This exercise was designed to encourage discussion of the most appropriate ways of communicating with patients as clinics start to reopen post lockdown. You were asked to consider the following scenario.
You decide to run a staff meeting and refresher training session to help get through the situation. Consider the following points for discussion:
- What are the key verbal and non-verbal skills that you feel are most important for you and your staff to deal with the situation?
- Should you ever have to do anything like this again, what lessons could you learn to avoid the problem arising in the first place?
Responses
There were some very comprehensive discussion reviews. Here is just a sample of points raised in your discussions.
‘Good communication skills are key in every aspect of life be it at work or indeed at home and at no time perhaps more so than now during the current Covid-19 pandemic. Your customers are the life blood of your business and should be treated as such!’
‘Be conscious of the fact that many customers will be feeling anxious/frightened about returning to public spaces and that it is quite possible that they have lost family members to the virus. Be empathetic to this and it will be especially important to not only use appropriate language but to also display active listening and appropriate body language to demonstrate to the px that you are understanding their situation.’
‘Having re-opened, it would be pertinent to remind the team that “first impressions count”. In fact, you have less than 10 seconds to make it! Remind the team of the importance of smiling (even when answering the telephone), NOT a big cheesy grin but a simple upturning of the corners of the mouth will suffice perhaps accompanied by a cheery ‘hello’. Even with a PPE mask in place you are still smiling with your eyes and your customer will know if you are scowling behind that mask! Make eye contact with your px as this gives a clear indication that you are aware of someone’s presence and that you will help them as soon as you are available, ie when you have finished a telephone call perhaps. It is also important to use open arm gestures when greeting someone as these are very welcoming and non-threatening. In particular, avoid pointing especially with a pen in hand, any gestures with an open palm indicate an invitation (such as to take a seat in the waiting area) rather than an instruction to comply so are far more friendly and welcoming.’
‘In the unfortunate event that anything like this pandemic should happen again there are a number of steps it is possible to take to avoid causing any customer issues. Firstly, be empathetic. Put yourself in your customer’s shoes, how would you feel about your first reminder/communication from your healthcare provider?’
‘Place the emphasis on the healthcare aspect of the eye test rather than a supposed outcome of the need for new spectacles. Be clear about the steps you have taken in store to ensure the safety of customers and team members, such as enhanced cleaning protocols, queueing/appointment only system and so on. Perhaps, outline the benefits on any new pieces of equipment installed since their last test, such as an OCT, fundus camera again being careful to avoid jargon and overly technical descriptions.’
‘The key is reassuring patients with well trained staff and relaxed, professional communication throughout their visit, from the triaging pre-consultation questions which should help make the patient feel safe, to temperature taking on arrival and staff using appropriate PPE being visible. To achieve this, our discussion centred around:
- Separate routes for eye exam patients and dispensing patients, the latter guided into a specially designed dispensing area with all the necessary safeguards in place
- Adherence to a limited number of frame try-ons which are disinfected after the patient’s departure
- Clear discussion and continual explanation, all in a friendly professional manner, of our safety measures. For each process, it is important to make the patient feel at ease.’
‘The first thing I would do is to let the staff know that the
buck stops with me. That if they are ever uncomfortable dealing with a patient that I will take responsibility for the meeting and step in either there and then or later if that suits the patient better.’
‘We would need to look at conflict management, how to diffuse a situation. I am not a fan of role-play as a learning tool and, in training sessions with my staff, we have developed a peer review style of working through problems. I feel that the team we have learn well from each other. Initially we would probably discuss the problem in general. Ask for examples of when things have perhaps got heated. From the scenario presented it appears that these have been identified as:
- Insensitivity to relatives of deceased patients
- Lack of available appointments for those who consider their case urgent
- General boiling over of emotions following Covid captivity
- Lack of understanding of PPE.’
‘The understanding of PPE could be addressed through pre-appointment phone calls and this can easily be added to the pre-appointment triage call. It would be worth designing a flow chart to guide staff through this element of the call and ensure that a consistent message is projected. In practice signage both regarding adequate social buffer space and protective equipment and changes to the traditional eye exam would be beneficial.’
‘As we see a number of patients with low vision and learning disabilities, alternative forms of communication will be available. This does also bring the issue of companions and chaperones to the fore and again this will need to be discussed before the appointment.’
‘The lack of appointments will need to be urgently addressed. Demand can be moderated through the reminder system. Fortunately, the “culprit” is obvious to all so there is an understandable reason for delays and teething troubles on reopening and, hopefully, appeals to people for understanding will be beneficial in the majority of cases.’
‘Quality of life has always been an important goal for me in my staff. This has resulted in an open management style, where staff are kept fully aware of all decisions and challenges that the management team face. This would result in regular support for all members of staff that are furloughed; from phone calls to small presents just for “sticking with us”. We have also managed change in the past with transition of ownership etc and this has created a strong bond which will serve us in good stead.’
Looking Ahead
‘Were a situation like this to occur in the future I think I might address patient communication slightly differently and, rather than a “we are open again” letter, approach it with an ongoing newsletter. Making it a community of patients. Offering advice on common minor problems. Educating as necessary and also preparing patients for changes as we reopen. This might be an article on how the practice has been ‘refitted’ to maintain safety. So not overtly ‘selling’ the practice but more informing.’
‘As we go forward from this, I think one of the big lessons is that the patient journey does not start as we take them into the consulting room. It actually starts when the patient decides they need a visit. If we take this approach, we can adopt a mindset where we do not need to do everything on a single visit. We can triage over the phone and obtain information before the patient arrives. This will be beneficial as it will allow us to look up things such as less common medical conditions, peer review approaches before we see the patient, and so on. It will require a change of mindset and accurate record keeping, but should increase the value of the exam for the patient as they get more (of what they want) from the exam. Better medical care, more appropriate lifestyle advice/dispensing, etc. From an optometrist point of view, we should have a better quality of life as we are not constantly thinking on our feet but entering the exam prepared for each individual patient.’
Ian Davies comments: The feedback was excellent and touched on all elements of communication. From my perspective the key points to be drawn from the exercise were:
- Recognise the level of disruption that the lockdown has created in everyone’s lives, your own, your staff and your patients. You should be having honest and open conversations about how everyone feels about coming back. Try to build a sense of what the likely accepted patient beliefs are likely to be and discuss these with your staff so that you can be ready to address concerns from your patients in a proactive and empathetic manner.
- Someone made the good point about the patient journey, which may be different in a Covid safe environment. It is important to focus on the first 10 seconds of each stage of that journey. Body language is key to reassuring patients and the points about open arm gestures, genuine smiles and making appropriate eye contact were all nicely bought out in the feedback.
- Finally, the maintenance of regular feedback whenever there is business disruption is critical. The more you can communicate on a regular basis with their patient base about what is happening and how the practice is managing, keeping health at the forefront, the more prepared the patient will be for the new experience.
Ian Davies is an optometrist now working as an independent motivational speaker, coach and business consultant.
- Communication Interactive 2 is still available online at opticianonline.net.