iNancy Elder Care with Nancy Karen Culp RN. As a Registered Nurse with almost 38 years of nursing experience I bring to you a series of articles & guides to help navigate thru the workplace setting. Over the years I have been thru the School of Hard Knocks so to speak and I’m still learning! Experiencing a wide range of work settings, situations and challenges along the way has allowed me to share what I have learned or that which those around me have learned. This information is presented to give you support and advice. Here is my unique perspective of the experiences I have had along the way for your benefit!

I was fortunate enough to attend a Disney sponsored Customer Service Program for Health Care Workers with a colleague several years ago.  I have incorporated the Disney experience along with my own personal experiences and other programs attended over the years to give you a 4 part series on Customer Service. The additional articles you would want to read are:

Excellence in Customer Service from a Management Perspective in the Health Care Environment
Customer Service in Healthcare from a Hands-On Care Giver Perspective. 
Customer Service Perceptions & Outcomes from a Patients View in the Health Care Environment

The following is specifically how to deal with customer complaints and it is important for all employees to know and understand how to intervene and respond in an effective way:

DON’T TAKE IT PERSONALLY Have to keep ourselves under control.  They are trying to get you to react… choose to be proactive rather than reactive.

Anticipate what might happen and practice for when it happens so you are not in the position not to know what to do “I should have said”  “if I had only done…” 
Employees have to learn to not take it personally.  It’s not what’s the matter with “You”? The problem lies not with you but with them. 
Positive self talk (75% is negative,  “there I go again” “I can’t do it”  etc.)  every time we successfully deal their the negative, we need to remember our successes.  “I can handle this” “I can usually solve the problem myself”

LET THEM VENT in order to help them get themselves under control and avoid making matters worse, realize that they don’t make sense (because they are out of control)  what you need to do is to wait until they get over their angry, let them vent to get it all out.

If they get abusive, need to think of level of abuse/ “craziness” you will go.  Use an I message, rather than a U message.  instead of saying “You can’t talk to me like that”  say  “I feel very uncomfortable” then “I can solve your problem” then give them a solution. 
Ignore the unrealistic statements, the personal attacks (I called you a thousand times) “you’ve got to be the stupidest person in the world” not realistic, just ignore it.  Treat it like dealing with a FOG.  You also need to hear about their “feelings” and acknowledge them “I can see that you are upset”.  Angry people feel they have been damaged.  Be real though, you may not know exactly how they feel but you can acknowledge them. 
Pause before you respond.  Wait… hardest thing…  don’t rush…  be still…  if we speak right out, will most likely react rather than respond

STICK TO THE FACTS & SOLVE THE PROBLEM:  this is the easy part, dealing with the emotions was the hardest thing.  Paraphrase first.  Confirm that you understand the problem sufficiently to begin the problem solving stage.

“What I hear you saying is….”
Stay with the customer.  If you need to refer them to someone else who can solve their problem then do so by saying “I will take you to someone who can take care of this for you.” 
Summarize the problem as part of the introduction/referral to someone else appropriate to solve the problem. 
Regarding solutions you have 2 choices:

HOW WOULD THE CUSTOMER SOLVE THE PROBLEM? ask them what you need to do to correct this problem.
HOW YOU CAN SOLVE IT – let them know that: this is the best way we have found to solve this problem, best way to handle this, when we do this, our customers are satisfied…

RE-BUILD THEIR TRUST

Do it now (don’t punish them because they have a complaint) the sooner the better to move toward having a satisfied customer.
Keep them in the loop.  How long, what we’re going to do, give them more information, sometimes the news may be bad news (3 weeks to get fixed), tell them right up front, better that they be disappointed than angry. Then at the end of the specified time period, ask if they are satisfied with the result. 
Apologize not only for the problem but apologize for the inconvenience. 

