We encounter “scripting”, or standardized responses, every day. Order a cheeseburger and the cashier will ask if you want to Supersize it. Rent a car and the staff will ask whether you prefer the gas purchase option. Fill up with gas and the screen on the gas pump asks if you would like a car wash. You anticipate the next question and have a ready answer because scripting is so ubiquitous that we come to expect it. Customers are extremely savvy in recognizing when they receive a script in a service encounter, according to two new studies from the University of Utah’s David Eccles School of Business.
The study found that customers don’t mind scripting in more mundane, process-driven situations like checking into a hotel or paying for a meal. However, in the event of a personal matter, individuals perceive scripting less favorably because it can lack a sense of one-on-one connection. So when you ask a waiter for a suggestion for dinner and you get “the script” for the evening specials, his or her reply may seem disingenuous.
Sophisticated firms with a reputation for excellent customer service overcome this issue by designing scripts that sound sincere and individualized. In highly ranked companies, scripting is nearly imperceptible to customers. These companies use scripting to ensure consistency of service, serve as a foundation for customer interactions, and act as a framework for problem-solving.
We hear much discussion about whether to employ scripting in healthcare interactions. Those in favor of scripting believe it improves the consistency of service, helps when handling difficult situations, serves as the foundation for starting or redirecting a conversation, and it improves patient satisfaction scores. When executed well, scripting can demonstrate respect and empathy for patients, two important aspects of personal healthcare interactions. Some health systems use patient satisfaction survey questions as the foundation for scripting to connect what staff say to the metrics.
Those against scripting say that the communication can seem forced or robotic without meaning or sincerity; some even refer to those who use scripting as “Stepford Nurses.” Certainly, one must take great care to project empathy when delivering a standardized response. Imagine how a patient or family member would perceive the exact same phrases spoken repeatedly by different staff.
In all communication, a sincere, respectful, empathetic and unhurried conversation is more likely to generate a favorable outcome. Where could these sentiments be more important than in healthcare?
In addition to a baseline awareness and administration-approved messaging, hospital staff need training about non-verbal communication. Body language, eye contact, and attitude convey a message beyond the words. Humans convey 7% of a message through actual words, and communicate the rest through tone, body language, gestures, and facial expressions. So it is extremely important that the total message conveys respect, sincerity, and does not feel rushed – or practiced.
We suggest the following healthcare-specific situations may benefit from empathetic scripting:
Asking for Payment
Asking patients for money during an urgent or emergent healthcare visit places the clerical healthcare worker in an uncomfortable and awkward position. Requesting either a deposit (self-pay) or an insurance co-payment has become a necessary practice in these times of medical insurance coverage uncertainty. Providing a script to hospital staff helps them successfully request payment. For example, “You have an insurance co-payment or deposit due today. How would you like to pay that? We accept cash, check, and all major credit cards.”
Discussing a Difficult Health Situation
News of death, critical injury, heart attack, or emergency surgery is difficult to relay to family members. Hospital staff must anticipate verbal or physical reactions that make a stressful situation even more so. The ability to offer spiritual support or social service assistance helps assuage individuals as they process very difficult news. An available script or pre-printed information sheet equips the nurse to ask appropriate questions and provide accurate answers concerning the traumatic event.
No one likes to wait. Patients frequently experience delays for registration, diagnostic imaging studies, or surgery. And when staff await overdue test results, supplies, or equipment, these delays transfer to the patient. Delays could cause a fasting patient to wait even longer for a test. Delays may even cause a completed patient to postpone discharge or adjust their treatment plan.
In the restaurant industry, wait staff can mitigate news of a delay by offering a beverage or even an appetizer. It is not uncommon to hear, “It will be about 20 minutes for a table; may I get you a free appetizer of your choice while you wait?” In a healthcare setting, we too wish to ameliorate the patient’s increased anxiety levels, restlessness, or disappointment, but informing patients of a delay for a procedure or diagnostic testing can cause further irritability and frustration.
Using scripting, a nurse might say, “We have had an unexpected critical patient that requires a CT scan. The test should take about 15 minutes and then we will be able to complete your CT study. I am very sorry for the delay, is there anything I can get anyone?” Employees who can alleviate these situations help to improve outcomes and overall public opinions of the organization.
Construction and renovation projects can be a major headache for staff and a real inconvenience to patients and families. Maintaining a smooth construction project while continuing to provide exceptional patient care requires a great deal of ongoing communication.
Saying, “I am so sorry for your inconvenience today, our construction project is __ months from completion and once it is complete we will have a new _______ (parking lot, waiting room, CT scanner, etc.) Won’t that be wonderful?” Keeping patients informed engages them in the improvement process and inspires excitement about the hospital’s future. We have found that such positive communication with patients and family can even improve satisfaction scores.
Have you successfully used scripting at your hospital? Are there other healthcare interactions that benefit from a standardized response? We invite you to share your experiences in the comments below.
CONTRIBUTOR: Kathy Clarke RN, BSN