By Annamarie A. Fuchs, Creator. Partners in Health | Conversations.
“Two things remain irretrievable: time, and first impressions.”
Years ago I attended a conference where the speaker from a large private healthcare organization in Eastern Canada talked about a crucial role that existed within the organization. That role was entitled “Coordinator of First Impressions.” She described the organization’s recognition of the strategic and personal value of making people (clients, staff, family members, and the public) feel comfortable and welcome from the first point of contact and throughout their entire experience. I’ve never forgotten that. Sitting there I thought back to so many moments more than 30 years ago when family members would stand nervously at the nurses station, waiting for someone to speak to them. Eventually someone would look up and acknowledge them while asking vaguely “what can I help you with?” I’ve had dozens of people tell me that they’ve stood at desks like that and waited 15 minutes or even longer while several people sat within inches of them, appearing to completely ignore them. It drove me nuts as a young nurse when I saw my own colleagues disregard people that way. As a family member who’s stood in that very spot in front of nurses stations, diagnostic imaging desks, and doctor’s offices, I can tell you that it has felt disempowering, embarrassing, and even frightening. So many times I’ve wondered why it’s so hard to just be warm, welcoming, and calming. It takes seconds to put someone at ease as far as I’m concerned. And I’ve wondered why, in health care, we don’t recognize the incredible importance of ensuring that people who stand nervously at our front desks and information desks need to feel like they truly matter to all of us.
I spoke with someone this week who was scheduled for a repeat mammogram. She is young, in her 30’s and a mother of two. Months ago she had a breast lump that was investigated and fortunately, appeared to be non cancerous but the surgeon explained that she still needed follow-up and undergo a 6 month repeat mammogram. So imagine her state of mind as she approached the front desk at the imaging center. She was nervous and likely a bit frightened. I know I would be. Because of COVID-19 she couldn’t have anyone with her – yet again – and frankly she no doubt preferred to be just about anywhere else at that moment. But her health is important to her. She didn’t have a requisition but she had been given an appointment for that specific date and time which had apparently been arranged from her physician’s office. Here’s a paraphrased description of the encounter she relayed later to me about what took place when she arrived at the imaging center only to discover that her appointment couldn’t be found.
Front desk staff: “Do you have a requisition?”
“Well you’re not on our list. Do you go to the pharmacist without a prescription?”
“Well we are about the same here. We don’t do mammograms without a requisition.”
Done. The conversation was over. The individual summarily dismissed her. She stood there, uncertain about what to do next and ultimately left. We were talking later and she mentioned that she’d had an experience that made her feel uncomfortable. I’d say that may be the understatement of the month.
How do you suppose that young woman felt? Would you like to know how I felt when she told me? I was angry. I was embarrassed. I was ashamed that our health system is frankly quite fairly judged by the public based on these sorts of experiences. It’s fair because this happens every day. But what’s unfair is that there are people who do care and who do recognize the value of making people feel comfortable and these sorts of behaviors fall onto them as well. But even more importantly, I was frustrated that this woman who needs a re-evaluation not only didn’t get it but has to arrange to see her physician to inquire about how to proceed and ultimately wait for who-knows-how-long before she gets that imaging done. She’s probably fine but what if she isn’t? How many stories have you heard about the devastating effects of unreasonable wait times in health care?
I don’t think I’ve ever seen values statements in health care that say something like “we’ll get to you when we can” or “high quality service will be provided when we have time” or “we care but please recognize that we are very busy people.” I know I might be offering a wee bit of tongue-in-cheek attitude but why do we have values statements in the first place if they’re not actioned by everyone? If we don’t make an effort to ensure that everyone in our system contributes to making them real to the people we serve, then what’s the point?
First impressions should be a means of actioning the values we champion in every health system. They might offer a reminder to the fact that, as healthcare professionals, virtually every face you look at in health care is likely attached to a person who is worried, nervous, frightened, or who is accompanying someone who is experiencing all of those emotions. Healthcare can be a scary place on a good day. Every person would probably prefer to be anywhere but in front of you at that moment. And every single person has a story, needs our help, and wants to trust that we all care and we all will all do our jobs to put them at ease and to help them receive the services, the answers, or the compassion they need at that moment.
If we believe we want to transform health care; if we believe we want to create person-centered care, then we need to start with that very first point of contact and make every single experience with the health system valuable. Frankly, we need to care enough about every person’s role in the system so that we’re willing to see that individual at the nurses desk or the information desk as our “coordinator of first impressions” whose contribution to saving lives is every bit as essential as the surgeon’s role or the nurse’s role or the medical imaging technician’s role.