Allowing your staff to resolve issues on their own for frustrated and dissatisfied patients is asking for trouble. Without a clear intervention plan in place, you can’t know for sure that your patients are being managed the way they should be. Without a formal intervention plan in place, your patients and practice reputation are at significant risk.
The challenge is that just having a plan doesn’t mean it will get used. You must get your staff to buy in to your intervention plan; otherwise, its implementation will be spotty at best. The answer is in how you develop and roll out your plan.
Assembling Your Team
Drafting an effective intervention plan doesn’t mean that you sit at your desk and write out a manual and then hand it off for your staff to follow. Instead, you’ll have more success getting your staff to buy in to your plan if you involve them from the beginning.
Your plan creation team should include staff that directly interact with patients, regardless of whether they are managers or not. Sometimes frontline or new employees can add a fresh eye to your processes and provide you with valuable input on how to help dissatisfied patients. Some of the staff you should consider asking for input include:
- Manager/Administrator
- Front Desk: Manager and all staff
- Billing: Manager and all staff
- Scheduling/Phones: Manager and all staff
Note: You may want to involve your clinical staff in your plan development process, but actually getting them to participate may be difficult. Instead, consider meeting with your lead physician, nurse, and nonphysician practitioner separately to get their perspective. Or you could choose to provide your practice’s leadership with a draft of your document so that they can add their comments before it goes live.
Spotting Warning Signs
You can’t help your team resolve issues that lead to dissatisfied patients if they’re unable to identify them.
The trick is for your staff to have a strong handle on patient escalation warning signs, and a step-by-step process to resolve each. This will allow your staff to quickly put your intervention plan into action to avoid what may come next – yelling, profanity, or worse.
Writing down the warning signs as part of your action plan allows your staff to carefully read the descriptions and refer back to them in tense situations. This helps your entire staff get better at identifying patient issues early and decrease a patient frustration from escalating.
Here are several key indicators that can help your team identify and resolve dissatisfied patients before they get out of control (i.e. yelling, cussing, assault, or worse):
- Agitated Appearance: Some visual signs that a patient may be frustrated include a red face, heavy breathing, or stuttering or stumbling over their words.
. - Raised Voice: Dissatisfied patients won’t always yell when they’re angry. Instead, your patient’s vocal tone may be at a higher pitch. Upset patients may also talk more quickly (spitting out their words more aggressively) or even speak more slowly while articulating their words.
. - Pacing: If you notice a patient walking back and forth in your waiting room unable to sit down, this can be an indicator that they are upset.
. - Glaring or Staring: If you notice a patient glaring or staring at you from the waiting room, don’t ignore it. They are trying to get your attention and want you to notice that something is wrong.
. - Inability to Sit Still: Not all annoyed patients pace the room; some jiggle their legs, change sitting positions frequently, or cross and uncross their arms and legs. Just like pacing, this can be a way for frustrated patients to expel pent-up or negative energy.
. - Difficulty Voicing Thoughts: As a person’s emotions get the better of them, they may have trouble recalling words.
. - Making Threats: This is one of the last ports of call before a patient completely loses their cool. Common low-level threats can include, “I’ll do it myself” or “Bring out your supervisor,” but may also include threats to leave your practice or file a formal complaint.
Note: While some of the items on the above list are reserved for those patients you see in your office, keen listening skills during phone calls can help head off frustrated patients becoming angry and combative over the phone.
Drafting Your Plan
Remember, that it’s impossible to include every scenario related to dissatisfied patients when writing your plan. The goal is to highlight specific events that might occur when a patient is upset or angry and provide your team with the tools they need to successfully resolve them.
Utilize this outline to help you formalize your intervention plan:
- Identification:
Patients won’t always come right and tell you that they are upset or angry. Instead, patients may provide you with cues that will help you identify how they are feeling. Use these common indicators to help you identify when a patient is dissatisfied. Include the warning signs listed above here. For each warning sign, consider providing your staff with a specific resolution that they can employ to resolve the issue.
. - Listen:
Once you’ve identified a patient that is displaying frustration warning signs, how can you figure out why they are upset? Was someone rude to them? Have they been waiting for an extended period of time for their appointment with the doctor? Did they ask a question and not receive a satisfactory answer? The reason really doesn’t matter. The bottom line is that, whatever happened, the patient is upset, and the only way to help them is to figure out why. The only way to gather the information you need is to listen carefully.
. - Keep Your Cool:
As you are trying to figure out what is causing a patient to be upset, don’t take their responses or tone personally. It’s vital that you keep your cool, never become argumentative, and always avoid sounding judgmental about the patient’s issue. Doing so may make the patient angrier and can escalate an already delicate situation.
. - Offer a Resolution:
Once the patient has told you why they are upset, they are going to expect you to resolve the issue. In many cases, they’ll want you to immediately fix the problem, but the issue may not be something you can fix on the spot. When this happens, it is important that you communicate what will happen next, a clear timeline of events, and how you expect to be able to resolve the issue. However, don’t EVER say you are going to do something that isn’t possible. This can send an angry patient over the edge.
. - Ask for Help:
If you are not able to help the patient with their issues, it may be time to ask for help. If your supervisor is available, politely ask the patient to have a seat while you get your manager. If your manager is not available, explain this to the patient and give them a specific timeline of when to expect a follow up.
Here are several key items to take into consideration when asking for help:
a. Before your manager speaks with the patient, it is important that they have an understanding of what the issue is. The more detail the better. If the patient feels like they have to repeat themselves it may make them more upset.
b. If at any time during your interaction with an angry patient they demand to speak to the practice manager, make it happen. Sometimes patients have their minds made up that only the practice manager can help them. If this is the case, respect their wishes, and arrange for the meeting.
c. No matter how angry a patient is, you should never feel abused. It is never acceptable for a patient to yell, curse or threaten you. If this occurs, you should explain to the patient you can’t help if they continue the behavior. If the patient continues to be abusive after being warned, contact your manager immediately. If your manager is not available, ask the patient to leave. If they refuse to leave, you may have to inform them that you will have no choice but to call the police. This should ONLY be in extreme circumstances. If a patient is abusive over the phone, inform the patient that you will not help them as long as their behavior continues. If they don’t stop, tell them that you will relay their issue to your practice manager, and hang up the phone. Be sure to inform your manager immediately of the situation.
Utilizing Your Plan Dissatisfied patients
Your patient intervention plan should be included in all new-hire training. It is also important to provide periodic training for your existing staff to ensure that everyone is on the same page. Your staff should also always be able to easily access your intervention plan.
When your implementation plan is successful, it provides your team with the skills necessary to resolve difficult patient situations, it ensures that patient issues are dealt with quickly and consistently, patient turnover is reduced, and you have confidence in your team.
For more methods for dealing with frustrated and dissatisfied patients in your practice, check out Healthcare Training Leader’s online training, Diffuse Angry Patients at Your Front Desk. In this 60-minute training, Mike Cummings, CPP, provides you with a blueprint for identifying patients who may become angry, decreasing the tensions when problems strike, and growing your staff’s confidence. Access this training today!
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