Tuesday, February 21, 2012

I am sick, and I am tired of waiting..

"...we should not have to accept this ten hour wait as unavoidable, and be content to watch our tax dollars bleeding to death on the Emergency Department waiting room floor."

Over the last two years, I have been required to undergo two separate rather significant surgeries. Throughout these experiences, I have had the opportunity to be under the care of dozens, if not hundreds of health care professionals, from doctors, nurses, orderlies, even a cleaner that took time to sit beside me and share stories from my home province of Newfoundland. Without exception these people were incredible, caring and clearly cared about my condition. All comments below must consumed with an absolute understanding that I have all of the respect in the world for each and every one of them, and all of the individuals that have chosen to make healthcare a part of there life, without exaggeration, I owe my life to a good number of them.

Yesterday, as a result of complications of one of my surgeries, I had no choice but to visit a local emergency room. Thus it began.

Within the waiting area, it did not take long for the message from the Emergency Room staff to circulate around the waiting room that the wait will be in excess of 10 hours. Before you succumb to the temptation to comment on this with the inner workings and challenges of dealing with ER patients, including triage, ambulance arrivals, low staffing, over usage etc, etc, I am very familiar with the mechanics of attending to patients in this environment. Having a mother who was head nurse at an ER provided me with lifelong insight to the challenges behind the swinging doors of this part of our health care system.

With respect to all of the challenges that meet the ER process, a waiting time of 10 hours is ridiculously unacceptable, and should be an embarrassment to anyone involved that considers this as “just the way it is”.

I am unsure as to why we (the customers of this service) typically consider this acceptable level of service? Maybe it is the mystery of the health care system, the intimidation of what goes on behind those ER swinging doors. Maybe mere citizens are willing victims of this completely unacceptable level of service, because our life (on occasion) depends on the service and we are willing to take whatever we are given.

Interesting that if we were are forced to endure these ridiculous wait times dealing with government services that we found less intimidating (such as transportation, education, public safety) the streets would be filled with protesters, and the newspapers will be filled with letters to the editor. Consider (locally) the amount of protesting and rights groups up in arms about a rather inert subject as Hydro Fracking, yet, the timely emergency health care of our citizen can be virtually ignored.

I trust that I was unequivocally clear that I do not in any way hold the health care workers responsible for this almost laughable poor service to the public, but without question I think the accepted “process” or “system” bears 100% of the responsibility. Obviously something within the structure of these public services is fundamentally broken. Almost without exception, when the topic of this service is aired, it is met with outcry from those that are responsible, or accountable is that there is not enough money, or we do not have enough staffing... I cannot disagree more.

Feeding more money, more resources into a system that is broken, will not resolve any issues (other than waste). Building new walls and waiting areas will not fix the problem. Changing the lighting and painting lines on the floor will not help.

Also, the finger is frequently pointed at us, the receivers of the service.. “Pay for use” models have been implemented and failed in the past, in order to discourage using this service, and the echo of “people are misusing the emergency services”. This is incredibly is pointing the finger at the customers for poor service.

I can only imagine how the board of directors of a publicly traded company would be laughed out of their jobs; if they decided that as a result of over demand of their product or service that they are going to take steps to discourage the purchase of their product.

Maybe in the public service, overcoming demand with a broken system is impossible? Not a chance. Many years ago, in New Brunswick, all vehicle registrations came due on the same date. Line-ups on the last day were out the building and long into the parking lot, hours of waiting resulted. UNTIL, someone within the public service, came to the realization that this is not appropriate treatment to their clients (taxpayers), they showed the courage to start with a blank slate and consider all aspects of their process. Changes were made, and now, the process of renewing your vehicle registration takes less time than depositing money in your bank account. It can be done.

We need to find someone with similar courage to be willing to look, from the grass roots, the method that emergency services are delivered to the public. Working with existing budgets, existing staffing levels, a basic wash of the accepted ways of doing things, and rebuild it with the patients in mind. Impossible??? Not a chance. Private sector businesses do this daily, motivated by profit; continuous quality improvement programs are in place, private businesses deal with actually cutting budgets and still improving customer experiences.

If any private business was met with the challenge of too many customers and declining customer service, without a moment’s thought EVERY option,. EVERY change, EVERY rebuild would be considered to increase satisfaction, and maintain all of their clients and try to earn even more loyal customers. In these boardrooms, the demand to spend more money to offer continued mediocre service and maintain a process that does not work, would result in those who suggest it, packing their personal belongings and seeking new employment.

I insist that we should not have to accept this ten hour wait as unavoidable, and be content to watch our tax dollars bleeding to death on the Emergency Department waiting room floor.

On a personal note, I was unable to tolerate the physical discomfort of sitting waiting for ten hours, I returned home, and my condition remains undiagnosed.

Monday, February 13, 2012

Bullying - Part II

We need to clearly separate our efforts on eliminating traditional bullying and cyber bullying. The two solutions are worlds apart, as are the mechanisms of the bullying.

My start to blogging was a reaction to a CBC interview with Teenagers working to eliminate bullying in schools. I might suggest before continuing to read this article, that you read my initial post.

Once again, my morning drive, I enjoyed yet another CBC interview, this time with adults on the topic of bullying. To echo my thoughts in my first post, I do not feel that Adult intervention and Adult solutions are the magic bullet in elimiminating inter and extracurricular bullying.

Be it politics, economics or social systems, I continue to be in awe that we refuse to accept the new world that includes the internet. We ignore how our old methods of thinking must be adjusted to account for the immediate access to information and at the speed of light share thoughts, information and views with anyone on our earth.

