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Cataract Surgery | Oct 2014

Pointers for Providing a First-Class Patient Experience

In addition to patient perceptions, environment makes a difference in efficiency.

For patients undergoing premium eye surgery, the experience should be analogous to travelling first class or staying in a five-star hotel. Patients expect excellent outcomes from laser eye surgery and laser-assisted cataract surgery (LACS), and their journey should match their outcomes. The patient experience should be consistently relaxed, the environment pleasant, and interactions with physicians and staff members satisfying.

When it came time for us to build a new surgery center, these considerations were at the forefront of our consciousness. The Centre for Sight has three locations: in metropolitan London; in a rural area in East Grinstead, Sussex; and on the high street in the village of Oxshott, Surrey. At the London center, consultations and Nd:YAG laser procedures are performed. Laser eye surgery is performed at the other two locations.

Knowing that we planned to offer premium refractive surgery at our facilities in Sussex and Surrey, we wanted these centers to represent the appropriate high-end environment. Therefore, in designing these facilities— one of which we built from the ground up and the other of which was extensively refurbished on the site of a former chemist’s shop—we strove to achieve certain ends. We wanted the patient experience to be pleasant, convenient, and efficient and to involve minimal footfall, or travel from one location to another.

As it happened, an architectural design that involves minimal footfall for patients also provides efficiency for doctors and staff; if patients do not have to walk too far, neither do those taking care of them. In these facilities, we can see a large volume of patients quickly, without providers or patients feeling hurried or rushed. Also, as patients are not spending time shuffling down long corridors, staffing can be minimized; we do not need many porters transporting patients from location to location.

KEY MOMENTS IN THE EXPERIENCE

An important part of the patient’s journey through refractive surgery is his or her arrival at the eye center. This is where the patient will undergo laser eye surgery—a potentially lifechanging event. Therefore the approach, the entry, and the reception by staff are all key moments in the experience.

Our facility in East Grinstead is truly out in the country. Patients arrive at the center after driving through farmland and scenic countryside. After such a trip, in such a setting, it would be jarring to arrive at a modern, high-tech building. We wanted this center, which was built from the ground up, to reflect the countryside that surrounds it. The building is located on former farmland, and the architects used the farmland vernacular in their plans. The shape of the center resembles an old barn that used to be on the site, and sections of the structure of different heights are stacked one behind the other to suggest a cluster of farm buildings (Figure 1A).

We do not want patients to be jarred by their experience of the center. We want them to arrive, enter, and feel that they are in the right place. Once inside, they transition from being in the countryside to being in a high-tech environment (Figure 1B), and when they leave they transition back out into the countryside and back home again.

Thanks to our architects, Toh Shimazaki Architecture, the design of the center works. The architects took our vision and presented many ideas of their own for the decor and interior design to make it all come together. The only time patients feel like they are sitting in an eye center is when they are in the examination or laser operating rooms. Their design uses natural materials, especially wood, but in such a way as to meet modern microbiological standards. The woods, for example, are painted with an antibacterial varnish but still retain their natural look.

We also want to project the subliminal message that our facility is clean and tidy. In the waiting rooms and the postsurgical recovery rooms, the operating chairs (Doge Medical; Figure 2) are made with white fabric. The furniture makers thought our request was bizarre, as they normally supply this type of chair with black, blue, or green fabric. White chairs get dirty, and dark colors hide dirt better; however, my rationale was I want to know if the chairs are dirty, and, if they are, I want them to be cleaned properly.

In the recovery area, these chairs, which convert to operating tables at the touch of a button, are separated by wooden partitions. So while they give a sense of cleanliness, the area as a whole projects a warm, human feel.

From the perspective of the physicians and staff, the design of this center is tremendously successful. The place is a joy to work in: a calm, pleasurable environment environment where everything flows beautifully and efficiently.

This location is our biggest investment; it is also our nerve center. All of our staff that run the Centre for Sight organization, including marketing, administration, and the call center, work at this main building.

ADDITIONAL LOCATIONS

Oxshott. Around the same time as the East Grinstead center was built—before the recession of the previous decade—we decided to open another center closer to London. The opportunity arose to buy an old chemist’s shop in the village of Oxshott (Figure 3), where my wife and I live with our children. We gutted the place and extended it, and it is now an eye center with an operating room for laser eye surgery. We also plan to be able to do LACS there within the next 6 months.

