Key Words at Key Times
By Mark Lerner
A few years ago, an associate administrator at my hospital introduced me to
the subject of key words at key times.
Or, as the subject has been known in the
past: scripting. When he first described
the notion of using a prescribed phrase
during particular situations I didn’t like
the idea. I thought it would make staff
sound robotic. But there were a couple of
situations that make me realize that the
concept could have a powerful impact on
patient perceptions of care.
The first hint occurred during a trip
to Chicago for the annual RSNA conference. My wife joined me and as we were
leaving our hotel room to check out we
noticed a housekeeping cart to the left
of the room’s entrance. Standing next
to the cart was a housekeeper, and when
she saw us approach with our suitcases
she said without hesitation, “I hope you
enjoyed your stay with us and when
you return to Chicago you will consider staying at our hotel.” It was obvious that this employee did not make up
this sentence when she saw us leaving.
The staff member had been scripted to
say this salutation when she came upon
guests with bags departing the property. The scripted phrase impressed me.
It made me feel important. I believe I
reflected to my wife that perhaps we
will stay at this hotel when we return to
this city. The comment also gave me an
extremely favorable impression of the
hotel’s management in that they spent
the time and money to train their staff
in service excellence.
This was my first hint that there was
something to this notion of key words
at key times. The next example came
directly from my department.
We have five MRI scanners in our system; however, for a long period we only
had two. It was common during this
period to get phone calls from patients
requesting to get their scans completed
that day. Here is what we would say:
“Sure, come over at 9: 30 AM. It may take
three or four hours for us to get you in for
your study, but we will get the test done.”
Each and every day I would have patients
lined up at my door upset that they had
waited three or four hours and had not
had their exams. One day a patient made
me understand why this was taking place.
She was crying in my office because she
had taken off work, had not eaten, and
had waited four hours for her MRI test
without it being done. There is no service
recovery that can be realistically done at
this point. She left my office dissatisfied
and I went off to lunch. When I returned
there was a message on my voicemail
from this patient. She said that she had
forgotten to tell me something when we
met. She added that when she called to
arrange her study a technologist had
told her she was an “add on.” She said
she didn’t know what that was and she
didn’t want to be one of those.
As a result of this message it was as if a
light bulb went off it my head. It became
clear that the words my staff were using
for work-in patients made them believe
they had a 9: 30 AM appointment. From
the day I met this particular patient I told
my staff that they were to no longer use
the label “add on.” It was derogatory. We
now refer to same day cases as “fit ins,”
meaning these individuals are being fit
into our schedule.
Mark Lerner is the director of diagnostic imaging at
the George Washington University Hospital. He can
be reached at Mark. Lerner@gwu-hospital.com.