Book: If Disney Ran Your Hospital: 91/2 Things You Would Do Differently

Author: Fred Lee

Publisher: Second River Healthcare Press, Bozeman, MT, 2004

Reviewer:
Darlene J. Johnson, MBA, CCRP, FAAMA
Program Administrator
Moffitt Cancer Center
Tampa, FL

This is one of the best books on healthcare management I’ve read in a long time. It is very entertaining, and it is filled with personal experiences and real life stories to back up the suggestions and ideas. Fred Lee has been both a senior vice president at a major medical center and a cast member at Disney University, so he brings his insight from the front lines and adds the Disney approach to his management style.

This insightful book suggests that our traditional methods to examine procedures in hospitals and improve efficiency may not be the answer to productivity. Mr. Lee suggests that a culture of courtesy----placing service above efficiency----will occur as internal customers (across departments) begin to work together to reduce inefficiencies in a culture of teamwork and responsiveness instead of competition.

Because I come from Florida, I’m very familiar with the Disney philosophy of customer service as a priority. And as Mr. Lee points out in this book, all businesses are now compared to Disney. Our competition is anyone with whom the customer compares us, and the engine for growth is patient-perception. The author suggests that we focus on what can’t be measured, rather than on patient complaints. Press Ganey and Gallup have been in the patient-satisfaction survey business for many years; their top drivers of patient-satisfaction relate more to perceptions about how one is treated as a person than to clinical competency. This is a difficult concept for the traditional healthcare manager who is very process-driven. Mr. Lee suggests that the road to patient-satisfaction is to emphasize courtesy over efficiency.

Exactly how do you gauge satisfaction? Disney strives for “very satisfied” as their measure. Mr. Lee quotes a Residence Inn manager as stating, “If we don’t do something special for our guests, they won’t remember us. And if they don’t remember us, why would they come again?” It is suggested that we work to improve, not to impress. Promoting customer service to increase loyalty is more important than providing customer service that merely satisfies. If all you want is satisfied, then a “yes” or “no” will suffice. Very satisfied customers promote loyalty, and patient loyalty is too important to be blurred by satisfaction. Mr. Lee suggests that even lower-level employees be empowered to make the customer happy. By the time a manager or vice president has to step in to make something common-sense happen for the patient, nobody wins and the customer is not impressed.

The author suggests a shift in language from service and courtesy to one that highlights experience and theater. Hospital guests don’t talk about the services they received----they talk about the experiences they had. When the goal of hospital workers is to provide the patient with a memorable experience, rather than just give excellent service, a true paradigm shift will occur.

Mr. Lee goes on to talk about harnessing the motivating power of imagination. He recommends reading First, Break All the Rules by Buckingham and Coffman. He states an example of their thinking: “Every role, performed at excellence, requires talent, because every role, performed at excellence, requires certain recurring patterns of thought, feeling, or behavior. This means great nurses have talent. So do great housekeepers and teachers.”

There is also a chapter on dissatisfaction. He states that dissatisfaction (with the “as is”, or status quo) is the father of improvement. And, if dissatisfied with the “as is”, dream of the “could be” and make it happen. Disney does not focus on employee satisfaction. The pay is relatively low, and the company’s rules and regulations are very strict. What Disney does do is recruit self-motivating people with an enthusiasm for creative opportunity and a love for putting a smile on other people’s faces. Those employees who stay with Disney have a fanatical devotion to creating a magical experience for children and adults of all ages.

And the final chapter----close the gap between knowing and doing. It takes a strong “want to” for a manager to have the energy to figure out how to implement a new program with full support from the staff and pull it off. Great managers, like all great performers, will make this look easy!

Reprinted with permission from the Journal of Oncology Management, September/October 2004, Volume 13, Number 5.  Copyright 2004©, American Academy of Medical Administrators.   All rights reserved.