Tag Archives: services

Healthcare, empathy, the NHS and the power of video

Thanks to Tim Brown for posting the link to this fantastic video from the Cleveland Clinic.

Please give it 4 minutes of your time.

In his post, Tim asks readers to consider how this would work as a design brief for someone designing a hospital or healthcare system. I cannot help think that the relevance and value of the video goes much deeper. Particularly in the UK.

Amidst budget crises, reorganisations of Hospital Trusts and the creation of new markets, the whole point of what the NHS does and who it is ultimately there to serve seems to be lost.

You, me, our families are increasingly relegated to the status of statistics. We seem to be incidental to the redesign of the NHS.

Our voices rarely listened to as hospitals are closed, services transferred and the magical ‘market’ is introduced.

Our only involvement in this whole process appears to be to cause inefficiency by our recurring problems of becoming ill and getting old. Perhaps if only we were not such a burden, the NHS could reach that politicians nirvana of ‘being efficient’. I cannot help think that achieving this in healthcare is akin to having ‘quiet’ in a primary school – something that is possible, but not something that we actually want.

What this video does so well is remind us what healthcare is about.

It reminds us what hospitals are for and why they matter.

It reminds us that however bad our day has been, it is unlikely to compare to that of a doctor  giving his patient a diagnosis that will see his life change forever in those following few minutes.

One that makes the word ‘pension’ redundant.

One that measures lifetimes in weeks.

It reminds us that we are not that patient. At least not today.

Most importantly the video reminds us that healthcare is about people.

Not markets. Not targets. Not performance measures. All these are there and important, but they are there to support the core business – they are not the business.

Perhaps those who want to challenge the latest hatchet-wielding ladder-climbing Junior Health Minister giving a trite soundbite on News at 10 to justify cuts to our NHS should take a lesson from the Cleveland Clinic and focus on what really matters. Instead of duelling with statistics, we should go back to what matters. People. Not in an abstract way. Not in a markets/targets/performance way, but in a human way.

Perhaps pressure groups should engage not with flyers, but with YouTube links. 

Perhaps we should forget reasoned and rational debate and instead go for emotion.

BOLDLY put emotion first.

Why? Because emotion is the most powerful human instinct. If you don’t make a connection with emotion, nothing else matters. The statistics and reasoned arguments can follow, but start with the emotion.

Why? Because emotion, empathy, caring, love is the very essence of what being human is about.

Cleveland Clinic know this works.

Learn from them.


Learning lessons from HMV

The collapse of the High Street continues as HMV enters administration this week with the potential loss of over 4000 jobs.

Unfortunately, this was a failure that was absolutely predictable.  There were no shortage of signs – from the first profit warning in early 2011 ago, subsequent profit warnings, and finally the drop in sales to below £1bn in mid-2012. The final closure this week is the inevitable result of failure to respond to pressures on the business.

The problems didn’t start though in 2010 with the profit warning. They started in 2003 with the launch of iTunes. Music services were available before then, but when Apple moves, companies should be taking notice. Even when Apple became the most popular music vendor in the US in 2008 HMV had not committed to a digital future. By 2010 when Apple was the worlds largest music vendor, the point of no return had surely been reached.

As a former fan and big spender in HMV I have watched the demise with a combination of amazement and anger.

Amazement that HMV fails to make any change in its operations that is visible to me (as a customer), and anger as it is clear where this will end – in the demise of a once great British company and the loss of many jobs.

Failing to adapt was never going to be a viable strategy. Yet, this is the one strategy that I, as a customer saw HMV adopt, the ‘head in the sand strategy’. Core problems in the business and operating model were simply not addressed, despite these being repeatedly raised by analysts and their own staff to senior management over many years. Philip Beaching gives a very readable account of this, clearly describing the hubris and sheer ignorance of wider market shifts at the senior levels in HMV.

And then the inevitable happens …

A long list of causes is cited: internet shopping, supermarkets, pricing strategy, High Street costs, digital downloads … and so on.

And yes, each of these is a valid contributing factor to the problems that HMV faced, but the core issue lies not outside the company, but within.

The core problem was an unwillingness to change; it was sheer arrogance. Arrogance that HMV was immune to market changes and was assured a future.

Wrong. It wasn’t.

No company is. Every company is at risk. Constantly. Failing to respond to changing markets and evolving customer demand sows the seeds of your own failure. It is simply a matter of time for the seeds to germinate.

Adapt or die. Simplistic, but true.

This is nothing new. Good to Great by Jim Collins does an excellent job of explaining why companies fail, but despite these lessons many executives in failing companies still fail to act. Only when put into administration are hard decisions taken. Often these decisions are the same ones that done 3 or so years ago would have helped the company survive.

So where do business leaders go to learn these lessons?

Going back further to economist Joseph Schumpter’s ‘Creative Destruction’ in the 1950s we find useful lessons for managers. Continuing back through Hegel, Marx and beyond we find the same lessons with the same outcomes for those who ignore change. Look at many empires and civilisation failures and the same lessons apply.

