Imagine a hospital where everyone -- well, almost everyone -- smiles.
And says hello, introduces himself and asks, "Can I help you with anything?"
And generally treats you like a fellow human being.
This is the ambitious goal at Arlington Hospital, which last June launched a new program called "HOSPITAL-ity," a frank, if slightly saccharine, way of saying that a hospital ought to be both a healing place and a hospitable place, a place, one is told, "like a hotel."
Or like a hotel ought to be.
Being a hospital worker, be it doctor, nurse, technician, housekeeper or clerk, is not easy. Stress and death are part of their lives.
Can we nonetheless expect hospital staffs to be decently human and helpful? Absolutely yes, answered a teacher of HOSPITAL-ity, Wendy Leebov of Albert Einstein Medical Center, Philadelphia, at Arlington Hospital recently.
"Yes, we are really asking a lot of you," she told a group of Arlington employes. "Yes, it puts a lot of pressure on you. But when you're the patient, how do you want to be treated?"
What is more, she added, "These times demand new behavior."
"These times" are times in which use of hospital beds is shrinking, and some analysts think use will drop another 50 percent. Hospitals are competing fiercely for patients, and both hospital workers and doctors are beginning to get the message: "If I don't like it here, if I don't like you, I can go elsewhere next time, and you may not have a job."
Three years ago, administrators at Philadelphia's Einstein hospital became aware of increasing patient complaints, especially complaints about curt or rude employes. Leebov became one of a small group who studied patient relations at other hospitals and guest relations at hotels.
All hospitals had employe training, but none, Leebov and colleagues felt, did enough. So they developed HOSPITAL-ity, a top-to-bottom intense and then continuing effort to make every employe feel that everyone who walks or is carried into the hospital is his or her guest.
In sessions with Leebov and each other, Arlington hospital employes are being told or reminded, "Break the ice. Make eye contact . . . Does someone look confused? Stop and try to help . . .
"Smile . . . Listen . . . Respond quickly. When people are worried or sick, every minute is an hour . . . Show respect. Knock as you enter . . . Keep it quiet. Noise annoys. It also shows a lack of consideration . . . Imagine you're on the receiving end.
"Help each other, and you help a patient . . . You're part of a long, proud tradition. Look the part."
It's too early for an accurate gauge of Arlington's results. Still, a typical employe -- pharmacy technician Debbie Peterson, who does not even deal with patients ordinarily -- said: "The program has made me aware that I have to make some special effort. We're down the hall from X-ray, and I often pass patients who say, 'Which way is X-ray?' Instead of just saying, 'It's down the hall to the left,' I find myself talking to them now. And I've had some nice conversations."
At Einstein, where there has been more opportunity for measurement, 92 percent of patients said this year they would be willing to return to Einstein for treatment, compared with 83 percent in 1982. The admission staff's "courtesy" rating went from 79 to 99 percent, the food staff's from 78 to 94 percent, the nurses' from 85 to 90. A consultant found the hospital's image in its surrounding community has gone up spectacularly -- from 42 to 85 percent, for example, for "interest in a patient as a person."
What if an employe can't measure up or refuses to?
"You must set an example yourself," Leebov told Arlington supervisors. "You must then be very explicit in saying what kind of behavior you expect, and what you will not tolerate. You must stick to this. If employes see you permitting unacceptable behavior, they'll let down, too."
The last resort, but a necessary one at times, she said, is to fire someone, which can be a favor to other employes, patients and even the fired one.
Einstein has marketed the HOSPITAL-ity program to 32 other hospitals, including Sinai Hospital in Baltimore, Prince William Hospital in Manassas, Mary Washington Hospital in Fredericksburg and, two new recruits, Georgetown University Hospital in the District and the University of Maryland Hospital in Baltimore. Fairfax Hospital has a similar program called "Applause," Providence one called "CARE." Some other hospitals say they are developing their own programs.
With any results? Ask the patients.
Next Week: A look at the soon-to-open National Rehabilitation Hospital.