Military Medicine Embraces Disney's Customer-Focus

By Donna Miles
American Forces Press Service

Aug. 26, 2010 - Two years ago, still stinging from a 2007 scandal that rocked Walter Reed Army Medical Center to its foundation, the Army turned to a seemingly unlikely partner to instill throughout the institution a mindset of putting patients first.

Then-Col. Patricia D. Horoho, now a major general leading the Army Nurse Corps, recognized that the same principles that had made the Disney Corporation so successful could apply to the Walter Reed Health Care System she had stepped in to command, so she turned to the Disney Institute, the corporation's external training arm, for insights into how to transform the Army's health-care culture.

Mandatory sessions for every Walter Reed employee, led by Disney trainers, emphasized every person's role in providing patients and their families the best possible hospital experience.

"One day of training with Disney isn't going to change our hospital," Horoho said as that training was under way. "Disney is one piece of a whole systemwide process we're trying to change."

But the initiative proved so successful that when the Disney contract expired, Army Medical Command hired a former Disney employee for an additional five-year stint to build on the groundwork.

The goal, explained Frederick Larson, who now serves in Walter Reed's care, service and cultural transformation office, is to extend those lessons -- throughout the joint task force overseeing all military health care in the Washington national capital region, and ultimately, to the entire Army medicine community.

Earlier this week, an auditorium full of medical professionals gathered at the National Naval Medical Center here, watching images of Donald Duck, Snow White and Mickey Mouse flash on the overhead screen as Larson described the formula that's made Disney theme parks the gold standard for customer service.

"At Disney, every single person, from the executive suite to the guy who cuts the lawn, is in the business of creating a magical experience, of creating happiness," he told the audience, some in uniform or civilian clothes, others in lab coats or hospital scrubs.

They succeed, Larson said, because they all keep their focus on the customer -– the guest or vacationing family.

"It's the center of everything the organization does," he told American Forces Press Service after the presentation. "It drives the business decisions that are made, the operational decisions, the safety standard. It covers every single element, right down to how the salt shakers should look."

That same customer focus and attention to detail can go a long way toward transforming the way the military medical community treats its patients and their families, he said.

"When you instill at the organizational level, in each and every individual, the notion that 'It is my responsibility to provide care and service,' 'It is my responsibility to understand what that patient, what that family needs,' the natural outcome is providing a more relevant, caring service experience," Larson said.

He shared Disney's recipe for success with his Bethesda audience, emphasizing that they apply equally in patient care: understand your mission and who you serve, set standards and design processes to consistently meet them, and continually evaluate what you're doing and make changes when they're needed.

Too often, groups of people within large organizations -– the military included –- develop a "silo mentality," Larson explained after the presentation. They may do a great job within their own narrow scope of responsibilities, but don't fully understand their role as members of the larger organizational team.

"I tell people, each of us experiences this hospital at about 15 percent each and every day," he said. "But our patients experience this hospital at 100 percent. So it is vitally important that we all think in terms of what it feels like to experience this hospital as a patient, so we can actively develop those cooperative and collaborative relationships that benefit the people we are here to serve."

Larson used a show-business analogy to underscore the importance of every person within the health care system -– from the appointments clerk to the receptionist to the operating room nurse and surgeon -– in formulating a patient's hospital experience.

Each person is an "actor" within a "greater show," he said, and needs to understand their connection to the other players as they all work together according to a well-rehearsed script. "If we apply that theatrical metaphor to the way we render care and service, we inevitably create a better care experience and a better care outcome," he said.

Larson admitted he sometimes runs into skeptics who scoff at the concept of turning military medicine into a "Mickey Mouse operation." But he's impressed by how quickly they become believers. "Once they hear the material and the rationale and theory behind it, they realize that this all makes sense," he said.

So much sense, in fact, that Larson is working with the Army's surgeon general, Lt. Gen. (Dr.) Eric Schoomaker, to take some of the best practices being realized through the program beyond the Washington Beltway.

Larson anticipates a major outreach initiative within the next 12 months, "at least through the Army system, and maybe further."

"We're working on it right now," he said. "A number of folks are working very hard right now to articulate those best practices and get them pushed out."

As he focuses on that effort, Larson said, he still gets regular phone calls from former co-workers from his 20 years with Disney, expressing amazement that he "walked away from the best job in the world and joined the Army."

Larson quickly clarifies that he's a civilian employee, not a soldier, but said he's never once looked back.

"It was the best job in the world, but frankly, this has turned out to be an even better job," he said. "Every night, you go home dead tired, but with the sense that you have accomplished something, that you have made a difference in people's lives. It's very real; it's very tangible. There is no ambiguity whatsoever."