Management Lessons From Healthcare

Image: Ezra Klein

I just finished reading Letting Go, the latest treatise by surgeon-cum-writer Atul Gawande, which explores the ambiguities of end-of-life care. There is a lot to be learned from the study of healthcare. It helps us gain “insider” information that can not only empower us as healthcare consumers, it can also be instructive as we think about our own work.

As Drs. Leonard Berry and Kent Seltman point out in their book, healthcare customers are unique in that they are usually sick or injured and under considerable stress; medicine requires them to bare themselves–emotionally and physically–to doctors and caregivers to a far greater degree than any other industry. Healthcare providers must continually perform well together in the face of vulnerable customers, known human error, system failure and vast amounts of technology to provide the intangible service called health and well-being. It goes without saying then, that there's much to be gleaned from the individuals that serve us in this unique–and often life altering–way.

More than 70% of Americans now earn a living in the service sector, which encompasses everything from health, law, telecommunications and entertainment to retail, finance and beyond. The chances are high that we will all work in a service job at some point in our career. And the notion of service has applications for all industries. Management guru Tom Peters believes the concept of "servant-leadership" is critical for success no matter what business you're in. At its core, service is inherently about performance so medicine is a great place for management to look for insight about how to improve service for both their internal and external customers.

Gawande has found a theme in trying to understand human failure and imperfection and studying how individuals, teamwork and process can be improved against a backdrop of dizzying technology and massive amounts of information. What he also shows us along the way is that excellence isn’t innate; it is an ingrained practice borne out of learning from mistakes.

In his first book, Complications, Gawande recognizes that medicine, even with all of the latest technology, is imperfect and asks how we become even remotely competent at something that’s inherently flawed. What he discovers time and time again, is a powerful truth applicable to all of our jobs: excellence in anything is never just about the science; and even with “perfect” science, or well-established process, or advanced levels of education and experience, fallibility is a constant. Excellence in service, whether it's for our customers, colleagues or business partners is about accepting failure when it happens and moving on from it quickly to improve. In Letting Go he teaches us that it’s also about artistry–the human touch, collaboration, generous acts, personal courage and core values that guide decision-making and inspire extra effort.

He is arguably one of the best healthcare essayists for the medical layperson to read.

Natalie Zensius is a marketing communications strategist with experience in both the for-profit and non-profit sectors. Learn more about Natalie at http:www.linkedin.com/in/nzensius. 

The Importance of Research and Good Infographics

Image: Neeta Lind

I had some routine blood work done yesterday to test, amongst other things, my cholesterol levels and whether or not I had diabetes. My results pleased me as much as if I had scored perfectly on the SATs (which, physiologically speaking, I had.) It took me a while to figure out that I was as healthy as can be though, because the numbers didn't mean anything and the information my healthcare provider had on their website explaining what the tests were looking for was confusing and sparse. I ended up having to do some searching around on the web to decode it.

Literacy levels in this country are going down and they are inextricably tied to two key demographics: the health and wealth of our population. The 2003 National Adult Literacy Survey found that adults with the lowest literacy levels (a number that has increased since the last time the survey was conducted in 1992) are more likely than those at the higher levels to be poor and to have a physical, mental, or other health condition. Older adults (who typically have more health concerns–such as diabetes and high cholesterol–to deal with) are more likely than middle-aged or younger adults to demonstrate limited literacy skills: 40% of seniors aged 65 or older read at or below the 5th grade level. Yet most health-related materials are written at the 10th grade level.

If I, as a college educated and web savvy individual, have a hard time understanding what my test results mean, I worry about what some people with less education must make of theirs.

I give major points to my healthcare provider (Kaiser Permanente) for the speed in which I received my results and how easy it was to access them. I had blood drawn at 10:30am and by 3:35pm I'd received email notification that the results were available on my password-protected user page. Within 24 hours I also got an email from my doctor telling me how great the results were, asking me if I had any questions, and to keep up the good work. Talk about fantastic customer service. But what about the people who can't get theirs if they can't read, don't have a computer or are not technologically comfortable?

