001-Introduction-to-Heathcare-Industry-Lecture-1 (1).pptx

Introduction to healthcare industry prelim

1. Course Description: This course deals with the introduction to health care system, managing health services organizations and systems, health care environments, responsibilities and structures, and function and roles of professional and non-professional staff. It also deals with the types of governance and management issues of the Philippine health care delivery

2. VISION of ARELLANO UNIVERSITY: A model institution of learning where relevant knowledge is acquired and skills are developed in response to the needs of the global community

3. MISSION: To provide equitable access to learning through relevant, innovative, and industry-sensitive and environmental-conscious academic program and services

4. ARELLANO GRADUATE ATTRIBUTES INTENDED LEARNING OUTCOMES A. Professional Competence Apply relevant knowledge and skills required for an effective professional in the field of specialization B. Analytical and Problem Solving Skills Exercise critical and innovative thinking in providing solutions to the problems C. Communication Skills Demonstrate effective oral and written communication skills using the English language D. Lifelong learning Continuously acquire knowledge, skills and values through formal, non-formal and informal learning E. Social and ethical responsibility Hold ethical values and beliefs of peace loving, environment –conscious and freedom-loving Filipino, consistent with industry-desire values and global citizen values

5. PROGRAM OUTCOMES: Apply knowledge of physical, social, natural, and health science and humanities in the practice of nursing. Perform safe, appropriate and holistic care of the individual, family, group and community, utilizing nursing process Apply guidelines and principles of evidence based practice in the delivery of care. Practice nursing in accordance with the existing laws, legal, ethical and moral principles Communicate effectively in speaking, writing and presenting using culturally appropriate language. Report/document client care accurately and comprehensively. Collaborate effectively with intra, inter, multidisciplinary and multi-cultural teams. Practice beginning management & leadership skills using system approach in the delivery of client care Conduct research with an experienced researcher. Engage in lifelong learning with passion to keep current with national and global development. Demonstrate responsible citizenship and pride being a Filipino. Apply techno-intelligent care systems and processes in health care delivery. Adopt the nursing core values in the practice of the profession. Apply the entrepreneurial skills in the delivery of nursing care.

6. COURSE OUTCOME: The course is designed to provide students with an understanding of the Philippine health care delivery system ; changes in the health care industry and environment, and management’s role in health care organizations.

7. DEFINITION OF TERMS: HEALTH the state of being free from illness or injury a person’s mental or physical condition the condition of being sound in body, mind , or spirit especially: freedom from physical disease or pain (Merriam-Webster) a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO) the condition of a person’s body and the extent to which it is free from illness or is able to resist illness ( Collins)

8. Health Care Delivery System Health Care System. - an organized plan of health services Health Care Delivery – rendering health care services to the people Health Care Delivery System- the network of health facilities and personnel which carries out the task of rendering health care to the people

9. Healthcare Delivery System of the Philippines The 1987 Phil Constitution mandates the state to observe health as a fundamental human right, highlighting the gov’ts role in the protection and promotion of the health of the people and the instillation of health consciousness among them

10. The Phil Health Care Delivery System is composed of 2 sectors: 1. Public sector 2. Private sector (A19)

11. Regional Health Office of the Department of Health

12. Public Sector, which is largely financed through a tax-based budgeting system at both national and local levels and where health care is generally given free at the point of service It consists of the national and local gov’t agencies providing health services. National level- DOH is mandated as the lead agency in health. Regional field office in every region and maintains specialty hospitals, regional hospitals and medical centers . It also maintains provincial health teams made up of DOH representatives to the local health boards and personnel involved in Communicable Disease control, esp. For malaria and schistosomiasis . PGH is also a part of this sector.

13. Private Health Insurance

14. HEALTHCARE INDUSTRY (also called the medical industry or health economy) is the range of companies and non-profit organizations that provide medical services, manufacture medical equipment, and develop pharmaceuticals (WP). FDA – FOOD AND DRUG ADMINISTRATIOBN

15. Health care industry - comprises of providers of diagnostic, preventive, remedial, and therapeutic services such as doctors, nurses, hospitals, and other private, public and voluntary organizations. It also includes medical equipment, and pharmaceutical manufacturers and health insurance firms.

16. Health care providers - a doctor of medicine or osteopathy, podiatrist, dentist , chiropractor , clinical psychologist, optometrist, nurse practitioner, nurse-midwife, or a clinical social worker who is authorized to practice by the state and performing within the scope of their practice as defined by law.

17. Health care professionals – HUMAN RESOURCES maintain health in humans through the application of the principles and procedures of evidence-based medicine and caring. may operate within all branches of health care, including medicine, surgery, dentistry, midwifery, pharmacy, psychology, nursing or allied health professions. A health professional may also be a public/community health expert working for the common good of the society.

18. Healthcare team members includes: Doctors Physician Assistants Nurses Pharmacists Dentists Technologists and technicians Therapists and rehabilitation specialists Emotional, social and spiritual support providers

19. Types of Healthcare Providers involved : Primary Care Provider (PCP) is a person you may see first for check-ups and health problems. They can help manage your overall health Generalist refers to a medical doctor (MD) Nurse Practitioners (NP) are nurses with graduate training Physician Assistant (PA) can provide a wide range of services in collaboration with a MD

20. 2. Nursing Care Providers Licensed Practical Nurses (LPN) are state- licensed caregivers who had been trained to care for the sick. Registered Nurses (RN) have graduated from a nursing program, have passed a state board examination, and is licensed by the state Advanced Practice Nurses have education and experience beyond the basic training and licensing required of all RNs

21. Advanced practice nurses include nurse practitioners (NP) and the following: Clinical Nurse specialists (CNS) have a training in a field such as cardiac, psychiatric or community health. Certified Nurse Midwives (CNM) have training in women’s health care needs including prenatal care, labor and delivery. Certified registered nurse anesthetist (CRNA) have training in the field of anesthesia . Anesthesia is the process of putting a person into a painless sleep, and keeping the person’s body working so surgeries or special tests can be done.

