Keep 'Em Happy: Customer Experience with Wayne Paradis

Today I have with me a dear friend and colleague from my workplace, which I will not name, except to say that we both are at the same Augusta Waterville area Health System. And this is our patient experience coordinator, Wayne Paradis. Thanks for joining me today. It's absolutely my pleasure to be here, Lisa. You and I actually share something that I think almost immediately when I joined Maine General, I could tell we we were gonna be in sync about, and that is the importance of making the patient experience a good one. Because healthcare these days, I mean, it already is stressful 'cause people come in to see us and they're upset, or they're in pain or they have questions and uncertainty. So it's just right outta the gate. It's a very difficult thing to be in healthcare, but there are ways that we can make it more or less uncertain, you know, more or less scary. And I have always thought, you know, that really should be a big part of my job. And that is essentially the entirety of your job. It is. So tell me about your job and how you got to be a patient experience coordinator. Well, Lisa, I had a very circuitous route to the role i I hold today at our work, at our workplace of, I began as a way back, as a stay-at-home parent, believe it or not the only guy in a field that was largely female. and it was through that work that I learned quickly how to socialize with just about anyone. And when I came back to the workplace at the place we work now, I, I meandered through in different roles, starting in prevention. Then I, I worked in as a health coach for the organization. And what ha something interesting happened right at the beginning of the pandemic many staff where we work were redeployed. and I was redeployed to our cancer center. And in that capacity much different role screening people for c I D and it was through that process that I watched people at their worst days of their lives come alive as a result of how I interacted with them to the point where they made me a badge that said And while they might sound a little a, a little you know, silly, it was a badge of honor that I carried very closely. And as it turns out what was happening there at the, at the entrance of that facility essentially was shaping that patient or each individual patient's experience. And it was noticed by others around me that this guy's got a knack for turning the mundane into something that's pleasurable for other people. And one thing led to another an opportunity opened up where we work and I was gratefully chosen to carry on this important work for our organization. And that is the ideology of how I became where I am now. And frankly, I love coming to work every day because I know individually we can make differences simply by being present with people and doing those small things that don't tell the patient or, or suggest to the patient, you know, what's the matter with you? But rather what matters to you. I think I first met you when you were still doing prevention and you came in. So our organization has a two day orientation and we, we call the first day day one, not not a super creative name, but I'm not criticizing it, is day one. And you came in and you were talking about wellness with a group of people that you'd never met before, kind of a disparate mishmash of, we had some administrators, we had some doctors, we had some front office staff, housekeeping, and you're like, I'm gonna get everybody excited about healthy living and prevention and, you know, like wearing our Fitbits and wearing our sneakers and like, what can we do for you to make your life better? And I could tell that day that you had this background in health coaching that you're like, I, I'm gonna try to get this group excited. I don't know them, they don't know me, but I'm gonna try to get this group excited. Why did you go into kind of the area of health coaching that you started with? Where I first intersected with you, I was always fascinated by behavior change and other models for, for behavior change, whether it's the trans-theoretical model motivational interviewing. I really enjoyed psychology and social sciences. And what health coaching did is it put me in a place to kinda kind of draw into what was, I'd like to think innate as far as, you know, where my strengths lie. And amusingly in a way as this translates very clo closely into my current position. You know, with patient experience, it's leveraging behavior to create sweeping change in our, or, you know, or continued po process improvement changes with our, with our entire staff to affect a change that builds loyalty at our hospital, people don't always remember, you know much about their appointment. They remember how they felt, they remember how folks interacted with them. This drives loyalty, you know, as much as oftentimes as much as the clinical outcomes that they potentially get down the road. So did you major in psychology as an undergraduate or do you, did you have any sort of academic background? sociology. and, you know, the, that can go a lot of ways. you know, vocationally but I was drawn to, drawn to cognitive behavioral work and aspects of behavior. that background drew me to this type of work and, and my predecessor, he saw that in Manie, and he, he said, you ought apply for this when, when, when I retire. And it was, you know, it was absolute an absolute honor to be, to be esteemed as highly as that, to step into someone's shoes that had done things so well and paved the way. So here I sit continuing to vol evolve with everything that I've learned and everything. I continue to learn in the name of what will keep our patients coming back, but not just because it's a game, but because this is really what people need. And, and that understanding of people and that background in sociology, I think is so much more necessary than sometimes we think, and, and actually our, our new slash current c e o from the healthcare system we work with this person's background was actually in sociology. That was his undergraduate major at a small liberal arts college, which, and then went on to get a business degree. But I just think that that's so