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Network Leadership

Nobody Likes a Healthcare Mystery

Jeff Doleweerd

Mysteries are fun to watch in the movies, but mysteries are rarely fun in real life.

  • It’s 4:00pm and your cable guy was supposed to show “sometime between 8am – 5pm”…
  • You ordered food at a restaurant 30 minutes ago and haven’t seen the waiter since…
  • You sent in an application months ago and were supposed to hear back by now…

Often the mystery while waiting is worse than the waiting time itself.  It makes us anxious and angry.  Our imaginations fill in the blanks with all kinds of worst-case scenarios (I’m going to have to wait at home again tomorrow for the cable guy … I’m going to get home really late after our meal, I’ll be tired at work tomorrow … I’m not good enough to get accepted to that program or ANY program).

In health care, mystery while waiting is routine:

  • You have been sitting in the ER for 3 hours due to a burn on your arm, and told there’s no way to know how much longer you will have to wait…
  • Your family doctor sent a referral to a cancer specialist 2 weeks ago because of concerning lab results…

The worst case scenarios get amplified when it’s related to our health. (I’m going to have a burn scar for life on my arm … I have cancer, and it’s getting worse while I wait. That referral must have gotten lost…).

Patients should not be burdened with this kind of stress-inducing mystery.

Are your patients experiencing mystery in your processes? What type of mystery? 

1) Shrouded in obscurity – The patient knows next to nothing about who they will see next and when.

2) Some clues are provided – The patient is provided an “educated best guess” about who they will see next and when, but will have to wait for more details.

3) Mystery solved – The patient knows exactly who they will see next, and when.

We have observed a lot of health care processes, and unfortunately 1) Shrouded in obscurity is the norm – even when 2) or 3) are viable options.

Moving from  1) Shrouded in obscurity to 2) Some clues are provided, is easy. Simply tell the patient what you know (e.g., How long did the last person like you wait? How many people are on your wait list? How many people do you see a week/day/hour? What determines how fast you will go through the line? etc.).  Health providers often leave wait information shrouded in mystery because they don’t have the exactly correct information or they have information that the client might not like. However, something is better than nothing, even if the information is not exact or not what the patient wants to hear.  Give a reasonable, conservative range based on experience and facts when you can’t be exact (1-2 hours, 2-3 weeks, etc.). If something highly unusual happens and you expect to go past the upper range, proactively let your patients know.

Moving from 2) Some clues are provided to 3) Mystery solved requires a strong process built on the quality improvement principles such as value flow and pull. An example would be a referral process where you directly book the first appointment for a patient with the referred service, providing the name of the person providing the appointment, the date, time, and location.

Solve your patients mysteries whenever possible, and they will have a much less anxious health journey.

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