22. DRUG THERAPY Licensed pharmacists have graduate training from a college of pharmacy. - prepares and processes drug prescriptions that were written by your primary or specialty care provider - provide information to people about medicine - consult with health care providers about dosages, interactions and side effects of medicines

23. 3. Specialty Care Providers Allergology - determining the cause of allergy Anesthesiology – general anesthesia or spinal block for surgeries and some forms of pain control Cardiology- heart disorders Dermatology- skin disorders Endocrinology- hormonal and metabolic disorders including diabetes Gastroenterology – digestive system disorders General Surgery – common surgeries involving any part of the body Hematology – blood disorders Immunology – disorders of the immune system

24. Infectious Disease- infections affecting the tissues of any part of the body Nephrology – kidney disorders Neurology – nervous system disorders Obstetrics- pregnancy Gynecology - women’s reproductive disorders Oncology – cancer treatment Ophthalmology – eye disorders and surgery Orthopedics – bone and connective tissue disorders Otorhinolaryngology – ear, nose and throat disorders Physical therapy and rehabilitative medicine- for disorders such as low back injury, spinal cord injury and stroke

25. Psychiatry – emotional and mental disorders Pulmonary – respiratory tract disorders Radiology – x rays and related procedures ( such as ultrasound, CT and MRI) Rheumatology – pain and other symptoms related to joints and other parts of the musculoskeletal system Urology – disorders of the male reproductive system and urinary tract, and the female urinary tract

26. TOP HEALTHCARE INDUSTRY TRENDS TO WATCH IN 2018 AND BEYOND 1. Telemedicine – a great way to bridge the gap between physicians and patients. 2. Artificial Intelligence (AI) 3. Robotics 4. IoT (Internet of Things) and Wearables 5. Blockchain

27. The 4 Pillars of Service The Healthcare Warrior’s CUSTOMER SERVICE STANDARDS Meet the Healthcare Warrior. “We’ve got the PPWR (power)” Module Service Standards Description 1 The 4 Pillars of Service - You’ve got the PPWR 2 Greetings -The importance of a warm and professional greeting on arrival 3 Offering Service - Appropriate ways to offer service in a Healthcare setting

28. 4 Requests - How to handle requests professionally 5 Unreasonable requests - How to compromise with positive outcomes for all 6 Dealing with complaints in a Healthcare setting - From the patient and from the patient’s family/loved ones 7 How to deal with angry and irritated patients 8 Serving children 9 Addressing the specific needs of women 10 Appropriate ways to touch patients 11 Professional dress standards 12 Telephone Etiquette - Answering the Telephone professionally - Why its such a big deal 13 Telephone Etiquette - Transferring calls - How to and when is it OK 14 Telephone Etiquette - Taking messages and the importance of relaying them correctly to patients

29. Module #1: The 4 Pillars of Service The aim of this module To differentiate between poor & exceptional customer service To introduce the 4 Pillars Of Service To develop a clear understanding of what the 4 Pillars Of Service stand for To keep the 4 Pillars Of Service in mind whilst conducting daily tasks

30. CHAT POINT Think about your favorite café or restaurant. Why do you go there? Think about the worst service you’ve encountered. Would you go back?

31. Why Do We Need To Have Standards Of Service in Healthcare? Customer service in the Healthcare industry is finally getting the attention it deserves. Outstanding service ensures survival in increasingly competitive markets. We can’t afford to ignore its importance.

32. The Healthcare Industry is starting to recognize the need for superior customer service. However, because those formulating policy have not considered the industry to be a ‘service’ provider, standards are way behind other service-orientated industries. This is causing (financial) damage to the Healthcare industry.

33. Did you know that it costs 6 times more to attract a brand new customer than to keep an existing one or have one referred by word of mouth? https://slideplayer.com/slide/16848616/

34. What is Customer Service? Why is it important? Customer service is anticipating and satisfying the needs of your customers and potential customers in a consistent and dependable manner. Great service in the Healthcare Industry cannot always be gauged by the normal service measures used in other industries e.g. “fast” does not always mean “good” in Healthcare.

35. The industry still needs to establish the indicators that demarcate good service vs. bad service. Health Industry benchmarks are needed. This Healthcare Customer Service Training Module series works towards establishing those benchmarks. We have a lot of catching up to do.

36. YOUR CUSTOMERS - Who are they exactly? Before you can meet the expectations of your customer’s, we must first understand who our customers are. There are 2 types of customers – external & internal. External External Customers – are the customers who pay for your organization’s product or service. Internal Internal Customers - are the people within your organization who rely on you to provide services, products or information they need to do their jobs.

37. LEARNER ACTIVITY Who are your external & internal customers?

38. Service foundations Foundations of Superior Customer Service What makes one organization better than another organization? With your experience as a customer, you can probably name several characteristics that make one company shine above the rest? These companies have a genuine interest in exceeding their customers’ expectations. They want their customers to walk away thinking how great the service was.