So how do we prevent this?

How do we build companies that can evolve and adapt?

How do we develop leaders who can keep companies alive?

The starting point has to be with the education of those responsible for companies, that is executives – the business leaders – those intelligent few trusted with steering the corporate ship and keeping it away from the rocks of administration and bankruptcy.

But is this happening?

It appears to me that a fascination with complex financial engineering, operations efficiency and supply chain management is giving us leaders able to manage the minutiae of business, but unable to recognise the disruptive forces that threaten the viability of the organisation? We are managing the stocking of the wine cellar, but failing to notice the ship is heading for the rocks.

Instead of seeking professional business leaders obsessed with micro managing market performance, we should be looking for passionate explorers with a good understanding of history – able to spot the rocks and storms that threaten the ships very survival.

HMV is the first High Street casualty of 2013, but it will not be the last.

I hope the one positive outcome of the HMV debacle is the recognition that many High Street companies need to quickly change direction. You can argue against the rocks, you can shout they they shouldn’t be there, but fail to change direction and they will sink you.

Remote means remote

After what seem like endless trials and pilots, companies are finally starting to embrace remote working.

Not the ‘work from home every Friday’, but a more fundamental permanent disconnection from the mothership of a Head Office.

Whilst work practices and attitudes have evolved though, in many cases though the support hasn’t. IT Support departments too often rely on physical connections for upgrades, repairs and fixes. In most of these cases, this attendance is driven primarily by outdated processes rather than physical requirements. The default model in most cases is expect the end user to jump in the car and travel to the office. Whilst this is an inconvenience many remote employees, it fails completely for those who work many hours from the office (as is possible) or even from another country (have broadband will travel).

Just as we have rethought remote working, we need to rethink remote support.

The model needs to be ‘remote by default’. A high quality service designed to meet the needs of the end user, not the support department.

Most importantly, the IT team need to stop thinking of how to fix technical problems and start to think about excellent service.

The priority needs to be how we enable the end user to stay productive and keep working whilst the issue is resolved – and resolved as quickly as possible. None of the options to deliver a service such as this are without cost, but this needs to be weighed against the lost time of the end user.

The good news is that logistics services have improved in leaps and bounds, as they have implemented technology to improve their services, and competition has provided a range of options at affordable prices.

Working closely with a logistics company allows a support team to design truly customer centric services – and critically to quickly launch these whilst technical architectures and applications/services are updated to better enable ‘bring your own device’ (BYOD) and browser based working.

Departments should realise that they will not get this perfect for the first release, but by learning from other service companies, and in particular leading internet retailers, they can start to make a big difference quickly.

As a remote worker of many years, here is what I would be looking for:

  • Let me speak to someone who wants to help. Customer service matters. I don’t want to bounce through switchboards, be passed around trying to find someone who can help. I want someone who understands what I am doing and cares about getting me working. If you want to get an A* for service then give me a dedicated number, staffed by empowered people passionate about helping. Think: American Express Travel Service
  • Help keep me working. My time is valuable so respect this. From the first call, take ownership and schedule the fix as soon as possible. I don’t want to log a call in the morning, only to be called back later in the day, when it is too late to courier a replacement piece of hardware.
  • Keep spares of key peripherals, parts and kit. I don’t want to wait weeks for a fix. Have the main kit ready to ship to me with ‘next day’ delivery. You cannot stock everything, but at least have the core devices boxed, tested and configured ready to go. You can provide me a box to ship back broken kit at my convenience. Think: Amazon
  • Have ‘hot swappable’ replacements. If you need my laptop/phone/tablet back, bring me another one – configured and charged – at the same time you pickup the one to be fixed. I know it may not be perfect, but have it configured and ready to go. Think: Apple
  • Not just 9-5. I work flexible time shifted hours some days, so extend the service hours to reflect this. Whilst 24×7 may not be practical, you should certainly have processes in place that allow me to log calls out of hours and have kit shipped when needed. If you are thinking that this is not cost effective then compare the cost of shipping me kit vs. the cost of me not completing the sales presentation for a £10m client bid.
  • Come to me. If the fix cannot be sorted remotely, is it possible that someone could jump in a car and come to me? This level of service is not unusual for CxO’s and directors, but can this service be offered to others in the organisation cost effectively?
  • Include follow-up. Don’t assume that the initial solution fixes the problem. The lack of contact from me could be that the problem is solved, or it could be that I have no confidence in your department and I am trying to find another solution.
  • Plan for failure. Kit breaks, applications fail, software screws up. This is reality, so assume failure and plan for this. Be proactive and have multiple ways of resolving a problem.

One final tip. If you cannot do this, get someone in who can!

And the final test … give yourself a deadline, go home to finish the work, then break a piece of kit and see how effective your support services are. My bet is that these are far less effective then you think they are. So, sort these before YOU need to use them.