interesting that that was where that person's mind went initially, because understanding where people are coming from, kind of either scientifically or just behaviorally or interpersonally, I mean, it just, it makes such a huge difference as to how much you can affect change. It absolutely does. And for so many people, no matter what it is, whether it's your mechanic, the dentist, if someone gets the sense that the relationship is transactional in nature, really think about that. They want my money. This is just in and out. Nothing personal about the experience. I'm woo wible elsewhere. I wanna go someplace where someone knows who I am, uses my preferred name remembers things about what I shared with them the last time. These are quote unquote soft skills. These are critical skills. These are skills that keep any, any organization healthy. Starbucks, you name it. If they do these things better, they're gonna gain more market share. Coffee's the same pretty much everywhere. I mean, I suppose I'm a, I'm a, I'll admit off the record, since no one's watching this, that I'm a coffee snob, so I have my preference. But with that said, coffee's, coffee, groceries, or groceries, people go to certain places. It's because of their experience there, their loyalty. That's, we drive that every day with every interaction we have with every individual person. One of the reasons I wanted to have you come in and talk with me on this show is because I had watched a grand rounds that you gave, and it was about communication, which of course we're, we're talking on a show. So it's about communication, right? So for me, this is extremely dear to my heart. And I've heard people say, well, you know, what difference does it make? They're just words. It's just semantics. And I'm like, I do not believe in that at all. I think words are everything. They're, and how they're delivered is everything. And so, when you are giving this grand rounds, that was so kind of focal to the message that you were sharing did somebody ask you to give that grand rounds about communication and patient experience? Or was this something that you came up with on your own? It's something I came up with on my own, because what underpins most dissatisfaction in any experience is a lack of communication. people mean well but that doesn't mean the words that folks use are gonna align with their meaning. many studies show that our words are just a small part of our communication. Our body language is the biggest part. Our tone. I could say something that sounds creepy and, and then the next sentence say the same thing, and it sounds welcoming. How are you, how are you? Right? There's two different things, same words. And we have to be absolutely cognizant of the tone. We use our word choice how we apologize, how we do service recovery. If we do these things in a way that blames someone else or puts them on the defensive, you know, we, we are swimming upstream at that point. So it's absolutely crucial to challenge our teams to look at how individually they communicate with our customers to ensure that people are spreading the word about this. There's an expression when you're good, you tell people when you're great. People tell you, I use this analogy a lot. We all know that singer who says they're a good singer, and you know, well, I'm sure you are right. But if we hear that from somebody else, all of a sudden they're a good singer. And any hospital, any restaurant, any ice cream shop, when it's great, people tell other people about it. And we wanna be who people talk about. For all of the reasons mentioned before, it's been Difficult during C O V I to try to get back to a place of, of I think, mutual kindness within healthcare. I mean, everybody right now is still feeling a little less resilient than usual, a little more tired. we're still working through things that happen maybe with our kids or our parents and, and, you know, the adjustments we had to make, it's getting better. It's over time. But I think oftentimes because again, we are the interface where somebody comes in to see us when they're feeling their worst in healthcare, it makes it really hard because in healthcare, you know, you and I never stopped working. We were there through the whole pandemic. We, we were not taking time to walk in the woods or you know, somehow replenish our souls. I'm not sure that anybody else truly was either in Covid, just to be clear. But how do you help people on both sides who are already feeling a little sensitive, a little tired, a little less resilient? How do you help them understand one another and come to a place where you can say, listen, I got you. You know, you are not in your best place, but let's, let's, let's try to work together on this. Well, related to my role specifically I, I have the good, the good fortune of bolstering our staff with our positive feedback from our patients every day. One of the joys in my work is to find something very, very personal that I can, that I can share directly with our medical staff. Heck, our nurses, our janitorial staff, it's irrelevant who it's about. If it's personal, it has detail. I want them to know what they did to touch somebody else versus the vague feedback of they did great. That to me, that's, you know, it's nice, but I want the details that A, reinforce the behavior. And b, bring a huge smile to someone's face to know that what they do matters, what they do will, you know, there are things they do that can fill their own cup, you know, for, on the, on the patient side, I, I hear a lot of things that we could do better. It is one of the joys of my work also, is to talk with these folks to learn what we could do better and to validate where we could improve and to restore their faith that their voice matters. And, you know, ideally earn their loyalty back. Not with words, but with, with, with our proposed actions for the future. So it's really both sides I get interacting with, with both, with both segments of, of the, of of those who interact through the patient experience is where the groundwork happens and where, where I come alive as an employee. Because you and I work closely together on multiple service lines. Yes, I, I get to