Like all of the above, the issue of Bullying has been compounded with the advent of social media. Bullying within our academic system becomes exponentially more difficult to police, now that the fences of the schoolyard no longer provide a reprieve for the victims.

Personal attacks permeate through Facebook, Twitter, Texting etc 7/24. I suggest that cyber bulling can even be more vicious, as the bully need never stand face to face, or fear physical ramifications as they hide behind the distance that the internet provides.

As fundamentally different are the mechanics between schoolyard and cyber bullying, as do I think are the solutions. We will be unsuccessful in working in traditional ways to solve a technology based problem. Primarily, the responsibility (arguably) of dealing with School bullying, falls on the shoulders of the academic administrators, doling out punishment and protection as required. But who “owns” the issue of cyber bullying?

To deal with a problem that technology has created, technology must also be the solution. On a lesser scale, parents must become much more educated and aware of the mechanics of technology that allows this bullying to take place. Primarily the responsibility falls on those social network applications that make millions of dollars off of their customers.. Included in those customers are bullies and victims. I (of all people) want to make clear that it is not the responsibility of these social networking sites to monitor the content of its users. It is their responsibility to provide simple technical methods to prohibit unwanted comments, threats and the plethora of personal attacks on a victim. Most social networking applications do offer rudimentary blocking settings. But these need to be enhanced, and offer more options to the user and the user’s parents.

As with all new technical innovations, we don t know what we don’t know.. it is impossible for me to suggest a technical solution to combat bullying, but as Facebook, Twitter continue to develop new ways to share photos, offering GPS services, improving chat etc.. It should also be their responsibility to improve the ability to combat cyber bulling. These service providers should NEVER be held accountable for the user’s activity, but SHOULD be held accountable to offer tools to control who and what is being said about you personally.

We need to clearly separate our efforts on eliminating traditional bullying and cyber bullying. The two solutions are worlds apart, as are the mechanisms of the bullying. Diluting our efforts across both worlds will only minimize our efforts of eliminating the problem.

Oct 16th, 2012 - Postscript.. it seems that the internet community has risen (for right or wrong) in the case of Amanda Todd's Suicide.. A hacker group has done the work that I suggest the Social Media Companies should be doing.. Full article here.

Monday, February 6, 2012

How to turn $20 into $20

"...ensure the health and growth of the company you work for, and ultimately the security of your employment." 

We do this almost daily, we enter a convenience store, select our milk and bread (or other required items), approach the cash register. The amount is tallied on the cash register, we reach into our wallets, select a twenty dollar bill, hand it to the cashier, they take it, put it in the register and hand you appropriate change, and are on our way.

Nothing notable in this, one would expect... but there is something significant that just transpired. A closer look might be interesting. I suggest, the next time you have the opportunity to watch a person in front of you in the register line.. Examine the body language of this transaction.

The customer looks closely at the total amount displayed on the cash register. It represents money, it is not a number.. it is value or a cost. Opening a wallet or purse, there is a very quick analysis of how much money is in there, as they flip through the bills, an instantaneous inventory of how much money remains, as a bill is subtracted from the total to cover the cost of the purchase.

Instantly, as the bill is handed to the clerk, it changes, in the hands of the clerk, it becomes valueless, it is just a piece of paper that will only be stuffed (rather disrespectfully) along with the stacks of money already in the till. It only becomes a number that will be counted at the end of the shift and recorded on a piece of paper for deposit. The deposit book is filled with numbers, not a value of what the money can buy, or how much work it took the customers to do to earn that cash... It is just a number on a spreadsheet that will later be added to a balance in a bank account.

I was pleased to be asked to speak at a hospitality business this coming weekend to assist in training their staff on customer service. The organization deals with the public spending their own money for their services (not business to business industry, but a consumer to business industry). I will be basing my presentation on the scenario above.

How would company representatives react to a new policy such as:
" If a client is not unconditionally satisfied and be without hesitation, willing to repeat the service again, the company representative would be required to pay all cost of the service personally and return all of the money to the customer from their own pocket." 

You have a decision, you are booking a vacation and have a choice of two resorts, nearly identical in service offerings, but one has a policy as detailed above, you are aware that if you are not completely satisfied with your expensive experience, the staff you interact with will open their wallets and pay your expense. You would know for a fact that every staff member you interact with would recognize the value of your money. They would not stuff your money in a register and treat it as a mere exchange of a piece of paper. They would ensure that you had a flawless experience, and go above and beyond to fix any issues that might arise. The decision of which resort you would travel to would be a very simple one... a service that you would be please to repeat again in the future.

Of course, this sort of policy does not exist, and never would. However, this extreme example serves a purpose. Having staff or being a company representative that pause before robotically jamming your money in a till, ensures that the client is happy with the exchange and will return as a repeat customer.

A company that maintains at all levels, from the staff that accepts clients payments, to the staff that deliver the service, to the management that decide the direction of the company, the ability to recognize the fact that the clients are giving them real twenty dollar bills, not just numbers on a deposit book will easily beat out their competition.

On a personal note, I have the pleasure of dealing with a local musical instrument company, Tony’s Music Box, where, when I hand them my money, I can easily sense that they are very aware and respect the value that money has to me and although there are other music stores I can purchase identical items,  I am loyal to this establishment for the positive experience.

Try these two items. One, examine the body language of a customer in front of you and how the money loses it value the moment it is in the cashiers hands, and two, reflect on a very positive service experience you have and in the past, and how the customer service representatives respected your money.

This is a very simple awareness for anyone working in an industry that serves the public that would ensure the health and growth of the company you work for, and ultimately the security of your employment.