39. 3 Main Characteristics There are 3 main characteristics that are the foundation to providing exceptional customer service: SKILLS – knowing how to complete all the tasks within your job function KNOWLEDGE – the experience of and lessons learned from doing your job ATTITUDE – the energy & enthusiasm & positive feelings you have towards your job & dealing with customers

40. LEARNER ACTIVITY Why would customers choose us over our competitors. What do we offer that our competitors don’t?( Location, Food quality,Price,Reputation , Nursing care, Service) CHAT POINT What makes great customer service? What makes lousy customer service? What happens to organizations that provide poor customer service?

41. The 4 Pillars - PPWR What gives us the power to make a difference? For our potential patients or guests, coming to a hospital or clinic is a very stressful time and patients want their temporary home to be happy, welcoming & comfortable. We want our high standards of service to differentiate us from our competitors, because at the end of the day, without our customers/patients, we don’t have a business, and without a business, none of us would have jobs.

42. Our patients are our business. In the Healthcare Industry, we want to create a culture that is focused on excellence in service . Believing in the 4 Pillar’s of Service and practising them will give you the power to deliver exceptional service every time.

43. The Healthcare Warriors 4 Pillar’s Of Service Professional Personal Warm Responsive “ We’ve got the PPWR

44. Professional Service Knowing our jobs Knowing our company’s standards, procedures & policies The way we dress & our hygiene standards Having an appropriate work attitude Having pride in what we do

45. Personal Service Treating customers as individuals, not a number. Consider them as guest. Respecting and acknowledging resident’s rights and choices Ensuring that a customers’ individual environment is well maintained & their personal belongings looked after

46. Warm Service It’s doing everything with sincerity Responsive Service Responding to customers & their relatives needs in a caring & timely manner Taking the time to listen to our customers

47. The Healthcare Warrior’s 10 Commandments of Superior Customer Service Customers are: The most important people in any organization Not dependent on us – we are dependent on them Not interruptions to our work – they are the purpose of it Doing us a favour when they call – we are not doing them a favour by serving them

48. 5. Part of our organization 6. Not cold statistics – they are human beings with feelings like our own 7. Not someone to match wits with 8. People who have wants – it’s our job to fill those wants 9. Deserving of the most courteous and attentive treatment we can give them 10. The lifeblood of this and every organization

49. Module #2: Greetings The aim of this module To understand the importance of greeting patients and guests in the correct manner To have a solid understanding of the standards expected when you greet customers within your organization

50. Why are greetings so important - The moment of truth The moment a customer comes into contact with your organization for the first time, whether the customer walks into your office or receives mail from, or talks to an employee over the phone, these first seconds of initial contact are called, The moment of truth.

51. Greetings can be a moment of truth in many instances, as it is the first impression a customer may have of our company. And as you know, you don’t get a second chance to make a first impression. So it needs to be done correctly, every single time.

52. Greetings are not just the words we use, but also the acknowledgement we give patients and guests upon seeing them .

53. We can greet our patients & guests in such a way that we can change their world in an instant, because “we’ve got the PPWR”. we set a standard that adheres to the practice of being Professional, Personal, Warm & Responsive.

54. CHAT POINT Have you ever been upset, angry or just generally in a bad mood and then you went somewhere, maybe to visit a friend, or you went into a shop and you were greeted in such a way that the person changed your bad mood and made you feel better? You hold this power - use it!

55. 4 Greeting Standards There are four (4) main greeting standards that MUST BE met as a minimum. 1. Within 3 seconds of arrival, acknowledge patient or guest with a) eye contact & smile OR b) greeting & smile 2. Greet patients using their name or preferred title and if possible, greet guests by name 3. Offer service within a 3 minute period 4. Initial statement to patient or customer to be a non-business related statement or question

56. 1. Within 3 seconds of arrival, acknowledge patient or guest with a) eye contact & smile :) OR b) greeting & smile :) These combinations will ensure that the patients and guests feel welcome and will understand that you know they are there in need of service. Smiling Sometimes when we are busy it’s easy to forget to smile. When we are smiling, we need to ensure that our smile is genuine & not forced. A simple warm, genuine smile can break down barriers and this will help our patients feel welcome.

57. Eye Contact Eye contact is also very important. Eye contact means looking people in the eye, but at the same time, not staring and trying to intimidate them. *ASK “Have you ever walked into a store or a party or any setting and the service person or host has ignored you? Looked away without acknowledging you? How did it make you feel? Initial Greetings The following are acceptable greetings: “Good Morning…” “Good Afternoon…” “Good Evening…”

58. LEARNER ACTIVITY What type of greetings are NOT acceptable in a healthcare setting? CHAT POINT Shouting out Waving from across the room Greeting with silence Not announcing yourself on entering a patient’s room Using humour - not everyone has the same sense of humour - you may unintentionally offend. Does our first greeting standard (1) reflect the four Pillars of Service - PPWR? How could we make them fit better into this service philosophy? What else could we be doing when we make initial contact?

59. 2. Greet patients using their name and if possible, greet guests by name. Greeting patients and guests by name gives personalized service and gives patients a sense of belonging Tips For Remembering Names ….. • Use the persons name a couple more times in the course of the conversation • Write down their name after they leave • Associate their name with someone or something that may help you remember it

60. 3. Offer Service Within 3 Minutes - Is it possible? It is important that we set a benchmark so that the patients will always have confidence in knowing that they will be attended to within an acceptable period of time. If you are already dealing with a patient or guest, your offer of service may be, “Hello there, I will be with you as soon as I can”.

