers (versus having them tossed or relying on family or friends to transport them) are also common tactics. In my opinion all of these, save for the "Care Bear" toys for kids, should be part and parcel of every basic transport. As in just part of the care or common decency. After all our business is dealing with people, not livestock.
Let me tell you what my former service, Ringgold County EMS, came up with and the effects it had on our operations. Granted, as a hospital-based service we did enjoy certain advantages and cost-savings but the techniques can apply to any agency intent of boosting performance, customer satisfaction, and improving overall outcomes.
First, we changed uniforms. Okay, so that doesn't sound like a customer service but bear with me.
When I arrived as Director the service was composed of volunteers. Uniforms consisted of orange or navy Dyna-Med shirts with the service name embroidered across the shoulders. That - provided the EMT bothered to don one - plus whatever else they were wearing at the time. The result was that an ambulance showed up staffed with 2-4 people that looked like someone stopped by a street corner and grabbed whom ever was standing there at the time. Hardly intended to inspire patient confidence. After all, our society is conditioned to regard qualified healthcare providers as uniformed in a recognizable manner. Nurses may no longer wear whites but they do wear at least colored scrubs. Scrubs work well in the clinical environment but not on the street.
What we adopted after a time were navy EMT pants with leg pockets for all those nice things we otherwise don't/can't carry in our civilian clothes, and light blue security-style shirts with navy epaulets, tabbed with plaid slip-over tabs. RCEMS was based in a community with a strong Scottish heritage, so it added to the sense of identity and served to distinguish us from similar-uniformed agencies when we made transfers to regional hospitals. Shoes or boots were to be clean, polished or suede, black, brown, or blue in the case of the nylon/suede combinations. Simple nametags that didn't reek of rookie-wannabe, first name only along with certification level, were added later as experience showed people relate better to someone they "know" vs. an unnamed stranger.
Finally, we added shoulder patches. One was a generic county-wide EMS patch that even the First responders could wear, as we were eventually a semi-combined county-wide system. The other was the state-approved certification level patch. Simple, uniform, standard and easily identified from a distance as they were color-coded.
Later we made changes to the manner in which we dressed our cots. Instead of simple flat sheets that always hung down underneath the mattress no matter how often you tucked the corners up, we made our own fitted cot sheets. Much neater, less to trip over in the confined floor space of the ambulance interior, and more professional looking. Even adding labor costs they were far less than ready-made fitted cot sheets from Ferno-Washington and other companies. Later we took this one step further, but I'll get to that in a minute.
Also added were cot quilts, the 2-sided-with fold-up footpiece that is an industry standard. They are a serious improvement over bath blankets, which, by the way, were never intended for an Iowa much less a farther north winter. We did find they are not long lasting though as the washing/drying cycle tends to cause the Velcro fasteners to snag the nylon covers and tear them up. The nylon itself is cold to the touch. Try it sometime. Nylon fabric is a poor heat retainer.
We eventually solved the pre-mature wearing of the quilts by the simple expedient of refurbishing them. We had a seamstress cover them with a cotton flannel plaid that matched our epaulet tabs. Granted we lost the Velcro closures but after a time we found that didn't matter. The flannel was warmer to the touch, and the plaid was found by a majority of people to be very pleasing to the eye. It hid dirt well so that even MVA traumas didn't roll in looking like they'd bled out a few gallons all over the linens. Some may have but the plaid downplayed things when you were trying to get past onlookers who'd gathered while you were still at the scene. These were the ones waiting at the ER doors, BTW. Amazing thing, that grapevine.
Mattresses were looked at. After testing including ride-alongs by crewmembers and questioning frequent transport patients - usually long-term invalids - we decided that the bolstered mattresses were both more comfortable as well as more reassuring to the patient. They felt that they were less likely to roll off the narrow cot. Later still we added cut-to-fit pieces of foam egg crate mattress to soften further the ride. If perchance they got soiled they were merely disposed of. Otherwise they were placed under the sheet and never came on contact with the patient. Infectious cases had theirs tossed each time. Overall cost was about $2.00 per strip as we could easily get 3 strips for foam mattress pad.