In addition to being aware of the literacy constraints that many people face it’s important for healthcare communicators to understand other aspects of their audience demographic. How do healthcare providers give out test results for folks in poor rural areas, for example?

Whether the delivery mechanism is in person, an online message, or a printout received by mail, it's commonly accepted that more than 60 percent of individuals are visual learners yet my test results were all text and numbers. Couple a lack of graphic design with words that are hard to understand for most people and it's no wonder some healthcare communications (in this case test results) don't make sense. A 2000 Harvard literature review of medical and public health research addressing literacy issues offers little in the way of recommendations to improve communications beyond the written word, yet these communications are often critical to helping patients understand and manage their ongoing health. Good visual cues and clever use of iconography can help all healthcare customers, regardless of their reading level.

In my test results I would have liked to see symbols that represent what each test is for and some sort of chart that shows the scores on it. People are by nature, typically competitive, even with themselves, and this would be a great way to show a person visually how they rank, normatively. Since these tests are done regularly, it could also be customized to track a person’s improvement (or not) over time, which could be a useful teaching tool for docs to use, regardless of how they communicate it.

It's great that I got an email from my doc, with an open invitation to ask questions. It turns out that I was able to find what I needed and didn't need help, but here's yet another instance where doing the research to understand your audience is important. A lot of people who have problems with literacy hide this fact from family members, co-workers and, most likely, their doctors. Plus, people can be busy or lazy, or both. How many people are going to take the time to follow up on these test scores to make sure they really understand them, and wouldn't it be more efficient for everyone if that information could be gotten easily from the initial communication?

Natalie Zensius is a marketing communications strategist with experience in both the for-profit and non-profit sectors. Learn more about Natalie at http:www.linkedin.com/in/nzensius.

A New Approach To Board Recruitment

I attended a great workshop today called: “An Unconventional Look at Board Recruitment & Engagement.”  The workshop was put on by the wonderful East Bay Community Foundation and was led by Jan Masaoka, a non-profit management consultant. Jan was previously the Executive Director of CompassPoint in San Francisco. She's now the managing editor of Blue Avocado, an online magazine and resource for non-profit leaders.  

From my notes, here's Jan's patented method for recruiting new board members. 

Form a Blue Ribbon Nominating Committee
•    You will need about 15 people to be part of the committee. (Ask about 25 people to come, so you’ll end up with 15 people or so.) Comprise it of people that you think you’d want on your board but you are pretty sure they’d say no. Tell them this is a one- time commitment; this committee meets once, then disbands.

•    Hold the meeting at your organization's office, over lunch (be sure to serve lunch!) The Executive Director and board leadership should be present.

•    Give attendees a no more than 15 minute indoctrination of what your organization does, plus an overview of what needs to be done in the coming year. Then tell them: "What we need you to do is suggest 4 people for our board, based on what we do as an organization, and what we need to accomplish as a board this year. Tell us who they are and why they would be a good fit."

•    Then, have a roundtable discussion about all of the recommendations.

•    The goal is to end up with a list of about 25 recommended people.

•    Next, the Executive Director and/or board leadership call them to set up an in-person meeting to recruit them.

What works so well about this approach is that when someone comes on a board as a result of this process it will be apparent why they are there and what they will accomplish. As board members we often recruit friends and acquaintances, then once they join the board we tell them: “Find something useful to do and organize yourself to do it." We hope that they will step up and get something done once they are engaged, when what we should do is make it clear to them from the outset what is needed from them.

Another great by-product of this nominating committee is that this is also an excellent way for non-profits to cultivate a major donor list.

Once I've fully digested Jan's talk, I'll be blogging in the coming weeks with my own thoughts about some of the other topics she touched on; she presented some really useful information that got me thinking about new ways that we can all approach our work as board members.