61. If it is obvious you will be spending longer than 3 minutes with your current guest, ask the other guests to “please take a seat” because you “may be more than a few minutes.” Be honest and let them know an estimated time frame if possible. Golden rule - when it comes to service time, do not promise what you cannot deliver.

62. CHAT POINT Do these greeting standards (2 & 3) fall in line with our PPWR service philosophy? How can we make them better?

63. 4. Initial statement to patient or customer to be a non-business related statement or question Making our initial greetings non-business related personalizes our communication with the patient. We are also building a rapport by learning more about them and who they are. At the same time, we are showing them warmth and helping to ensure they feel wanted and suitably cared for. Greeting

64. LEARNER ACTIVITY Write down some of your own examples of non-business related opening statements or questions. Explain why they are appropriate in a healthcare service setting. Betty, that colour looks lovely on you Mr Smith, how are you today? J John, how is your shoulder going? Mary, will we see your son again this weekend? Mrs Rodgers, you’re looking well today.

65. ROLE PLAY FUN! Each person to pair up with someone else and role play a greeting from start to finish, using all 4 standards and PPWR. Walk around offering constructive advise to participants.

66. Offering Service Appropriate ways to offer service in a Healthcare Setting Why do we need to offer service? Why can’t they just ask us for it? Service. It’s something you give - not wait to be asked for. Remember that and you’ll always be a customer service superstar. As mentioned in the Greetings module, we established that it is important to offer service to our Patients within a 3 minute period. Why? Because we must maintain service standards that adhere to our Four Pillars of Service Philosophy - PPWR.

67. Four Pillars of Service Philosophy - PPWR. Professional - We consistently serve Patients within a specified time frame Personal - We always use the Patient’s name Warm - Through our words and actions, we show Patients that we care about them and their needs Responsive - We serve Patients within a 3 minute period or when we can see that they need it.

68. When Patients feel that in the hospital environment, the staff care and are eager to help, they will be more happy and satisfied. In turn, the positive atmosphere will make our jobs far more easier and enjoyable. Offering service also improves positive “word of mouth” for our business.

69. By offering service which adheres to PPWR we have the ability to generate great word of mouth - we want people to say - “The staff here are VERY helpful - we never have to ask for anything - they always offer their service”.

70. CHAT POINT Have you ever gone into a store where you really wanted to buy something, and even though upon entering the store you were seen by the assistant, no-one came up to help you and offer assistance? How did that make you feel?

71. There are four (4) main service offer standards that MUST BE met as a minimum. 1. Look the person in the eye 2. Face your whole body towards the person 3. Personalise Conversation - Use the Patient’s name and if possible the patient’s visitor’s names 4. When offering service, begin with “May I...?”

72. 1. Look the person in the eye Appropriate eye contact shows that you are focused on that person, and at that point in time, that particular Patient or visitor is our main concern. ROLE PLAY - 2 scenarios - In pairs. Participant A asks questions of participant B, but A is not to look at B at all, he looks away or over their shoulder. 2. Swap over and this time, B asks the questions, and this time they stare intimidatingly at A whilst asking questions.

73. LEARNER ACTIVITY When giving eye contact, what are some things to keep in mind? Make Eye contact but do not stare Don’t focus on just one spot If patient is seated or lying down try to move to a position where your eyes are level i.e do not “look down” or intimidate. Did you know that you can tell when someone likes you just through their eyes? Eye contact communicates interest in someone. When we like someone this occurs naturally, and we will tend to look at them a lot. You can tell when a person really likes you, because their pupils will dilate :) ROLE

74. 2. Face your body towards the person As with eye contact, facing your body towards the Patient or visitor shows that you are focused on them in that moment and open to what they have to say. REMEMBER - Body Language is a form of non-verbal communication. It can : • affect how people think of you • reveal if someone is lying to you • improve your overall communication • make people like or dislike you • Body language is very powerful. By positioning your body and head towards the other person, you signal that you are interested. You can certainly move your body and head around, but for most of the time, when you are offering service, you must face your body squarely towards the person.

75. ROLE PLAY - In pairs Participants offer assistance to each other, but their bodies are totally facing in opposite directions. How did this make them feel? CHAT POINT What impressions do you give when you are not fully facing the person that you are talking to? How do you think it makes them feel?

76. 3. Use a Person’s name and, if possible their Visitor’s names Using the person’s name is important for personalized service. It gives Patients a sense of belonging, which is important, as this is their temporary home. LEARNER ACTIVITY What are UNACCEPTABLE terms/names to call Patients, when adhering to our PPWR Philosophy? Darl , Mate, Luv, Sweetie, Hun, Hey, Buddy etc

77. 4. When offering service begin with “May I...” The correct way to begin asking a Patient if they would like assistance is to say “May I...”. “May I...” is a professional way of asking permission to do something, and in this instance, asking the Patient’s permission to assist them. What is the difference between saying “Can I...” and “May I...”?

78. Handling Requests The importance of handling requests effectively. Why Do We Need To Know How to Handle Requests? Handling a request sounds simple enough. Doesn’t it? But it isn’t always easy. Our guests make many requests from us every day. We need to ensure that we provide the same level of service standards each time. Why? Because we must maintain request handling service standards that adhere to our Four Pillars of Service Philosophy - PPWR.