Then came the issue of pillows. We use pillows to position orthopneic patients, to splint extremities, and for basic comfort. Have you ever tried the smallish, disposable ER pillows that are much the fashion these days? Compare the number it would take to position a "3-pillow" orthopnea. Try a dozen, perhaps more since they have very little loft. They only good thing you can say about them is they are cheap if lost, and take very little space in the cabinets.
So, being the spendthrift administrator that I was I ordered brand new semi-plump pillows. If we lost them we were out some bux, true, but only a few. In the end it they fit as pieces of a larger puzzle. You have to weigh investment vs. return over time, not just a matter of weeks or even months. If you have the smoothest riding rig in the state, the nicest linens, the best care as measured 16 ways from Sunday, the brightest medics and the lowest rates going, all the patient is going to remember are the holes in your bridge planking. In other words the flat, do-nothing, or lumpy-as-bad-gravy pillow they had to rest their head on, or to elevate their thrombosed leg. The same as all they will remember is the IV stick was rough because you used the square needle, though your ALS care literally saved their life.
Just to take stock of where we are at for a minute here, let's quickly review. We have thus far:
1. Bolstered mattresses
2. Egg-crate foam mattress overlays
3. Flannel covered cot quilts
4. Fitted cot sheets
5. Semi-plump pillows worthy of the name
6. Well uniformed personnel
So far seems like we should have a very professional looking set-up. I agree, and most services would stop there. But we still had holes amongst the planks on that bridge we were trying to build. The one between being a mediocre service and state-of-the-art as it were. I'll save that for the next part of this thread.
Over the years I have often heard of services that loudly proclaim their version of "customer service." This presumed "service" consists of such as after-service opinions and questionnaires, crews remaining in the ER to "assist" with patient care, or making sure the patient has a pillow under their head once they are deposited at the ER or bedside. Offering stuffed toys to child patients is very common, offering to carry large quantities of flowers and cards and gifts for hospital-stay patients returning to home or care centers (versus having them tossed or relying on family or friends to transport them) are also common tactics. In my opinion all of these, save for the "Care Bear" toys for kids, should be part and parcel of every basic transport. As in just part of the care or common decency. After all our business is dealing with people, not livestock.
Let me tell you what my former service, Ringgold County EMS, came up with and the effects it had on our operations. Granted, as a hospital-based service we did enjoy certain advantages and cost-savings but the techniques can apply to any agency intent of boosting performance, customer satisfaction, and improving overall outcomes.
First, we changed uniforms. Okay, so that doesn't sound like a customer service but bear with me.
When I arrived as Director the service was composed of volunteers. Uniforms consisted of orange or navy Dyna-Med shirts with the service name embroidered across the shoulders. That - provided the EMT bothered to don one - plus whatever else they were wearing at the time. The result was that an ambulance showed up staffed with 2-4 people that looked like someone stopped by a street corner and grabbed whom ever was standing there at the time. Hardly intended to inspire patient confidence. After all, our society is conditioned to regard qualified healthcare providers as uniformed in a recognizable manner. Nurses may no longer wear whites but they do wear at least colored scrubs. Scrubs work well in the clinical environment but not on the street.
What we adopted after a time were navy EMT pants with leg pockets for all those nice things we otherwise don't/can't carry in our civilian clothes, and light blue security-style shirts with navy epaulets, tabbed with plaid slip-over tabs. RCEMS was based in a community with a strong Scottish heritage, so it added to the sense of identity and served to distinguish us from similar-uniformed agencies when we made transfers to regional hospitals. Shoes or boots were to be clean, polished or suede, black, brown, or blue in the case of the nylon/suede combinations. Simple nametags that didn't reek of rookie-wannabe, first name only along with certification level, were added later as experience showed people relate better to someone they "know" vs. an unnamed stranger.
