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Peter Betts

Isn't it amazing that nearly everyone who attends a Disney theme park comes away with a good feeling about the visit? Many will wait in line for an hour in the heat and humidity yet feel that they have had a good experience or certainly got their money's worth. There is, indeed, magic in the Magic Kingdom. That magic can be transferred to the practice of medicine and the delivery of health care. Wouldn't it be a nice goal or objective that everyone that left our offices or our hospitals would have same feeling of a positive experience as when they leave a Disney theme park?

It is no accident that Disney theme parks are the number one tourist attraction in America. They provide fun and entertainment for more than 25 million guests (80% are adults) a year. Most families will spend $500 a day to enjoy the Disney experience. And more than half will return again and again to enjoy the experience.

Do we not marvel that Disney can transform thousands of 18 year-old "cast members" into ambassadors of the Disney philosophy of providing the "guests" everything you can give them in a clean place and in a friendly and fun environment? I believe we can transform that philosophy to apply to the health care profession. This article will describe one CEO's experience in incorporating the Disney philosophy into the hospital environment.

Who would ever guess that at a Disney training seminar where Disney techniques are shared with business and industry that 35% of the trainees would be from the healthcare profession? East Jefferson General Hospital in New Orleans, has made a commitment to incorporate the Disney philosophy into its administration. East Jefferson General Hospital has contracted with Disney officers and brought them to New Orleans to train its 1500 employees in the Disney methods of "creating happiness." The administration and the hospital board feel that the Disney methods of motivating employees and satisfying the guests are not Mickey Mouse. They say it's good for the patients, the employees, the doctors, and the entire community.

Let's look at some of the similarities between the healthcare professions and a Disney theme park. The common denominator is that both organizations have guests. These guests are prepared or expect to pay large entrance fees and therefore have high expectations of the service and the outcome of their experience. How we live up to the guests expectations will determine their satisfaction with our organizations, our image in the market place and ultimately our success.

Disney has recognized that there are critical "magic moments" or "moments of truth" where the guests have contact with the employees, the physical plant, and the Disney mystique. Disney has made an effort to clearly identify these magic moments. The Disney organization estimates that there are an average of 74 contacts per day between a single guest and the employees on the front line. These are contacts where Disney has an opportunity to create a positive impression on the guest and to make sure his experience is a favorable one. Disney definitely understands that you seldom get a second chance to make a good first impression.

In the healthcare profession we should adopt a similar attitude towards our patients, visitors, and physicians as Disney does towards its guests. When the magic moments of truth are identified you can anticipate that the patients will leave with their expectations having been met. When you place a priority of managing the magic moments you can expect to exceed the patient's expectations. It is then that the patients will have a positive feeling about the delivery of heath care in particular and our profession in general.

East Jefferson General Hospital has made a concerted effort to identify and manage the magic moments. The hospital studied the magic moments where the guest has contact and passes judgment on the hospital. They have studied the guest's impression of the hospital the moment he or she drives up to the hospital and have provided a professional greeter to help the guest and give clear concise directions to the guest and his/her family. The hospital manages the magic moment as soon as the guest enters the hospital and they continue to monitor each and every contact point between the guest and the hospital until the end of the hospital stay. The hospital continues to make contact with the guest long after he or she leaves in order to encourage the hospital guest to return if he/she or a family member or friend are ever in need of health care. Creating a service cycle and managing the magic moments doesn't occur by accident at Disney and not at East Jefferson General Hospital either.

What can we in the health care profession borrow from Disney? How does Disney do it? First, Disney leads by example. Most Disney executives come from within or from the bottom up. Disney has a rigorous selection process for all its employees. No one is selected after a single interview. Employees that don't work out in the job they were given are seldom dismissed. Disney assumes the person was right but the job was wrong and they are retrained for another position. Those employees that do a good job are promoted within the organization. Consequently Disney reports one of the lowest employee turnover rates in the entertainment industry: 22% in an industry that commonly has a 100% turnover rate a season. And for middle management the turnover rate is 6%, also one of the lowest in the industry.

