As book titles go, If Disney Ran Your Hospital; 9 ½ Things You Would Do Differently, is certainly one that captures attention.

The author, Fred Lee, has worked both in managing health services – and for Disney. According to his website, Disney recruited him because of his expertise in helping hospitals achieve a culture that inspires patient and employee loyalty.

His book was awarded the 2005 Book of the Year from the American College of Healthcare Executives, and is described as the “all-time best selling book on hospital leadership”.

Lee is a keynote speaker at ‘The Quantum Leap’ conference in Sydney this week, which is hosted by the Australian Council on Healthcare Standards (ACHS), the Australian Healthcare & Hospitals Association (AHAA), and Women’s and Children’s Healthcare Australasia. He is also speaking at a Hospital Alliance for Research Collaboration (HARC) forum later today.

In the article below, he describes how his personal history has shaped his professional perspectives.


What makes the difference between a great hospital and a good hospital?

Fred Lee writes:

Many years ago, my beloved wife, Margaret, hovered between life and death for two months in intensive care, and then rehab, eventually succumbing to encephalitis from a mosquito bite while we were living in Singapore. She was 28 years old. She left behind a 2-year-old son and 5-year-old daughter.

Now, decades later, I remember only two kinds of hospital workers—those who treated Margaret with compassion, as if she was a member of their own family, and those who treated her with seeming indifference and even callousness, probably because she was not aware of what was going on.

Unfortunately I can’t remember the majority who faithfully did a good job, with courtesy and competence.

There is an adage I often say: “A satisfied patient has no story to tell. Only the dissatisfied and very satisfied do.” In other words you cannot go from good to great doing just the things people expect, the things that satisfy them.

This event, plus two other traumatic episodes, have had a lifelong impact on me and shaped the lens through which I view the relationship between patient and caregiver.

This lens has been useful to me throughout my three decades working in healthcare (including a stint as senior vice president of one of America’s largest hospitals). However, it was the two years during which I was a part-time ‘cast member’ at Disney, working as a consultant, that were a turning point.

With an insiders’ experience and a keen eye for cultural comparisons between Disney and Florida Hospital, I discovered that hospitals could learn a lot from Disney.

One thing was my aforementioned point about satisfaction. Disney does not have a culture of satisfaction. No corporation that is number one is satisfied.

At Disney, we were given ‘guidelines’ on how to dress appropriately but they treated them seriously like standards. In hospitals, we often use the word ‘standards’ but treat them like guidelines and don’t reinforce them.

Also, like going to a Disney movie, being in hospital is an experience. It’s not a service, like dry cleaning. Disney is in the business of meeting the emotional needs of a family to have fun. Hospitals meet the emotional needs of a family going through fear, pain and even tragedy.

In fan letters written to hospitals singing the praises of staff, the most common words used are compassion, kindness, empathy, caring, help and comfort.

These words capture the essential variable that can take a hospital from good (our service) to great (their experience) in patient perceptions.

So, to the degree that patients in a clinic or health center are experiencing pain, fear, loss, anxiety, or emotional stress, staff need to be good at responding appropriately.

We have no trouble convincing nurses of the importance of empathy and compassion. However, many nurses tell me that the emphasis on clinical and financial outcomes in their hospitals make them feel that their gift of compassion and nurture (the Latin root for “nurse” is the same as “nurture”) is less and less important or valued.

Studies show a significant correlation between empathy and clinical outcomes in numerous diseases, shorter length of stay in the hospital, and higher patient perception scores.

If we are to achieve greatness in our health systems, we need to value compassion in the patient’s overall experience.

As Mother Teresa said: “We can do no great thing. We can only do small things with great love.”


• Declaration: Melissa Sweet is conference rapporteur for The Quantum Leap