FILENES
Salespeople in high-end retail stores never know whether the customer they’re helping is genuine or a “mystery shopper” hired to report on the store experience from the other side of the counter. This time-honored tactic accentuates the obvious—that in retail, the customer is king, and ensuring that he or she is helped by polite, responsive salespeople is a prerequisite for success.
In medical settings, “customer” service often gets short shrift as physicians focus more on healing than on courtesy. But the goals needn’t be mutually exclusive, and to have it both ways, executives at Fallon Clinic in Worcester, Mass., recruited Linda Adkins, former director of customer service for retailer Filene’s (now Macy’s).

Adkins’s approach borrows such retail techniques as the mystery shopper—though not by filling the clinic with ersatz patients. Instead, the “shoppers” are actual patients who are shadowed from the moment they walk through the doors by clipboard-wielding clinic employees. Each interaction, even in the examination room, is assessed, and before patients leave they fill out a comprehensive survey with questions on everything from the ease of getting an appointment to their feelings about the overall experience. Results are shared with employees to inform them of what works and what doesn’t—for example, a physician who spent more time looking at his computer than making eye contact with his patient, or a nurse who failed to knock on the exam room door before entering. Adkins’s own performance will be graded according to scores on a patient-satisfaction survey mailed out each quarter. Those numbers are starting to climb, Adkins says, although it will take time to plot significant trends.

LIFEWINGS
Some people would call it overcommunication. Every time a pilot and co-pilot enter a cockpit, they go through the exact same checklist. The pilot says, “Flaps,” and checks the flaps. The co-pilot checks and answers, “Flaps.” Then the pilot rechecks the flaps. And so on down the list. It is up to each team member, not just the captain, to monitor the systems and immediately report if something doesn’t seem right. This concept of team responsibility is one reason airlines have one of the best safety records of any industry.

During surgery, however, team members all too often defer to the surgeon without expressing their concerns, and the results can be disastrous. So the University of California, San Diego Medical Center has hired LifeWings Partners, founded by a former U.S. Navy flight instructor, two physicians who are former astronauts, and a commercial pilot, to teach its surgical staff to interact as pilots do.

The rigorous training instills a “stop the line” culture, so that during an operation, anyone has not only the power but also the responsibility to halt the procedure if something is amiss. And now, before an operation, each surgical team goes through a checklist similar to a preflight one to make sure all systems are working. Once the LifeWings program is off the ground at UCSD, the university will roll it out at its four other medical centers.