If they are victims – take 3 extra steps:

Empathy “I know you must be very frustrated, we understand.” Or “this is unacceptable” or “this was really a difficult thing and never should have happened”.
Follow-up to make sure what we did worked. “Did we correct the problem to your satisfaction?”
ASK FOR ADDITIONAL COMPLAINTS get customer input so next customer does not have to deal with that. Ask “If there was 1 thing we could do better to serve them what would that be?” and at the end of the year, you will have a whole list.  You won’t be spinning your wheels or heading in the wrong direction if you do 5 things they want rather than 10 things they don’t want! 

HOW TO INTREPRET YOUR CUSTOMER SERVICE RATINGS:

At Disney we also learned that Very Good is NOT Good Enough! Many organizations count the Very Good ratings in with the Excellent.  Disney only gives its employees results for the Excellent which gives a whole new perspective on needed improvement. Try it and see what happens with your customer survey results.  Other sources besides Disney came to the same conclusion like studies done by The Harvard Business School and Fred Lee who wrote the book “If Disney Ran Your Hospital”.  They all agree that a “satisfied customer” is not necessarily a “loyal” customer and that getting “Very Good” usually a 4 out of 5 on a rating scale, is not good enough. 

COMPLAINTS: A word of caution regarding complaints.  It is a misconception that if you focus on the complaints, you will be dealing with the issues that matter most to the patients.  This is a “process” mind set for perceptions or impressions.  Why is this? 

People complain about things that can be verified objectively – but these things are related to process not outcomes and most customers do not believe complaining will do any good when it comes to someone’s personality.
People do not complain about “attitude” – which is the leading correlation to overall satisfaction.  Only if someone is outright rude might someone even hear about it, even when the patient is asked specifically. Getting a person to complain about something like a nurses “attitude” is almost impossible.  The patient is afraid of retaliation and fear it could become a he said – she said stand off.
People do not mention what behaviors would win their loyalty because it would be behavior that is beyond what they could reasonably expect.
Only 4 out of 100 dissatisfied customers will actually complain.

Therefore, to raise satisfaction scores and get patient loyalty, we need to focus on the things that most correlate with overall satisfaction – even if there are no complaints in these areas for the reasons as noted previously.  Here’s what we can do from a practical aspect:

Concentrate on hiring cheerful, empathetic hands-on caregivers where resident interaction occurs most frequently.
Teach care givers to actively solicit the needs of patients by asking the right questions. “How do you feel about that?” “Does this solution make you feel like we are meeting your needs?” “What would make you feel satisfied regarding…?”
Based on poll results, dignity is a very important issue so train care givers to say something that shows they are concerned about their patients dignity when preparing for an immodest procedure. An example of this might be taking them to the bathroom “I understand that this may feel embarrassing but remember it’s something we all do and it’s part of my job so I won’t be embarrassed if you won’t”.  And if you have to stay with them when moving their bowels for example you might try using humor and saying something like “don’t be concerned, mine doesn’t smell like roses either!”
Stress the importance to all staff of constantly briefing the patient of his/her condition, delays, tests, treatments and what medications are for.  Being aware that a false promise or expectation should be avoided like saying “I’ll be back in a minute” verses “It may be 10 to 15 minutes before I can return, will that be ok with you?”
Take an active interest in the whole family and helping them feel part of the healing team.  Families have the most influence on the patients’ attitude so incorporate them into the care giving process when ever possible.
Show the value of demonstrating personalized empathy verses professional distance. “I understand” “I hear what you are saying” “this must be hard for you” verses “that’s the way it is” or “we take care of many knee replacements just like you”.

Practice all of the above.  These are things that the patients won’t complain about but that dramatically affect their emotional state and consequently their feelings of loyalty.

Statistics suggest that when customers complain, business owners and managers ought to get excited about it. The complaining customer represents a huge opportunity for more business.  Zig Ziglar

iNancy Nancy Karen Culp RN is an educator, writer and dynamic professional speaker with extensive experience in the Long Term Care sector of our health care continuum. Experienced in the areas of nursing administration, education and training, quality improvement and nursing informatics. Various roles over the years include Director of Nursing Services; Program Director for Nurse Aide Training; Clinical Information Systems Coordinator for Electronic Medical Record development and implementation and HIPAA Privacy Officer. nancy.culp99@gmail.com

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