At East Jefferson General Hospital the employment process is also very selective. Every applicant watches a video on the philosophy of the hospital and the expectations for all the employees. When some candidates learn about the dress code and the team member philosophy, they will not pursue the application any further.

Why are the employees so loyal to Disney? Disney executives believe in MBWA or Management By Walking Around. Disney executives are commonly seen walking around the rides and exhibits. They talk to the guests and the employees. They ask questions and they find solutions to make everyone's experience including that of the employees a positive one. The employee manual states, "We believe that guests will receive the quality of treatment we expect them to receive when the members of the cast receive that same quality of treatment." East Jefferson General Hospital also develops loyalty by recognizing the accomplishments of the employees, developing the feeling of pride in the hospital and that the employees are working for a "winner." As a result, 60% of middle management in the hospital comes from the ranks, many by promotion from the bottom up.

Everyone at Disney is on a first-name basis and they wear only their first names on their uniforms. It is in the training manual that all employees are to wear their name tags at all times. When Michael Eisner, the highest paid CEO in America, was noted not to have his name tag on while walking in the park or "on stage" he was reminded by one of the employees that he was "out of uniform." You see at Disney there is no double standard. Everyone, even Michael Eisner, follows the rules.

Everyone in Disney adheres to Walt Disney's philosophy of success which he expressed in just two words, "Quality and Pride." Every employee takes pride in the "set." In the Disney parks everyone is expected to pick up litter and trash. Also Disney makes it easy to keep the place clean as there are colorful trash containers nearly every 150 feet in the park that are emptied on a regular basis so they are never full. The walkways to and from the hospital are beautiful with flower beds, shade trees and benches.

Disney believes that extensive training of the cast members is a key to the employee commitment to quality and pride. Every new employee including the street sweeper has four days of training before he or she is considered ready to go on stage in front of the guests. I was curious about the lengthy training for such mundane tasks as escorting Goofy and Snow White around the theme park. The answer is that all cast members are able to answer most questions that are frequently asked by the guests. I can't remember a situation where I asked a Disney cast member a question and he didn't know the answer. The cast members know where everything is, when it starts, and how long the waits are. It all gets back to the Disney philosophy of friendly, smiling cast members who are always ready to help you and make your Disney experience a memorable one.

Smiling and being "on" for eight hours a day is a hard job. Disney management recognizes this and allows the cast members to periodically "go offstage". That is, to take a behind-the-scenes break. Cast members can take an offstage break whenever necessary without any penalty. There will be a cross-trained substitute immediately available whenever a cast member comes back stage for a needed break from the front line.

East Jefferson employees are also expected to be "on stage" when they wear their uniform. The hospital provides a "half time" area where the hospital's "cast members" can go where they are not seen by the guests or patients, their families or visitors. There they can sit down on comfortable chairs, take off their shoes, make phone calls, play computer games, or read.

Recognizing that employees often do not have an opportunity to take care of their personal needs during the daytime, the hospital provides banking, dry cleaning, film processing, video rental, prescription service, eye-glass care exclusively for employees.

Disney managers and executives have recognized the necessity of knowing what the customer/guest is thinking, seeing, touching, and smelling. That's why every executive and middle manager will spend several days each year as a cast member. That way the behind the scenes "stage directors" understand the feelings of both the front line cast members and the guests.

The word "Disney" is not found in the dictionary. However, it is translated to the entire world to mean "The Finest in Family Entertainment." There is no better example anywhere in the world of quality, excellence, creativity, and attention to infinite detail than that demonstrated at any Disney production. It is possible to transfer the magic of Disney from the world's most famous theme parks to almost any service industry, including health care. It is possible to take many of the Disney service concepts and modify and implement them into nearly any healthcare system. The comparison between Disney and health care may not match in all areas and many even say "far-fetched." There is one thing for certain: when a guest comes to a facility because they are ailing or seeking recreation, people react most favorably if they are treated with respect, and if their expectations are exceeded; they will tell their family and friends about their positive experience, and more importantly they will return. So take a little "Pixie Dust" and put sparkle into your delivery of health care.