Natalie Zensius is a marketing communications strategist with experience in both the for-profit and non-profit sectors. Learn more about Natalie at http:www.linkedin.com/in/nzensius.
 

It's The Little Things-Why Birthday Emails Matter

Image: Chaim Soutine

While I was in art school, one of my professors said something that stuck with me: when viewing a piece of poorly executed art, the average person cannot articulate why or how the perspective is"off" but they always pick up that something is not quite right. Their eyes, and thus their brain, knows that the world they are seeing reflected in the painting or illustration shouldn't really look like that.

Our professor cautioned us that we should either be able to draw perspective well enough to "get it right", or intentionally skew things in an unexpected way so that the audience would get our intention, and the piece would invite further evaluation. If we didn’t do either of those things, and were lucky, our audience might forgive our mistake and appreciate what we were trying to do. Most likely though, he said, it would turn them off to the work.

The same holds true in some ways for marketing communications. The average customer or member doesn’t question how they are being communicated with when things are humming along and it's business as usual, but they immediately notice when something is off; which can create negative perceptions towards the brand they're interacting with. Depending on the audience demographic, communicators have few chances to make mistakes. Older customers tend to be loyal to brands or organizations once they’ve committed to them, but younger customers are notoriously fickle and have little patience for brands that don't hit the right note in their communications.

Conversely, customers notice when something happens that goes above and beyond their expectations. It's my birthday in a few days and I've plugged my date of birth into online forms countless times so it's always interesting to see which companies and organizations that I’ve done business with reach out to connect with me on my special day. I could be jaded and unmoved by an email wishing me well as I get another year older, especially since I know the mechanics and intention behind it, but a personalized email–even if it is automated–still means something and I appreciate the effort that went into it. Someone, somewhere, understood that sending out a birthday email makes a difference and had the thought that it was worth taking the time to program the system to shoot out that email. And when they had the thought, they told someone, who told someone, who actually took the time to make it happen.



















Granted, these types of emails are a little self-serving and they're not always completely personalized (I got the birthday email above from the Marine Corps Marathon a full three days before the actual day of my birthday, for example), but they still add a personal touch that I often don't experience from many organizations. If some of the non-profits that I support thought to send me a birthday card expressing gratitude that I am still alive and kicking (and therefore able to continue sending them money) then maybe, just maybe, I'd be more inclined to write a larger check when it came time to solicit my annual donation. Or perhaps I'd be more willing to volunteer my time to help move understaffed projects along. There's no guarantees of course, but for those non-profits who want my continued patronage it's a small investment of time and should be worth a shot.

Furthermore, if executed really well, personalized birthday emails can communicate generosity to a customer; how nice that The Marine Corps Marathon reached out, connected and acknowledged me without needing anything. Now that's intentionally skewing my perspective of their brand, in a very positive way. (Note to non-profits: please don't ever insult your constituents when celebrating them with an ask for money in a birthday card. Same applies to thank you cards and holiday greetings too.)

Getting that birthday email made me feel good about the organization and in turn I spent some time on their website checking out their charity partners. They piqued my curiosity which took my relationship with the organization to a whole new level.

So, is your email marketing interesting your customers or turning them off?

Natalie Zensius is a marketing communications strategist with experience in both the for-profit and non-profit sectors. Learn more about Natalie at http:www.linkedin.com/in/nzensius.

How To Impress Me In An Interview

Image: Alex France

I've been reviewing resumes and conducting interviews for graphic designers and marketers lately. Unlike most of my colleagues, I enjoy doing it; I honestly love to learn about people and talk about the things I am passionate about. (One of my top five career choices as a kid was to be a talk-show host. To this day, my friends will sic me on people when they want to find out something about them – they claim I ask the most penetrating questions.)

It can be a dreary process though. It never ceases to amaze me why some people do not follow simple instructions regarding submitting their materials or cover letter. Haven't they realized that this is the first part of the evaluation process?

