Scott McKain Viewpoint

In my experience as a caregiver for a terminally ill spouse, I learned first hand the importance of wonderful, caring professionals in health care – and, what a difference they can make, both in the standard of care the patient receives, and the piece of mind the family experiences.

• This weekend, I experienced very little “care” from the health care delivered by St. Rose Hospital at Siena’s emergency room. 

On Friday, my right knee felt a little strange – however, as I didn’t remember doing anything to tweak it, I wasn’t too worried.  When I woke up Saturday morning to find it extremely swollen, my attitude changed.

It was my decision to err on the side of caution. When my late wife, Sheri, had swelling and pain in her knee, it was discovered to be a blood clot.  I didn’t want to take any chances, especially since I hadn’t twisted it, or done anything to it that would make me think the swelling was injury-related.

Tammy and I looked online, and saw that while Sunrise Hospital had a seven-minute wait and St. Rose was reporting eighteen, the ER with the longer wait was also about twenty minutes closer to our Henderson, Nevada home.  We decided to go to St. Rose Siena to see what was happening to my knee – as the problem was becoming not only more swollen, but increasingly painful, as well.

After registering, it was certainly longer than the St. Rose reported waiting time before seeing a medical professional.  (And, I certainly understand that if someone with a situation more dire than mine arrived — which could have been almost anyone — that I would be moved back in line.  But, that wasn’t the case here.) Then, I was taken back to an examining room to wait for several minutes before someone came to talk with me.  Next, a technician entered to draw blood from my arm. Later, a nurse came in to ask questions, feel my knee, and say she was going to talk with the doctor.  Shortly thereafter, a doctor entered the small examining area where I was stationed.

He was very nice, and highly thorough.  He acknowledged that my symptoms were strange for someone not involved in an injury situation.  He said his three concerns were: blood clot, crack of something in the knee that became infected, and, gout.  He reviewed the blood work and looked at the area, then ruled out a blood clot.

He then said that the nurse was going to tap into my knee and draw out the fluid around the kneecap.  This would both relieve the swelling, and let them analyze the fluid to see if it was infected – which would necessitate my admission to the hospital to treat – or, if a lab test would indicate the probability of gout.

The nurse put a needle in my knee, and filled three large vials with the fluid from the knee – which were taken, supposedly for the lab to test and evaluate.  The doctor and nurse told me that I would have to wait another hour for the results, and then they would prescribe what would happen next.

• After TWO hours of waiting, I asked if the lab results were in – only to be told to go sit down, because the lab was running behind.  I was treated as though I was being overly demanding because I only waited one hour past the time they told me I would have to before I asked the problem.
• Another hour later, I asked again – only to be told the lab was backed up and I would have to continue to wait – even though it was three hours after their promise of delivery.

After one additional hour, I was informed they had made a mistake. 

While they were intentionally unclear about what had happened, either the medical team in the ER had forgotten to take the fluid to the lab – or, the lab had misplaced it – but, either way, the testing had not even started, despite my requests for results…and the brusque, rude response I had received.  I was promised the lab was working on it immediately, and we should know something in twenty minutes.

As it was now after 5 PM, and I had not eaten lunch, we went to the cafeteria for a snack, returning about a half hour later to the ER, hoping for the results.  Imagine our disgust to learn the lab wasn’t finished, and would need another hour or so.

• An hour later, when I inquired, I was told it was going to be another 20-30 minutes.
•  By this point, I have SEVEN HOURS invested in an emergency room, with still no idea what is wrong with my knee.

So, the doctor suggests that I am provided ibuprofen for the swelling, and a pain-killer — and I should go home.  He notes that they will call me with the results, so if it’s gout that is the problem, I can receive an additional prescription.

• It’s 3 PM Sunday as I’m writing this…and I still have not received a call about the results.

I did call St. Rose this morning – and was curtly and rudely told results were not provided on the phone, regardless of the identification (Social Security number, address, phone number, my doctor’s phone number) that I could provide.  In fact, no one would be available until Monday to answer my question.

Oh, I DID receive a call from the hospital – asking if I “was feeling better” – and asking for a customer service evaluation.  I suggested they should read today’s blog.

And, the representative apologized – but made no offer whatsoever to help me solve the problem.

When I speak and consult with groups of all types – and, because of my experience as a caregiver, especially to health care groups – I emphasize there are three levels of customer (or “patient”) interaction.

1. Level One: Processing – doing what I, the customer, have a right to expect you to do
2. Level Two: Service – making the processing of your effort efficient and productive
3. Level Three: Experience – creating an emotional connection to bond me with your organization through your caring and concern

St. Rose Siena failed miserably at all three.

• They advertised a waiting time they couldn’t deliver upon and failed to simply process my lab work as they had promised – on multiple occasions
• They displayed an astonishing lack of service or assistance to make my choice to use their services — instead of the competition’s — one that was efficient or productive
• No one – with the exception of the nurse who drew the fluid from my knee and, to a lesser degree, the doctor – made any attempt whatsoever to make a positive emotional connection that would make me want to return or refer their services to anyone else.

 Today – my knee is still swollen and hurting. 

And, I still have no idea why.

I wonder if any of them would find that level of performance to be acceptable — if they were the patient — at St. Rose?

Remember my post a few months ago about the email I received from Apple CEO Tim Cook?  He said, “Scott — our goal is that every customer feels just as you do.”

I wonder what YOU are doing to ensure that NO customer ever feels about YOU the way I feel today about St. Rose.

*****UPDATE*****

I just hung up from a call with the Chief Medical Officer of St. Rose.  To his credit — and that of the entire institution — he:

1. apologized for the situation
2. promised to look into the specifics and,
3. examine the process that allowed it to happen

If you’ve read my books, you know that I write that “customers don’t want you to make it right — they want you to GET it right.”  Naturally, I would have preferred that this would have been handled right the first time.

However, I truly appreciate it when the effort is made to make a situation right that wasn’t handled properly.  St. Rose’s Chief Medical Officer did that — and, I am grateful for his effort.