Twelve Vital Business Lessons from an E.R. From Hell

I had the misfortune last week to end up in the Emergency Room of Sky Ridge Medical Center in Lone Tree, Colorado. Let’s just say that those who value their health will stay far, far away from Sky Ridge’s E.R. But the experience there brought up several lessons for business that all businesses should heed. Here are a few of them.

1). Go for substance over appearance. Sky Ridge is an absolutely beautiful facility. It looks more like a tony mall than a hospital. But appearances can be deceiving. A hospital with less flash and more competence would have been more to my liking. When you’re sitting in the E.R., you’re not concerned about the hospital’s interior decorator. You’re concerned about the competence of the doctors and nurses.

Businesses spend a great deal of money on their “branding” and “image.” While some of this is necessary, businesses should spend much more time on finding and hiring the best people for their teams. A great branding campaign will be useless if there is not also great delivery of services.

2). Don’t forget the little things. It took me hours to get a requested pillow. Blankets were also difficult to come by. And some water? Fugetaboutit! And, no, the E.R. was not busy the day I was there.

Customers judge a business on the little conveniences and courtesies that let them know they’re appreciated. Don’t make a customer beg for a “pillow” at your business.

3). Remember your mission. The mission of Sky Ridge should have been the health and safety of their patients. It wasn’t. A fairly large puddle of my blood remained on the floor for over 4 hours. Hospital personnel walked through it, and it was quite obvious. Fortunately, I don’t have any infectious diseases. But if I had, their incompetence would have tracked that disease to every patient in the Emergency Room, and, possibly spread it to the larger hospital population. Not cleaning up blood on the floor endangers the lives of everyone in an E.R.

What is your business doing that is neglecting a part of your mission? How are you endangering the loyalty, livelihoods or even lives of your customers? Don’t just walk through your “puddle of blood.” Clean it up!

4). Take care of the most important customer needs first. I’m a Type I childhood diabetic. During the 6 hours I was in the E.R., they only checked my blood sugar once, thus seriously endangering my life. Although they were reminded to do so several times, I’d hear, “OK. I’ll be right back to do that,” then never see the person again. Fortunately, I had my own insulin, blood sugar monitor and glucose tablets with me. If I hadn’t, I wouldn’t be writing this article.

If you’re neglecting a vital part of your customers’ needs, they won’t be customers for very long. While they might not die, as I might have, they will certainly be dead to your business as they seek other, more attentive businesses.

5). Don’t let a temp do a mission-critical task. I found out that the nurse who was supposedly taking care of me was a rent-a-nurse. In fact, most of the E.R. was staffed by temporary personnel (more on that below.) She didn’t know the equipment or the hospital. This greatly delayed my medical care as she would frequently have to go get the one regular employee nurse and ask for help.

Temps might be quite competent at their professions. This nurse knew nursing. But they don’t know your “shop,” and can make mistakes that can cause customers to be dissatisfied. Make sure that anything mission-critical is handled by someone who is loyal to you and your business, not a temporary employee.

6). Adequate staffing is essential. For this large, suburban E.R., there were two nurses and one doctor (with another doctor there for part of the time). This was gross under-staffing.

Like many for-profit hospitals, Sky Ridge puts profits above their patients and the care of their patients. Profits are important, but keep your eye on the ball. The most important factor for business success is the satisfaction of your customers. Having dissatisfied customers will result in the closure of your business, regardless of short-term profits.

7). Communication is vital. In addition to under-staffing, the staff at Sky Ridge E.R. did not communicate well with one another. There were several professionals there, but there was no team whatsoever. Everyone was doing his or her own thing. Your staff must truly be a team and work together as one. This means continuous and effective communication.

One of the employees of the Sky Ridge E.R. told me that no one had conveyed to him vital medical information on me…and this was five hours into my stay. This is pure incompetence. Make sure that your business does not pull a “Sky Ridge.”

8). Be careful what you delegate. As I indicated, I’m a Type I Insulin Dependent Diabetic. I also had a serious medical issue that brought me to the E.R. However, I saw a doctor for about 1.3 minutes. Then my case was delegated to a Physician’s Assistant. I didn’t even see the P.A. very often…perhaps a total of 5 minutes. This was entirely inappropriate and was probably malpractice on the part of the doc.

Delegation is often appropriate. But the buck stops with you. You, as the business owner, are ultimately responsible for everything that happens in your shop. Make sure that your values, policies and wishes are being carried out by those to whom you delegate. And remember that not everything is able to be delegated. Sometimes “the doctor” needs to be in charge and on the floor.

9). Train your people in courtesy. There was one nurses’ assistant who was condescending and incredibly rude. Keep in mind that even the lowest-level people you employ, even a custodian, are ambassadors for your business. Rudeness or condescension to a customer should be a terminating offense. Also keep in mind that your customers are not always going to be sweetness and light. Train your employees to be pleasant and helpful even if your customers are having a very bad day.

10). Respond correctly to complaints. The response I got to my complaints about Sky Ridge was far from adequate. The patient advocate did everything possible to absolve the hospital of its incompetence. If someone complains about your business to you, immediately ask how they’d like to see the problem corrected, then, if possible, do what they ask. Some customers can never be pleased no matter what you do. But most people are reasonable and will respond well to a good-faith attempt to correct the problem.

11). The most essential part of a business is the personal touch. It seems to be the goal of the medical industry to dehumanize and humiliate patients. Granted. But, as a diabetic, I have seen my share of Emergency Rooms over the years. Sky Ridge was the worst. It was clear that I was only a number (or a wallet) to Sky Ridge, not an individual with needs and wants. Don’t be like this incompetent hospital. Make sure your customers feel that you are personally invested in their success and satisfaction, and not just interested in their money. As the chains monopolize more and more American business, the company that wants to both survive and thrive will make personal service to their customers a priority.

12). Most importantly — listen to your customers. The worst part of my Sky Ridge experience was the numerous (failed) attempts to start an I.V. line. Although I was quite clear about the most effective way to start a line in me (I am a difficult “stick”), my clear instructions were ignored. Finally, on the ninth stick an experienced vampire listened to me. Of course, the I.V. line went in immediately.

Medical personnel are arrogant. They rarely listen to their patients, although their patients often know their bodies best. The egregious arrogance of some doctors “trickles down” to medical personnel in general. But I’ve also seen arrogance in lots of other businesses. Granted, you know your business better than your customer. But your customer knows his or her needs much better than you do. Listen to your customer and believe what they tell you their needs are.

Needless to say, the next time I need to visit an Emergency Room, it won’t be at Sky Ridge. Keep in mind that customers talk, and disgruntled customers say more than happy ones. While no business can be perfect, keep the number of mess-ups to the absolute minimum possible and correct those that do happen. You will retain your customers, get new ones, and have a great reputation if you do.

(Calls to Dr. Steven Heinz, who is in charge of the E.R. at Sky Ridge, seeking his side of the story, have not been returned.)

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