79. Our guests expect us to handle their requests in an appropriate manner for two main (obvious) reasons. They are paying for us to handle their requests which is part of our service. It’s our JOB. 2. They are unable to do things themselves. We need to show we CARE.

80. By handling requests in a manner which adheres to PPWR we have the ability to generate great word of mouth - we want people to say - “The staff here are VERY helpful - requests are handled professionally and promptly every time. I only have to ask for things once”.

81. CHAT POINT How many times have you asked for something from a customer service person at a shop or a restaurant and you have not received what you requested. How did that make you feel? As a paying customer what effect does it have on you? What effect does it have on the other customer service staff there? How could this damage their business?

82. Handling Requests Standards REMEMBER... Airline passengers want more than a flight. Hotel guests want more than a room. Restaurant patrons want more than a meal. Healthcare Guests want more than just somewhere to get well.

83. Be in line with Offering Service standards 2. Listen to request without interruption 3. Acknowledge & clarify request by repeating back to Guest 4. Action request – either straight away or state what action will be taken – within specified timeframe 5. Satisfaction of Guest is confirmed 6. Thank Guest

84. “With each request we handle, we want to give our guests a BLAAST of PPWR” 1. Be In Line With Offering Service Standards You must offer service to a Guest or visitor within a 3 minute period. - Look person in the eye - Face your whole body towards the person - Use the Guest’s name & if possible the visitor’s name - When offering service, begin with “May I…?”

85. 2. Listen to the request without interruption LEARNER ACTIVITY What are some common mistakes made during the process of listening to guests? Not Listening; Being distracted; Nodding when you don’t understand Finishing people’s sentences Assuming you know what they want

86. You may be surprised at how difficult it is not to ”butt in” or “talk over” someone who is requesting something of you. Pre-empting a service request can sometimes mean we rush with our responses. Listening is the first step to ensuring that we understand a guest’s needs. This does not just mean hearing with our ears, but listening with all of our senses. Whilst listening to the guest’s requests, use encouraging actions to show that you are interested and are understanding their request.

87. CHAT POINT What are some encouraging ways to show that you are listening to a person without speaking? Genuine signs of interest - Nodding, smiling, “mmm” LEARNER ACTIVITY What are some common mistakes made during the process of listening to guests? Not Listening; Being distracted; Nodding when you don’t understand Finishing people’s sentences Assuming you know what they want

88. 3. Acknowledge & clarify requests by repeating them back to the guest. Once you have heard their initial request, it is necessary to acknowledge that you have understood what was requested. A response to the guest’s request needs to start on a positive note. Always repeat the request back to them. It gives them the confidence that not only are we the right person to help them, but that we are eager to assist them.

89. Repeating the request back to the guest shows that we either understood or misunderstood their request and asks for their confirmation. For example: “Yes Shahana , I can help you with that, so you would only like 1 extra towel, is that correct?”

90. It is at this point in time that we want to find out if we have understood or misunderstood their request. It is far easier to fix things now by clarifying than by spending time & energy doing the wrong thing, whether it was our mistake or miscommunication by the guest.

91. CHAT POINT Think of a time when you went to a shop or service provider and they didn’t listen to you properly and you received the wrong product or service. How did this make you feel?

92. 4. Action request - either straight away or state what action will be taken - within specific time frame. Once we have listened to the guest and repeated back the request for clarification, it is now time to do something about it. Always let the guest know when to expect the request to be completed. It may be as simple as getting an extra towel, or a cup of coffee, but other times, it may take a bit longer, or you may need to refer the request to someone else.

93. If you are unable to complete the task straight away or you need to refer the request on to another staff member, then we must always do the following: • Let the guest know a time frame in which you can complete their request OR • Let the guest know that you will need to pass their request on to the appropriate staff member

94. CHAT POINT Think of a time you went to a restaurant or café and you asked the server for some clean cutlery/another napkin/extra sauce etc and they said “yes, not a problem”, but did not deliver as promised and you either had to ask again or you got upset? How did this make you feel?

95. Let the guest know a time frame in which you can complete their request When you are not able to handle a request straight away, it is important to let the guest know in what period of time it will be completed, as guests still need to feel confident that their request is important and will be handled. Allow yourself a reasonable and realistic amount of time to complete the task, then if you deliver more quickly, this will leave the guests with a positive feeling.

96. Let the guest know that you will need to pass their request on to another or appropriate staff member At this point in time, if you are unsure of how to handle a request or another staff member would be more suitable in completing the request, then you need to inform the Guest of this.

97. To ensure that the Guest’s do not feel like you are “palming them off” because you do not care about them, there are 3 things that must be mentioned to the Guest: 1. Who you are passing the request on to 2. Why you are passing their request on 3. Timeframe When passing requests on to another staff member you will need to inform the guest the timeframe in which: • You can pass the information on to another staff member • The other staff member will come to see them • Their request will be completed CHAT POINT Which of the 4 Pillars of Service does “Action requests” comply with?

98. 5. Satisfaction confirmed Once we have completed the guest’s request, we need to confirm that we have fully provided the service they asked for in an acceptable manner. It’s as simple as ensuring that what they asked for and expected is what they got. “Mr Pradeep , how is your cup of coffee?” Why is it important to confirm a guest’s satisfaction?

99. LEARNER ACTIVITY What are some other ways to confirm that we have satisfied a guest’s request? If a guest is not happy then you have another opportunity to fix it. If you walked away they would not complain to you but to someone else!