be the recipient of your emails that detail out patient experiences across the board. There's one favorite email that I think is maybe a monthly email that starts with all of the patient comments that are essentially like a level zero. Like these are the worst things that have come across our desk. And thank goodness we get to the end of the spreadsheet and we get all the, I don't know what it is, level five or whatever the highest level is. And there's some great comments, but wow, it is so hard to read through all of the comments because people do have a broad range of experiences and not just our health system, every health system. So how do you help people accept possibly the negativity of the comments, but also learn from them? Great question. It stepping back patient experience on the whole, it really comes down to one word. It's not whether we provide great care, it's the patient's perception that we provide a great care. We wanna provide, we're gonna provide great care, but if the patient thinks we are doing other things that they weren't present to them, they could rake us over the coals for that. And that's their right. So it's an opportunity, number one. It's really, it's really a conundrum in a way. In the past I used to put only the top ones on there, and then I'd put the, the nasty grams at the bottom. And what we found is that, you know, people ran outta time. It's a lot of, a lot of feedback. And people didn't read those. And yet, where's our opportunity? How, where's our service recovery opportunity? Where's our fact checking? We, there was so much to learn from that. Sometimes it's entertaining. I mean, there are a variety, a variety of, I mean, you know, you've, you've, you said, I really like this comment, which I very much appreciate that these things are looked at and considered. it's not just that email, you know, you mentioned this email, this monthly email that comes in. Ideally it's delivered in a way that invites our leadership to look at it versus Oh yeah, that patient experience stuff. Like, oh, what is there for me here? What's highlighted that I can really learn from? And how do we grow from an organization from this? And anybody watching this, like all feedback, you may wonder you get that, that survey call and you, you know, is anybody gonna do anything about this? We look at every piece of feedback. We challenge change in order to make experiences better for everyone after that point. So the comments that you receive are, yes, that is a batch, right? We take the learning nuggets from that batch for our change, and frankly, we take the positive feedbacks and we, and we glorify the great things that we do too. 'cause the lion's share of, because our feedback is incredible. And it, it, it, there's nothing I like more than to validate that work as soon as it comes into me. There are a range of comments. You have to take them where they're coming from. One was the ice didn't taste as good at, at this organization, at this institution, as in other places that I've been to, or maybe McDonald's. I don't remember exactly what the comparison was. And I was like, oh, I wonder what I could learn from this. I mean, maybe there was something bad going on with the ice in that machine that Day. Did you go down to the ice machine and give it a try or what? I Mean, actually, I regularly have water with ice in it from our cafeteria and our coffee shop. And I've actually never had a bad batch. But that doesn't mean that, you know, this person didn't have a bad batch at some point from one of the nursing units. I don't really know. But it, it is, it is always interesting too that you actually have to be open to getting all the feedback and saying, all right, well maybe there's nothing we can really do about the taste of the ice. 'cause maybe it's just related to the taste of the water, and maybe they're on chemotherapy medicines that maybe cause their taste to be off. but always being like, okay, what, what do we learn from this? What can we change? What can't we change? What do we just have to accept? And it's, it, there's a lot of different directions you could go in. I mean, you could really be chasing down some of these comments. Like that could be your whole job all the time, which I guess is, is sort of your job, right? All the time. It is and you're right, right? It's, it's, do we pursue the ice? Do we, you know, do we have a, you know, the equivalent of like a, a blind taste test of all the ice on the floors? You know what I mean? That's, of course, we're, that's probably not a level we're gonna go to, but perception matters, perception's reality. We know that experience can be marred by one small thing across the entire continuum of their care. it's everyone. And also everything people encounter. We can be dazzling in charismatic and remember names, children's names, you know, how their child soccer travel soccer league went. But if the ice wasn't great, and we may get a marginal review from that patient. So it's critical that we don't necessarily poo that, but we really look into that, you know, what, what could we do to change this? And much of that feedback drives our change too. And we look, we look at that stuff, it matters to me. It matters to my leadership. And it will continue to matter. And I Think it is, I mean, maybe this is actually an important thing for people to know. I mean, when you send these forward to me, you know, the chief, the other chief medical officers and I, we actually, we read this and we read our, we read the daily risk report with all of the issues that come through that are potentially a little hazardous to patient health. We read the patient advocacy advocacy report that comes through with all of the comments from patients who are concerned that their care wasn't at a level that they wanted. We read the patient experience comments. So if anybody's thinking that this is going into a void, I can't speak for any other person in my organization, our organization, or anywhere else, but I personally am reading these comments, and I think a lot of senior leadership does take these things very seriously. Agreed. And in what you say is a hundred percent true. that's why we, you