The Trust Practitioners (cont’d): The Health of Service Excellence

The Service Line with J. N. Halm: It’s A Joke...employing Humour at the Front Line
J.N. Halm is a columnist with the B&FT

The flow of information and the communication in the office of Dr. Ralph Armah was most reassuring. As I read what I found on the Net in the full hearing of my wife, he took his time to explain the procedure he was going to use to solve our problem. He took his time to listen attentively to any concerns we had, answering our questions and dispelling our fears as flawlessly as he could.

We had such an open, honest dialogue about the situation. That process of getting us to be a part of the healing process was super important in getting us to relax and by so doing, earning our trust. We just knew the doctor knew what he was about.

You could imagine how difficult it was for me to leave my wife at the hospital that night and to drive home alone. I do not remember sleeping that night. But I believe the trust I had in the good doctor helped a little. Also the relational approach he took with us, gave us the feeling that he genuinely cared for us. That lessened any fears I had of leaving my wife in his care. The subsequent results of the procedure and the resultant healing proved us right. As a matter of fact, things turned out far better than we had expected.

I must admit that, at the time, I found Dr. Armah’s methods positively unusual. It was new territory for me. The doctors I have come across in the past were not that friendly, not that accommodating. They would not ask you to Google information about your predicament. True, Google was non-existent at the time but I remember those doctors still had their voluminous books sitting on the desks.

They could have just turned the page to where information about that particular ailment was and asked the patient to read it. They did not. The doctors I knew from my past diagnosed and recommended treatments. Plain and simple. They did not have time for all these exhibitions of agreeableness.

But maybe, that was all in the past. Maybe, just maybe, the new breed of doctors was really different. But if they really were, what about all the negative stories we still hear of and read about day after day? If medical practice has changed from the days of unfriendly doctors, why are there still stories of poor treatment of patients? It seems much might have changed but there is still more room for improvement.

In my many readings on the issue of service excellence, I recently came across a study that convincingly argued that if the medical practice is to become synonymous with service excellence, then we need more of the Dr. Armah’s approach than what I was used to in the past. The need for doctors to be more than just medical practitioners and more of trust practitioners was clearly alluded to in the said study. The relational approach to patient care is the sure way to go, according to the study.

It was a 2021 study that took the notion of trust even further. Published in the Mayo Clinic Proceedings, a monthly peer reviewed journal sponsored by the world-famous Mayo Clinic, the study intimated that what medical practitioners and their patients should seek is more along the lines of a partnership. Titled, Trust-Based Partnerships Are Essential — and Achievable — in Health Care Service, the study touched on four key concepts.

These are empathetic creativity, discretionary effort, seamless service, and fear mitigation. Empathetic creativity is the combination of creativity and empathy that helps the clinician see beyond just the normal procedures for healing. There are instances where health facilities have even resorted to the use of art therapy to help patients recover fully. We know of doctors who even use some forms of entertainment to help cure patients. Those are examples of creativity being used to foster healing.

Discretionary effort is about clinicians going the extra mile. It is about the one looking beyond the frustrations that come with the job and still offering the care that the patient requires to get well. Going the extra mile is also about physicians calling in on discharged patients and following through on plans they develop with the patients in a climate of mutual respect.

Seamless service is where all facets of the service experience are woven into one flawless whole. It is one in which interactions at the dispensary and outpatient department do not end up marring the entire experience. It is one in which an overzealous security man does not do something that spoils the experience. Seamless service requires the organisation putting in place measures that ensure that nurses at that wards do not maltreat patients who have had great experiences during the initial encounters.

Fear mitigation is about doctors using the power of communication to calm the fears of patients. Fear mitigation means health workers not making statement that will end up worsening the plight of patients. In talking to patients, the good physician is able to find out what the patient’s worst fears are and to communicate in such a way that those fears are lessened.

The study advised healthcare facilities to invest in organisational cultures that are high in trust. This requires a commitment on the part of the leadership of the facility to measure and reward exhibitions of behaviours and actions that lead to high trust. To ensure that there is a culture of trust, management of hospitals must put in place systems and processes that solicit honest opinions of staff.

Hospitals were also advised to hire “health professionals for their values, not just their skills”. This will be a far departure from the norm where doctors are sought after based on how well they did in the examinations. Under this regime, health workers would be hired based on the intangibles they hold dear. A doctor who values monetary gains more than the health of individuals would therefore stand less a chance of being employed.

Beyond having the right values, there is also a need for continuous reinforcement of the right values within the organisation. Knowing that people’s values can change, it is critical that the organisation regularly reminds workers of the things that truly matter in life. It is important for all health workers to be reminded regularly that the sanctity of human life should be placed above all else.

There is also the need for the promotion of continuous learning within the organisation. As previously indicated, there is so much information available to patients that if health workers do not upgrade their knowledge regularly, they would be found wanting. The organisation must necessarily invest in improving the skills, knowledge and attitude of its employees, doctors and nurses included.

Another piece of advice is the use of the appropriate language in all care interactions. The words used by the care giver and the body language of the one must be such that they aid in the healing process. We are told that action speaks louder than words. Therefore, a good care giver must ensure the she is projecting herself in ways that accentuate whatever messages she is communicating to the patient. Telling the patient that all will be well while looking scared is not the best way to go about communicating to patients. People can sense doubt so health workers must communicate with confidence.

Finally, the study recommends that health facilities make use of technology to provide ready sources of information to patients. Mobile apps and databases containing useful information can be readily accessed by patients to help ease their fears at the onset of certain symptoms.

From the ongoing, it is clear that trust is as important as the medical procedure or medication that is administered to a patient. Trust is responsible for the total—both physical and emotional— healing of the patient. In the times we find ourselves, the issue of trust is even much more critical. The high human-to-human infection of the COVID-19 virus means that patients are mostly isolated.

In August 2020, there was an article published by the Washington Post which argued that not having their families by their side was making patients even sicker. When patients are isolated from their families and are at the mercy of the system, it is much more important for the patient to have trust in the care giver. It is important for the healing of the patient.

Trust, as we have seen, is not an easy commodity to come by. The medical practitioner has to earn it and from the experience of many of our people, many doctors, nurses and orderlies have not yet earned the trust of their patients. If only trust came in tablets. If only trust could be placed in a syringe and injected into patients before any treatment commences. If only trust came in vials. Unfortunately, it does not. It takes work from good trust practitioners.

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