100. 6. Thank Guest One of the most powerful ways to leave a positive lasting impression is to thank people. People want to feel important and appreciated and our Guest’s are no different. They want to know that we value them and that we will strive to keep them happy. A simple gesture of thanks requires very little effort on our part and yet can reap tremendous benefits. The Guest’s will remember you as someone who cares about their feeling, as well as their needs.

101. Here are some situations in which you can thank the Guest: When they offer feedback or suggestions – let the Guest know that you value their opinion and that you appreciate knowing how you can serve them better. After making them wait – even if they are unhappy about having to wait, let them know that you appreciate their patience. Demonstrating empathy and appreciation can go a long way in diffusing a Guest’s frustration.

102. UNREASONABLE REQUESTS- How to Compromise with Positive Outcomes for All

103. 1. Empathize. Unless this customer is deliberately screwing with you, he or she believes that the unreasonable request is in fact quite reasonable. This is because customers know less about your business than you do. If they knew more, you might be their customer instead. To turn this situation around, you have to begin by standing in your customer's shoes for just a moment. Knowing what they know-and not what you know-why does this seem like a reasonable request? Fully understanding where they're coming from is the necessary first step to solving this problem.

104. 2. Lift the veil. Once you understand your customer's point of view you also need to help them understand yours. One of the best ways to do this is to share inside information. At the  ASJA  conference in New York City, we serve luncheons that generally consist of a piece of chicken, some vegetables, some rice, a salad, and a dessert. Those lunches cost ASJA in the neighborhood of $100 a serving. It's a shocking number-if we simply handed out $100 bills, our attendees could each get a much more lavish lunch anywhere else. It only makes sense if you understand the hotel industry and the challenges involved in serving lunch to 500 people in the space of about 45 minutes. I tell people  the cost of our lunches as often as I can to help them understand a) why the conference price is what it does, and b) why we don't serve more meals.

105. 3. Ask why. Why does this project need to be completed by next week? Why do they want you to reduce your price? What problem do they have that's led to this request, and how else might you help them solve it? What kinds of offers are they getting from your competitors and are those offers really the same as what you're offering?

106. 4. Explore alternatives. Once you've learned as much as you can about the problem your customer is trying to solve (or the "better" deal your customer has been offered) start looking for solutions that will work for both of you. Can you meet that impossible deadline with part of the project instead of all of it? Can you solve your customer's cash flow problem with better terms rather than by lowering your price? Can you suggest a similar product or solution that might work better for them? I guarantee you will find new ideas or approaches that you haven't considered.

107. 5. Weigh the consequences. What are the consequences of saying no, and perhaps losing the customer, compared with saying yes? If what they've asked is flat-out impossible, and you fail to find an acceptable alternative, then you won't have a choice. But often it's more nuanced-you could say yes if you cut your profit margin out completely, or pull an all-nighter, or do something else you don't like. Every calculation and every situation is different, and there will be a different right answer in every situation. (Here are some tips on  how to say no without losing a customer .)

108. 6. Consider a one-time deal. If you really don't want to lose the customer, and you can't find an alternative that is good for both of you, then consider taking the hit-just one time. Tell them you can provide special consideration in view of your history together. Emphasize that this is a one-time-only concession that won't be repeated and stick to it if they ask again. Otherwise they will never believe that no means no. There are  risks  to this approach. You may merely be delaying the inevitable if the customer leaves anyway the next time the same situation arises. An even bigger risk is that your other customers may hear about it and ask for similar concessions. But sometimes this is the best among bad choices.

109. 7. Apologize. If you just can't say yes to the unreasonable demand, then make sure to apologize. After all, you are genuinely regretful that you can't make them happy. And an apology can go a long way toward  preserving a relationship . One caveat-if the customer's request made you angry,  take a deep breath , take a walk, play a video game, or do whatever you need to get over that feeling before interacting with the customer. Otherwise, your relationship-building won't come off as sincere because it won't be.

110. 8. Say thank you. Even if your customer is being unreasonable, even if he or she is leaving for bad reasons, you have a history together. Honor that history and preserve your connection by thanking the customer for all your past business. Besides being a good thing to do, it's a smart thing to do. Knowing you're still on good terms may bring that customer running back to you if whatever they're leaving for doesn't work out. More:

111. Ten Keys to Handling Unreasonable & Difficult People 10 Strategies for Handling Aggressive or Problem Personalities

112. 1.    Keep Your Cool Benefits: Maintain  self-control . Avoid escalation of problem. How: The first rule in the face of an unreasonable person is to maintain your composure; the less reactive you are, the more you can use your better judgment to handle the situation. When you feel angry or upset with someone, before you say something you might later regret, take a deep breath and count slowly to ten. In  most circumstances, by the time you reach ten, you would have figured out a better way of communicating the issue, so that you can reduce, instead of escalate the problem. If you're still upset after counting to ten, take a time out if possible, and revisit the issue after you calm down.

113. 2.    "Fly Like an Eagle" Benefits: More peace of mind. Reduce risk of friction. How: Some people in our lives are simply not worth tussling with. Your time is valuable, so unless there’s something important at stake, don’t waste it by trying to change or convince a person who’s negatively entrenched. As the saying goes: “You can’t fly like an eagle if you hang out with turkeys!” Whether you’re dealing with a difficult colleague or an annoying relative, be diplomatic and apply the tips from this article  when you need to interact with them. The rest of the time, keep a healthy distance.  