As communications professionals, we're in the daily business of delighting people so it goes without saying that our public personas should attempt to do just that. Candidates don't cut it as marketing communications professionals in today's business world without active accounts on LinkedIn and Twitter. Having a blog or website has become increasingly important too, and will immediately elevate applicants to the top of the  candidate pile. It shows me who is serious about their craft and is constantly working to become a better writer and or designer. Striving for self-improvement and a higher quality work-product is a critical component of successful marketing communications. Creating and maintaining that robust online presence is key– if candidates can't do it well for themselves, why would I think that they could do it well for me?

There are many people who are good at what they do and have a passion for communications outside of the daily grind; a passion they bring to their work. To get an interview with me candidates have to differentiate themselves and delight me so that I get a sense that working with them would be enjoyable; we would be sharing a common interest, ideas and enthusiasm, etc.

There's always a few that get through to the interview. For them, if they are looking me up on Google, and have found this page, I offer up a few pointers on the things that will make me feel all fuzzy inside when I am doing an interview:

Doing your homework
You should know about me and the organization I am representing, especially if we've already talked on the phone. Use search engines to find out something about me that could make for interesting conversation. It shows me that you care and that you've got the basic internet skills to do some simple background research. A good rule of thumb is to try and know more about me than I do about you.

Bringing samples, printed and digital, even when I didn't ask for them
I want to see what kind of work you've been doing lately, both in the online and offline space. I'm looking for fresh work that reflects the changing world of marketing communications. If it's print, it should be crisp and clean and well-executed. If you can't produce anything newer than five years ago and it was a college project to boot, know that I'll be rethinking whether you are a fit for this project.

Asking me questions throughout the interview
Don't wait until the end of our conversation to ask me questions. You should be interviewing me as much as I am you to find out if we are a mutual fit. Some of the best people I've hired have hit me with questions during an interview that I had to stop and think about before answering. I always want this kind of person on my team as it indicates to me that they are a thinker and will keep me on my toes.

Not being afraid to say that you can't answer my questions with the information you've been given (but telling me what information you would need.)
I don’t expect you to know exactly how to solve the problems I'm throwing out to you after a few short minutes together (and I’ll be sure to throw in at least one real zinger to see how you handle it.) Indeed it's often a good idea to show me that you know how to take stock of a situation and figure out the best way to get what you'll need to make an informed decision later. Knowing how to push back is sometimes more important than having the right answer immediately.

Having pursuits to talk about that on the face of it, have nothing to do with the job
This is always a great indication of someone's initiative. To make the effort to get involved in something without being told to is awesome. In particular, if you're doing something communications related this is a great sign. Examples include: writing your own blog, being involved in volunteer opportunities, or writing and getting published on a subject that interest you. If you can bring in something to your interview–perhaps it's an example of something you've written or a website you've built–that's excellent.

Demonstrating confidence and/or poise without arrogance
This is sometimes a fine line but one that is crucial to being a great communicator. You've got to believe in yourself enough to be respected by others but also know your weaknesses and when to ask for help. You don't have to do a full on salesman's routine to sell yourself but if you don't believe in your own abilities then neither will I. 

Being articulate
Thankfully the stereotype of the geek with no social or communication skills is less common than it used to be. As more people enter the profession so do the variety of individuals you come across. However, those who can clearly articulate ideas and thoughts are going to be far more successful in communications than those who prefer the company of computers to people

Smiling!
Need I say more? Work can often be stressful and demanding. It's important during those times to have a sense of humor and a positive attitude. If I can see you smiling and appearing somewhat relaxed during an interview–a situation I know is stressful for you– then it gives me an idea of how you will perform under the gun once I've hired you.

Natalie Zensius is a marketing communications strategist with experience in both the for-profit and non-profit sectors. Learn more about Natalie at http:www.linkedin.com/in/nzensius.