Finally, we added shoulder patches. One was a generic county-wide EMS patch that even the First responders could wear, as we were eventually a semi-combined county-wide system. The other was the state-approved certification level patch. Simple, uniform, standard and easily identified from a distance as they were color-coded.
Later we made changes to the manner in which we dressed our cots. Instead of simple flat sheets that always hung down underneath the mattress no matter how often you tucked the corners up, we made our own fitted cot sheets. Much neater, less to trip over in the confined floor space of the ambulance interior, and more professional looking. Even adding labor costs they were far less than ready-made fitted cot sheets from Ferno-Washington and other companies. Later we took this one step further, but I'll get to that in a minute.
Also added were cot quilts, the 2-sided-with fold-up footpiece that is an industry standard. They are a serious improvement over bath blankets, which, by the way, were never intended for an Iowa much less a farther north winter. We did find they are not long lasting though as the washing/drying cycle tends to cause the Velcro fasteners to snag the nylon covers and tear them up. The nylon itself is cold to the touch. Try it sometime. Nylon fabric is a poor heat retainer.
We eventually solved the pre-mature wearing of the quilts by the simple expedient of refurbishing them. We had a seamstress cover them with a cotton flannel plaid that matched our epaulet tabs. Granted we lost the Velcro closures but after a time we found that didn't matter. The flannel was warmer to the touch, and the plaid was found by a majority of people to be very pleasing to the eye. It hid dirt well so that even MVA traumas didn't roll in looking like they'd bled out a few gallons all over the linens. Some may have but the plaid downplayed things when you were trying to get past onlookers who'd gathered while you were still at the scene. These were the ones waiting at the ER doors, BTW. Amazing thing, that grapevine.
Mattresses were looked at. After testing including ride-alongs by crewmembers and questioning frequent transport patients - usually long-term invalids - we decided that the bolstered mattresses were both more comfortable as well as more reassuring to the patient. They felt that they were less likely to roll off the narrow cot. Later still we added cut-to-fit pieces of foam egg crate mattress to soften further the ride. If perchance they got soiled they were merely disposed of. Otherwise they were placed under the sheet and never came on contact with the patient. Infectious cases had theirs tossed each time. Overall cost was about $2.00 per strip as we could easily get 3 strips for foam mattress pad.
Then came the issue of pillows. We use pillows to position orthopneic patients, to splint extremities, and for basic comfort. Have you ever tried the smallish, disposable ER pillows that are much the fashion these days? Compare the number it would take to position a "3-pillow" orthopnea. Try a dozen, perhaps more since they have very little loft. They only good thing you can say about them is they are cheap if lost, and take very little space in the cabinets.
So, being the spendthrift administrator that I was I ordered brand new semi-plump pillows. If we lost them we were out some bux, true, but only a few. In the end it they fit as pieces of a larger puzzle. You have to weigh investment vs. return over time, not just a matter of weeks or even months. If you have the smoothest riding rig in the state, the nicest linens, the best care as measured 16 ways from Sunday, the brightest medics and the lowest rates going, all the patient is going to remember are the holes in your bridge planking. In other words the flat, do-nothing, or lumpy-as-bad-gravy pillow they had to rest their head on, or to elevate their thrombosed leg. The same as all they will remember is the IV stick was rough because you used the square needle, though your ALS care literally saved their life.
Just to take stock of where we are at for a minute here, let's quickly review. We have thus far:
1. Bolstered mattresses
2. Egg-crate foam mattress overlays
3. Flannel covered cot quilts
4. Fitted cot sheets
5. Semi-plump pillows worthy of the name
6. Well uniformed personnel
So far seems like we should have a very professional looking set-up. I agree, and most services would stop there. But we still had holes amongst the planks on that bridge we were trying to build. The one between being a mediocre service and state-of-the-art as it were. I'll save that for the next part of this thread.