114. 3.    Shift from Being Reactive to Proactive Benefits: Minimize misinterpretation & misunderstanding. Concentrate energy on problem-solving. How: When you feel offended by someone’s words or deeds, come up with multiple ways of viewing the situation before reacting. For example, I may be tempted to think that my co-worker is ignoring my messages, or I can consider the possibility that she’s been very busy. When we avoid personalizing other people's behaviors , we can perceive their expressions more objectively. People do what they do because of them  more than because of us. Widening our perspective on the situation can reduce the possibility of misunderstanding.   Another way to reduce personalization is to try to put ourselves in the difficult individual’s shoes, even for just a moment. For example, consider the person you’re dealing with, and complete the sentence: “It must not be easy….” “My child is being so resistant. It must not be easy to deal with his  school and social pressures…” “My boss is really demanding. It must not be easy to have such high expectations placed on her performance by management…” “My partner is so emotionally distant. It must not be easy to come from a family where people don’t express affection…”   To be sure, empathetic statements do not excuse unacceptable behavior . The point is to remind yourself that people do what they do 

115. because of their own issues. As long as we’re being reasonable and considerate, difficult behaviors from others say a lot more about them than they do about us. By de-personalizing, we can view the situation more objectively, and come up with better ways of solving the problem.

116. 4.    Pick Your Battles Benefits: Save time, energy and  grief . Avoid unnecessary problems and complications. How: Not all difficult individuals we face require direct confrontation about their behavior . There are two scenarios under which you might decide not to get involved. The first is when someone has temporary, situational power over you. For example, if you’re on the phone with an unfriendly customer service representative, as soon as you hang up and call another agent, this representative will no longer have power over you. Another situation where you might want to think twice about confrontation is when, by putting up with the difficult behavior , you derive a certain benefit. An example of this would be an annoying co-worker, for although you dislike her, she’s really good at providing analysis for your team, so she’s worth the patience. It’s helpful to remember that most difficult people have positive qualities as well, especially if you know how to elicit them (see keys #5 and 6).

117. In both scenarios, you have the power to decide if a situation is serious enough to confront. Think twice, and fight the battles that are truly worth fighting.

118. 5.    Separate the Person From the Issue Benefits: Establish yourself as a strong problem solver with excellent people skills. Win more rapport,  cooperation  and respect. How: In every communication situation, there are two elements present: The relationship you have with this person, and the issue you are discussing. An effective communicator knows how to separate the person from the issue, and be soft on the person and firm on the issue. For example: “I want to talk about what’s on your mind, but I can’t do it when you’re yelling. Let’s either sit down and talk more quietly, or take a time out and come back this afternoon.”

119. “I appreciate you putting a lot of time into this project. At the same time, I see that three of the ten requirements are still incomplete. Let’s talk about how to finish the job on schedule.”   “I really want you to come with us. Unfortunately, if you’re going to be late like the last few times, we’ll have to leave without you.” When we’re soft on the person, people are more open to what we have to say. When we’re firm on the issue, we show ourselves as strong problem solvers.

120. 6.     Put the Spotlight on Them Benefits: Proactive. Equalize power in communication. Apply appropriate pressure to reduce difficult behavior . How: A common pattern with difficult people (especially the aggressive types) is that they like to place attention on you to make you feel uncomfortable or inadequate. Typically, they’re quick to point out there’s something not right with you or the way you do things. The focus is consistently on “what’s wrong,” instead of “how to solve the problem.”

121. This type of communication is often intended to dominate and control, rather than to sincerely take care of issues. If you react by being on the defensive, you simply fall into the trap of being scrutinized, thereby giving the aggressor more power while she or he picks on you with impunity. A simple and powerful way to change this dynamic is to put the spotlight back on the difficult person, and the easiest way to do so is to ask questions. For example: Aggressor: “Your proposal is not even close to what I need from you.” Response: “Have you given clear thought to the implications of what you want to do?” Aggressor: “You’re so stupid.” Response: “If you treat me with disrespect I’m not going to talk with you anymore. Is that what you want? Let me know and I will decide if I want to stay or go.”

122. Keep your questions constructive and probing. By putting the difficult person in the spotlight, you can help neutralize her or his undue influence over you.    

123. 7.    Use Appropriate  Humor Benefits: Disarm unreasonable and difficult behavior when correctly used. Show your detachment. Avoid being reactive. Problem rolls off your back. How:  Humor is a powerful communication tool. Years ago I knew a co-worker who was quite stuck up. One day a colleague of mine said “Hello, how are you?” to him. When the egotistical co-worker ignored her greeting completely, my colleague didn’t feel offended. Instead, she smiled good-naturedly and quipped: “That good, huh?” This broke the 

124. ice and the two of them started a friendly conversation. Brilliant. When appropriately used, humor can shine light on the truth, disarm difficult behavior , and show that you have superior composure. In my book (click on title): “ How to Communicate Effectively and Handle Difficult People ,” I explain the psychology of humor in conflict resolution, and offer a variety of ways one can use humor to reduce or eliminate difficult behavior .

125. 8.    Change from Following to Leading Benefit: Leverage direction and flow of communication. How: In general, whenever two people are communicating, one is usually doing more leading, while the other is doing more following. In healthy communication, two people would take turns leading and following. However, some difficult people like to take the lead, set a negative tone, and harp on “what’s wrong” over and over.