know, where I work, I believe that it, we have a world class leadership looking at the voices of our patients for continuous improvement period experience more and more, whether it's liked or not, it drives future loyalty, no matter the business. And more and more emphasis. I mean, there is even things like reimbursement attached to patient experience when we do this well, I mean, where do you wanna send your loved one? A place where staff don't listen well, where there are lots of falls, of course not. So savvy consumers can look up this information and if they have a choice, they can send their loved one to, you know, hospital B if hospital A is, you know, something they perceive to be not the ideal health healthcare experience for their loved one. I mean, so it really does matter. We measure lots of things. We want to be seen as the best. And it's, you know, it's something that I go to work every day ensuring that, that we do to the, you know, the limits of my abilities for sure. Which I still haven't found. By the way, I'm, I'm wondering if you have had the same experience I've had, which is that as I've worked with people that maybe finished their education or even started and finished their education during C V I D, that because the lack of interaction with humans other than audio visually was, was their experience of education that, that when they actually reemerged into the workplace as perhaps young professionals, that they had to almost get skilled, retrained, re-skilled in how to be a human and engage in human conversations. And I'm not even just saying the younger people. I'm saying maybe there's a group of people that like, as a result of being not with other humans for three years, reemerged into the world and didn't know how to play in the sandbox. Well, have you seen that in any Way? You know, in many ways the, the pandemic became a loneliness pandemic for a lot of folks. Sure. Our youngsters, but even those who are isolated at home. and, and that is very, you know, we're, we're cognizant of that even from a training perspective. Like all our new staff receive patient experience training now, so that way the person checking in staff is, isn't feeling awkward about it. They know the, the best practices that reduce anxiety for those coming into the building. Those who are coming into the building may be in that post pandemic, you know, coming out of that loneliness place feel like, to admit loneliness. And it's like, it's like fear. We'd much rather, you know, express anger than to admit that we're hurt or afraid. You know, these are just human conditions. And loneliness is something too that in a way, you know, could carry shame, right? So in order to alleviate a lot of that, we train our staff on how to, how to essentially engage with someone that reduces anxiety right from the get-go. And it's really not, quote unquote rocket science. It's a warm smile, it's eye contact. It's using someone's name. Someone knows right away if you're happy to see them, or more bluntly, who the most important person is in the room, you know, right away. So it's critical that we set the stage appropriately. I mean, we don't really know. You can say, oh, so-and-so is a great doctor, physician, assistant nurse. but unless you're actually in there with that patient, it's really hard to know how that back and forth goes. So for me, I find it just fascinating and very helpful sometimes. Do you do that kind of shadow rounding yourself Occasionally? Yeah, absolutely. It's an initiative that I, I want to take on moving forward to have a, a more consistent and, you know, those listening more consistent, still a vague term, but have it be something that is a prioritized aspect of the work. it's one thing to shadow around, it's another thing to see someone who doesn't have a witness, right? You get, you're likely to get someone at their best, which is great, but it's still that opportunity to give feedback to someone, which is a, a I say a, a a fun thing to do, you know? And there are elements of giving someone that feedback where they hear it, where they will accept it and they'll grow from it. And I think from your shadow rounding, you, you know, you may come up with the same, you know, opportunities where, you know, if you're resistant to, if someone's resistant to feedback, it's, it gets you into that then what dynamic. But like anything developing relationships with those staff, that shadow rounding occurs with it, it sets the stage for that authentic feedback. 'cause at the end of the day, our staff want to grow and they want to be their best. And I, I, I think that those, you know, those characteristics alone, make, make that process, you know, make those staff open to feedback. I welcome all shadowing opportunities, mentoring, facilitation, you name it. Anything that, that will make our brand, our, our our patients in general more, more pleased about their time. Bring it on. Yeah. And, and I feel the same way. and also I, I went to shadow in the emergency room recently because that's one of the surface lines that I work with. And the person I think was so concerned that I must be doing this because this person had done something wrong that literally the person couldn't make eye contact with me for the first 10 minutes. They just worked on the computer and didn't really say anything, didn't really talk to me. And then, and I, I was, I was like, I just wanna be really clear here. I'm just trying to learn, you know, I'm not, I'm not here to give you advice. I just wanna know what is it like to be a practitioner in the emergency room? And I think allowing that person to understand that, look, you're the expert here. I, I'm not trying to be intimidating, but I, but I think it is sometimes intimidating. Of course. It's, and I think obviously, if you have somebody who's one of the chief medical officers come in and is following you around, you're thinking, oh, is my job at risk? But how do we create that place of comfort where we say, look, we're just, we're a learning organization. We just wanna learn from what you are doing in, in your work. How do we do that? I think what's been helpful, at least for me when I, when I go out with charge nurses