Tuesday, December 10, 2013

One of the highlights of IHI's annual National Forum on Quality Improvement in Health Care is the opportunity for attendees to take a full-day excursion to one of the major theme parks in the vicinity. I had the pleasure of helping to lead one yesterday to Legoland.  We all know about Legos, those versatile, creativity-building blocks, and this park is a physical embodiment of the toys. It is targeted at children from ages 2 to 12, including this little lady who was enjoying a gentle sprinkle in the new World of Chima section.

Our 44 participants were greeted in the moning by the smiling faces of my colleagues Azeem Mallick and Kate Bones. We decided to engage in an opening exercise designed to get the group thinking about the operational issues facing a theme park of this sort. The pedagogical scenario we created was: "You have been brought in as a consultant. What do you imagine are the major challenges facing this company in meeting the standards it has set for famimly visits? Pick the highest prioirity and develop your theory about how to address this challenge. What will you do with regard to interventions with leadership, front-line staff, and interactions with visitors.”

The breakout groups jumped in enthuiastically.  Here, patient advocate Ziva Mann from the Cambridge Health Alliance reports from her group.  Later, with the help of a colleagues, Lelsey Anne Smith (Quality Improvement Programme Director at NHS Education for Scotland) votes on her priorities.


The idea was to compare our preconceptions of the issues facing such a theme park with the actual experience of those working in the park.  So, next it was off for the visit.

First impressions are key, and the thing that grabbed ours was this nifty name tag worn by our guide Kim.  Everyone wanted one!  Sorry, the product is not for sale . . . but we learned that park guides-- getting down low to be face-to-face--trade the little people from their name tags with ones offered by young visitors to the park.  It is a way to establish personal connections between the staff and the guests and reinforce the park's friendly atmosphere.

From the entrance, we headed to the model shop, the place where those fantastical creatures and other designs are conceived and constructed--block by block. As far as we could see, being a master model-maker at Legoland is a career to be envied. Angie, shown here, made a point to show us one of her favorite set of small models based on a favorite movie,


as well as this familiar-looking creature, complete with movable mouth:


We also had time to view Miniland USA in the heart of the park.  This miniature set of depictions of major sites in the country is a favorite of the children, and they spend hours looking at the models and pushing buttons to create animations like this depiction of a dolphin show.

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We eventually convened for some serious talks with park management and focused on the kinds of questions we had previewed during our working session back at the IHI conference center.  We were left with very favorable impressions about the efforts made by the people in the theme park company to deliver the highest quality guest experience.  Of particular note was a rigorous system to collect and analyze each and every customer complaint and suggestion.  Once per month, every such comment is reviewed at a high level management meeting, comprising people from all divisions--not just those departments facing the visitors--at which action plans are made to resolve the issues systemically.  I should note that this monthly meeting does not in any way substitute for real-time problem solving.  When a guest brings up an issue in person, the staff member who receives the complaint "owns" the problem and stays with the guest until it is resolved.  The guest liaison staff and all frontline staff have the authority to solve the problem then and there, without further bureaucratic process.  Guests can also submit issues by texting messages to the park, and the problem is often solved in real time by a park official going to the site of the problem.

We (sadly) noted the comparison with most hospitals on this front, and people left with a resolution to explore ways to improve customer service at their home institutions.

We concluded with some free time to explore the park and, yes, go shopping: The bus was definitely more crowded on the ride back to the conference center!

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