Double Thank you is possible at Level of Culture in Healthcare?

Let me explain with clarity that in any business or venture especially healthcare the most crucial battle is won or lost depending on the ability of the hospital or service provider to provide a product/service which can compare and be equal if not better than the best experience of the service user at any place in their long or short life. At the heart of this puzzle lies many things but all of these can be encompassed in one word, CULTURE. This needs to be proclaimed so often that it is becomes a reason for existence creating an endless cycle of Plan, Do,Check and Act. This is what will eventually lead to double thank you moments.

Defining stakeholders in healthcare seems easy and we say service user and service provider are the obvious choices. So on first principles patients and doctors are included. To my mind there is an expanded list required and in a metro city like Mumbai where all kinds of healthcare facilities are accessible, for a private social purpose organisation (SPO) the doctor is the most important stakeholder because it is his skill, reputation and ability to influence the patient that determines the success of the hospital. The next important stakeholder is the caregiver in terms of nurses, patient care assistants, diagnostic department staff. The third are the family and friends who look after the patients. The fourth stakeholder is the employee of the organisation which includes the support staff of non clinical departments not directly related to the clinical care.

After defining the stakeholders the next important task is to create a clear mission and vision statement which is unambiguous and is acceptable to every stakeholder. The problem with these statements are loose terms like affordable cost, rational and ethical. The subtext for affordable is value and quality leads to the design of a service or product especially in healthcare. Healthcare organisations owe it to the users of their services to prioritise safety as the most important consideration in all their interaction with every stakeholder. It seems obvious that the patient seeks care only when he or she feels unsafe or relatively non functional when not in hospital.

The question of design is an extremely crucial component of healthcare services and the common bane is to create services which are process driven, imitations of what the competition provides with no differentiators. This is where healthcare needs to up it's game and look to the hospitality industry which have harnessed the power of imagination in creating services based on the requirements of customer rather than the ability of hospital to provide the same. While most persons with simple ailments expect and get the cure in the most basic centers, the crucial element is the perception created by the doctors, nurses, support staff in the hospital. Healthcare must realize that they are in the experience industry and the customer compares his experience in the hospital to what he has felt in other places in his lifetime. Therefore, to ensure customer loyalty the service has to have the following ingredients:

• Well defined, clarity in pricing with no hidden costs.

• Service delivered at all levels with courtesy, empathy, confidentiality and respect.

• Clear explanation and communication to ensure that patient is ready and cooperates with treatment and a explanation for any deviation from the explained process.

• Genuine feedback taken by the service without any attempt to garner a positive outcome.

So it is important to spend a great deal of time in designing a service rather than rushing into something and retracting and redesigning a product. A clear attempt to have an innovative mindset and a differentiator is the icing on the cake which will lead to customer loyalty as against satisfaction.

How does culture come into the picture? Most organizations, especially the older ones create a vibration and an atmosphere which is defined as a culture. This occurs based on a brand or legacy which is often driven by the founder or the leadership of an organisation especially in healthcare. The template of branding based on Integrity Democracy and Affinity is based on a book on Social Purpose Organization branding called: The Brand IDEA: Managing Nonprofit Brands with Integrity, Democracy, and Affinity.

There is a fundamental difference between branding for corporates and social purpose organizations which one must aspire for. Here instead of competitive brand battle it is a collaborative and participatory approach. The brand is arrived at in corporates as a top leadership driven exercise, whereas in SPO's it is an involvement of multiple stakeholders both internal and external who create a brand. The focus is on creating instant gratification to customers based on creating short term value, whereas in healthcare a long term relationship building based on trust is needed.

The exercise of brand building is both internal and external and linked as follows:

INTERNAL	EXTERNAL
Brand building based on creating an identity	This leads to create an external image
An identity building creates cohesion	This leads to greater trust in the brand
This leads to a better capacity to deliver results	This leads to a greater community impact.

Even so, one problem among SPO's highlighted is that they tend to focus on what they do rather than how they do their work and assume that people know the answer to why they do or need to do in their field. However, the template recommended is of figuring out the answers in the sequence WHY followed by HOW and finally WHAT is done which will enable one to affect cultural transformation.

The exercise of Culture mapping should be undertaken with five fundamental aspects which determine the Culture of a healthcare set up:

• Profit-Oriented Corporate Hospital Culture

• Charitable Trust Hospital Culture

• Hospital Culture that is Strong on Quality Standards and Processes

• Hospital Culture that Promotes Innovation and Creativity

• Hospital Culture that Cares for Its Employees

So if we desire a culture which is conducive to give affordable care which fulfills the charitable objectives of the trust, without compromising on processes and quality and remaining sustainable what should be done? Also, the culture must ensure retention of the employees' enthusiasm by way of work life balance and monetary benefits without stifling their ability to remain creative and innovative. This is the tall task which is required for cultural transformation.

Such a sweet spot fulfilling hospital will be in a position to create consistent Double Thank you moments in healthcare where care receivers, care givers, caretakers and indirect support staff are all satisfied and work with the acronym S.H.A.R.E. I am sharing link with an old blog on S.H.A.R.E.

https://vhjokhi.blogspot.com/2024/09/s-h-r-e-is-acronym-for-culture-change.html