or nurse managers who are new to their roles, their leadership is very much pushing it as an opportunity to get this right. what I found in my rounding with some super clinical staff who might not have the same background as I do, is it's very much like, how are we doing? Are we responsive? Anyone you wanna recognize? All right. You know, very, and you know, my, my my example is a little exaggerated for, for purpose. whereas my approach is, is, you know, what would you be doing if you weren't in the hospital today? And yeah, what did you do for a career? And tell me more about that. What town do you live in? Patient opens up next time I go in the room, I know I, I have instant small talk. They are happy to see me. Does it have anything to do with their clinical care? I, I contend that if someone is, is, has easy things to talk about with that care team, that their stay is better. And frankly, it's better for our staff too, who go in the room and they know that patient by name. They know the, they know the patient's spouse or the plus one by name and they know things about their life that they might be missing out on because they're here. And it adds to the overall compassion, you know, from our end. And it bolsters the relationship. So I think, you know, getting back to that question, it's the support of that top down leadership that says this is, this is going to happen, but here's why. And here's it. You know, here's not why. It's not to monitor you and, and, and talk about what you're not doing well. It's to build your skills to embody those patient experience traits that align with what our, what our customers want. So one of the things that people have noticed about notes that I write, and this is getting to your point about knowing patients is in the notes, even though there's absolutely no reason in our current electronic health record to make these sort of comments, I will say, this person enjoys going to Harley Davidson rallies. This person has three great-grandchildren that she cares for every Tuesday. and actually try to round out people's lives. Because I think you're absolutely right that if people feel known, whether it's a staff person or whether it's a patient, they feel like you really care about them, which actually I really come to care about the people that I interact with. 'cause there's usually a chance for connection that can be so much deeper than, let me just look at your, you know, white blood cell count with you and, you know, look at what these numbers are telling me about your body. It's more like, you know, Wayne, I know that you play classical guitar. So tell me about that, which I'm gonna actually ask you that question in a minute. So how do we create enough space in an interaction to ask questions like this? How do we encourage people to do that? 'cause it doesn't have to be a 25 minute conversation. It doesn't, how do, how do we encourage that? Well, so much of it, and it's what you do so well, it's the body language that shows the, in the li the, the, the speaker, the person you're with that you're really interested in what they have to say. And it's those traits like that, it's the appropriate eye contact. It's the body leaning in, paraphrasing where appropriate, asking probing questions. All of those things work toward getting to a place with anyone that you're earning the right to hear their story. If you think about people in our lives that we've earned the right to hear their story or not, we don't just give that away for nothing. And in that relationship that you're speaking about, right? Someone wants to give their story away, but you know what, you've gotta earn it in a way, and you're gonna earn that a lot more. And you're gonna enjoy your work a lot more when you know you've earned that right period. And you know what you do. And what most of our medical staff do that I interact with, you know, they strive to do this too. And it's part of their training. When, when, when medical staff onboard at our organization, they receive personalized, and by personalized, I mean tailored to their service line training, not just so they can do well in their surveys, is so that, so that folks understand what matters to our patients more than anything, based on hundreds of thousands of notes and of, of comments from them about their experiences continuing to morph what's important to them as our times roll on. So like, it's that body language piece. So ma so much matters. I ran into a colleague the other day and I was so happy to see them and the cafeteria, and within five seconds they pulled their phone out and they, they were half listening and they were teaching me right away, even though I didn't say it out loud, that I was more excited to see them than they were me. This wasn't where we work, it was somewhere else, of course. And the next time I passed them, I said, Hey, how you doing? But I did not stop. And so we're constantly teaching people how to, how to, how to treat us. And for analogy's sake, we, we do the same thing with, with our, with our, the people we're caring for. If we give folks a symptom or, or a signal rather, that we have better things to do, or we, you know, they aren't as important to us as that as we are to them. Like they will act on that and they will create their perceptions that are very difficult to change. So it's critical that we do all of these things in addition to, to providing great care. Well, I think you're, you're right. And I do think body language says a lot. And of course, you know, we're asked in, in our field, we're asked to gather a lot of data, which means a lot of times there's a computer and a screen that's in between the, the person that's that we're talking to and us and being aware, like you actually, you can turn the screen, you could actually look at the screen together, you know, this is, this is you Mr. Jones as the patient, let's look at these numbers so that we're interacting with each other and with the screen, you know, let's make sure we're always at the same level. So I don't come in and, and stand and tower above you know, Mrs. Smith, because, you know, I don't have that much time. You know, you come in and you sit down and you absolut