The feeling of working in this high street shop is phenomenal for my wife Marcela (also an ophthalmologist) and me. I like contributing to and working in the community where I live. It is a great space, with nice décor that fits the small village environment. Patients love it, too.

Granted, everything is smaller at this site—the footprint in Oxshott is about one-eighth the size of the East Grinstead center, and there are fewer rooms and fewer diagnostic instruments—but the facilities have similar functionality.

In the city. The center in London was set up in an existing building, and the arrangement is not ideal for seeing patients. There are two large rooms on each floor, which requires a lot of going up and down stairs. The building looks grand and very old British, in the style of many medical practices in the area of Harley Street, but, for efficiency, I must confess I prefer a place designed from scratch and architecturally suited to be an ophthalmology facility.

BRANDING

Until recently, I did not recognize the value of branding: that is, having a uniform look for one’s organization. I now realize its importance. Each practitioner has a certain set of values. This value set is reflected in the way you run your business, the way you present yourself, and the way you speak. It also extends to the furniture in your waiting room, the brochures in your vestibule, the design of your website, and the presentation of your staff. There has to be a level of consistency from location to location. It will never be exactly the same in each place, and some diversity is needed, but it cannot be too divergent. It should be recognizable that this particular center is a member of this group, so that patients can walk into our London optical shop, for example, and know that they are in a familiar place.

This relates to the statement at the outset of this article, that premium refractive surgery should be like staying in a five-star hotel or flying first class. You recognize the look of an airline or a hotel group when you arrive at the counter. We try to do the same. Patients expect it—perhaps not consciously but subconsciously. If they do not experience consistency from one location to another, it may unnerve them a little bit. “This is the organization that will be taking care of my eyes. If they can’t look after other things, how well can they look after my eyes?”

Patients have to know that they can trust us. Some of this comes from word of mouth, but the experience they have when coming to our offices must serve to convince them that we can be trusted with their eyesight. Branding is a subtle but an important part of this.

THE RIGHT MESSAGE

It is vital to convey the right subliminal messages to patients who come to us for care. These messages start with our own values.

I always want to make sure that patients have a good and memorable experience and that they come out of surgery seeing great and feeling great. If those things happen, hopefully they will become evangelical and recommend us to friends and family.

For us, patients are the center point. We try to do everything in their best interests, starting with basic concepts—the place will be neat and tidy, patients will move through the system efficiently—and everything else follows from that.

We also want to make sure that we are fairly straightforward about the services we offer. We do not want to sugar-coat or de-medicalize what we do: A surgical operation is a surgical operation. We do not mince words or try to dress it up with some fancy marketing name.

Other surgeons may approach things differently, and that is their right. But we have found that the patients who come to us value our matter-of-fact approach. They know they are being looked after like proper human beings in a caring environment, just as they would be at a five-star hotel or travelling in first class. On the other hand, we try not to overdo it. This sends the wrong message, that we are engaged in frivolous waste, something that is not appreciated by British patients. Nothing in our centers is too ostentatious.

The ophthalmic mission is our focus, but, in the process of taking patients on this journey, we want to make sure that they are comfortable and nothing is going to unsettle them.

CONCLUSION

By ensuring that the concerns for patients were paramount in our designs for our new facilities, the result has been phenomenal for us as providers. It is a great feeling as a surgeon to work in a place that is itself inspiring. When surgeons and staff arrive at our buildings, there is a powerful sense of belonging, of being part of a team. We walk in feeling good, and that is a tremendous way to start the day. We know our interactions with patients will be good throughout the day.

We are in the business of looking after people. To invest a little bit more into providing a great place to serve them better is rewarding on all fronts, for patients and providers alike.

Sheraz M. Daya, MD, FACP, FACS, FRCS(Ed), FRCOphth, is Director and Consultant at Centre for Sight, East Grinstead, United Kingdom, and a Chief Medical Editor of CRST Europe. Dr. Daya states that he is a consultant to Bausch + Lomb Technolas. He may be reached at e-mail: sdaya@centreforsight.com.

Oct 2014