126. You can interrupt this behavior simply by changing the topic. As mentioned earlier, utilize questions to redirect the conversation. You can also say “By the way…” and initiate a new subject. When you do so, you’re taking the lead and setting a more constructive tone.

127. 9.     Confront Bullies (Safely) Benefits: Reduce or eliminate harmful behavior . Increase  confidence and peace of mind. How: The most important thing to keep in mind about bullies is that they pick on those whom they perceive as weaker, so as long as you remain passive and compliant, you make yourself a target. Many bullies are also cowards on the inside. When their victims begin to show backbone and stand up for their rights, the bully will often back down. This is true in schoolyards, as well as in domestic and office environments.

128. On an empathetic note, studies show that many bullies are victims of violence themselves. This in no way excuses  bullying   behavior , but may help you consider the bully in a more equanimous light. “When people don't like themselves very much, they have to make up for it. The classic bully was actually a victim first.”  — Tom Hiddleston “Some people try to be tall by  cutting  off the heads of others.”  — Paramhansa Yogananda

129. “I realized that bullying never has to do with you. It's the bully who's insecure.”  — Shay Mitchell When confronting bullies, be sure to place yourself in a position where you can safely protect yourself, whether it’s standing tall on your own, having other people present to witness and support, or keeping a paper trail of the bully’s inappropriate behavior . In cases of physical, verbal, or emotional  abuse , consult with  counseling , legal, law enforcement, or administrative professionals on the matter. It’s very important to stand up to bullies, and you don’t have to do it alone.

130. 10.     Set Consequence Benefits: Proactive not reactive. Shift balance of power. Win respect and cooperation when appropriately applied. How: The ability to identify and assert consequence(s) is one of the most important skills we can use to "stand down" a difficult person. Effectively articulated, consequence gives pause to the challenging individual, and compels her or him to shift from obstruction to cooperation. In “ How to Communicate Effectively and Handle Difficult People ,” consequence is presented as seven different types of power you can utilize to affect positive change. In conclusion, to know how to handle unreasonable and difficult people is to truly master the art of communication. As you utilize these skills, you may experience less grief, greater confidence, better relationships, and higher communication prowess. You are on your way to  leadership success !

131. DECENTRALIZATION - the transfer of authority from central to local government; - the process by which the activities of an organization, particularly those regarding planning and decision making, are distributed or delegated away from a central, authoritative location or group.

132. CENTRALIZATION – the concentration of control of an activity or organization under a single authority. ** In a centralized organization, the decision- making powers are retained in the head office, and all other offices receive commands from the main office

133. HEALTH INFORMATION MANAGEMENT is information management applied to health and health care. It is the practice of acquiring, analyzing and protecting digital and traditional medical information vital to providing quality patient care.

134. PATIENT EMPOWERMENT . The process that helps people gain control over their own lives and increases their capacity to act on issues that they themselves define as important. The aim of empowering patients is to help them develop self-awareness , self-care and promote the understanding that patients can be equal partners in their healthcare decisions

135. PUBLIC HEALTH. As defined by WHO, it is the art and science of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals.

136. REFERRAL SYSTEM. A referral can be defined as a process in which a health worker at a level of health system, having insufficient resources ( drug, equipment, skills) to manage a clinical condition, seeks the assistance of a better or differently resourced facility at the same or higher level to assist in, or take over them.

137. PRIMARY CARE SERVICES. Includes health promotion, disease prevention, health maintenance, counselling, patient education, diagnosis and treatment of acute and chronic illnesses in a variety of health care settings ( office, inpatient, critical care, long term care. Home care, day care, etc.) Primary care is the initial point of contact between a patient and the healthcare system that provide individuals with access to the information and resources they need for optimal health.

138. SPECIALIZED AMBULATORY CARE. This is provided through a network of hospital outpatient departments, polyclinics, specialized medical centers , centers for diagnosis and treatments, and specialist physician offices. Ambulatory care refers to medical services performed on an outpatient basis, without admission to a hospital or other facility. It is provided in setting such as dialysis clinics, ambulatory surgical centers , hospital OPD, and offices of physicians

139. INPATIENT CARE The care of patients whose condition requires admission to a hospital.

140. EMERGENCY CARE. Means the performance of acts or procedures under emergency conditions in the observation, care and counsel of persons who are ill, or injured, or who have disabilities , in the administration of care or medication as prescribed by a licensed physician insofar as any of these acts is based upon knowledge and application of the principles of biological, physical and social science as required by a completed course utilizing an approved curriculum in pre hospital emergency care.

141. PALLIATIVE CARE. It is an interdisciplinary approach to specialized medical and nursing care for people with chronic conditions. It focuses on providing relief from the symptoms, pain, physacal stress and mental stress at any stage of illness. The goal is to improve quality of life for both the person and his family.

142. MENTAL HEALTH Care Mental health is a state of well being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can worl productively and fruitfully and is able to make a contribution to her or his community.

143. DENTAL HEALTH CARE. The goal of dental health care is to prevent complications such as tooth decay (cavities) and gum diseases and to maintain the overall health of your mouth. Includes diagnosing oral diseases, promoting oral health and disease prevention. Creating treatment plans to maintain or restore oral health.

144. ALTERATIVE/COMPLEMENTARY CARE Includes practices such as massage. Acupuncture, tai chi, and drinking green tea. Complementary- when these therapies are used along with traditional Western medicine. Alternative. These therapies are used instead of the traditional.