Module 7 – Service logic in the public sector

As far as my knowledge, Sweden is seen to have a quite well functioning health care. With this blog I want to share a really bad experience I had when my niece (7 years old) had been in a bicycle accident and needed medical care. She had been cycling into a cement block which lead to a big wound in the forehead (she wore a helmet but it cracked!) and some loose teeth. We went to our nearest hospital and was directly taken care of. We was directly shown into a room and a doctor came and examined her. This hospital are not specialized in children though, and since this had been a head trauma they sent us with ambulance to the biggest and most famous children’s hospitals in Sweden. The ambulance staff was also very professional and friendly and we felt we were in good hands. The ambulance trip was very fast with blue lights on but then the strangest things happened. Well at the children’s hospital, a nurse (!) looked at her wound in the forehead, talked to her a bit and then said to us “here, she shall take these two painkillers (Alvedon and Ipren) and then you go and have a sit in the waiting room”. Me and my sister looked at each other and said – “OK, but shall not a doctor take a look at her? Don´t we need to X-ray her head?” The nurse gave us an angry eye and said it´s no danger but we should just keep her under attention so she don´t start to throw up, start to be delirious and are not allowed to go to sleep(!)… Me and my sister didn´t believe our ears, we had just arrived with an ambulance driving in high speed and with sirens on… But we sat down in the waiting room, what else could we do?...

Hours passed by without anyone examining nor checking up on my niece. I don´t know how many times we told the personnel that we were really worried, shouldn´t a doctor take at least a quick look at her?... What was happening, they hadn´t forgot us? The only thing we was met by when we asked these questions was really really rude, snotty personnel giving us the evil eye.  I could not believe this! Here we were, at the best children’s hospital in Sweden, and we were treated like this?! They if someone, should be the experts in handling worried parents and relatives! I also told them this. As a mockery they had a sign on the wall saying “Any violence or threats are being reported to the police”….

Let´s give an example. We came in with the ambulance around 16.00 o´clock and around 20.00 o´clock my niece said she was hungry. Since she had had a head trauma, we asked the personnel if she was allowed to eat. Yes, no problem, just tell us if she throw up. We were told there was a “Pressbyrån” nearby but after five minutes my sister came back and said that it was closed. We turned to the personnel and asked what we should do, were there anything open nearby? The vending machine they had in another waiting room was out of order.  My niece had eaten around lunchtime that day to she was really hungry. And since we came in with ambulance we didn´t have a car with us. The personal said that it was nothing they could do, they didn´t have anything to offer. I was totally amazed… We were so lucky that the father to another patient in the waiting room offered himself to buy some food for my niece since he was going to buy their food…

At 22.00 o´clock my niece said she was really tired so we asked the personal if she were  allowed to sleep. Yes, no problem. After half an hour I noticed that the head wound was bleeding again, though the bandage. Again, I asked one of the nurses in the reception which was new on the shift. She came with me to have a look. Since my niece just had fell to sleep, she was heavy asleep and didn´t react when the nurse tried to wake her up. I then saw that she got worried and very quickly came back with a tool measuring the pulse. My niece was ok but that for me was a proof that they were not in control of us nor the situation…. Scary…  

Ten (10) hours later it was our turn to met the doctor which was nicer than the other people we had met during the evening, but to summarize this was one of the worst experiences I have ever had. I had quite high expectations in beforehand since this was the best children’s hospital in Sweden so it took a lot to change this to a bad experience. But this was so bad, it was a nightmare…

The hospital seemed to have lack of coordination, were missing resources and last but not least – the personal working there was no good…  In a hospital it´s crucial to have:

1)       the right people in the right place (it´s just a fact, some people shall not work with people…) 

2)       the staff should be educated how to meet worried parents/relatives that are in chock – how the personal are meeting you are of great importance! Of course I understand that the personal are under a lot of press and it´s not their fault that they are lacking resources but what they can control is their attitude – how they meet people.

For me, this hospital were not efficient, nor professional. Our customer experience could have been so different if we had been met in another way and with another attitude.

According to Per Echeverri, all customer interactions that customer experience are not harmonious[1] and value is formed in interaction. It can lead to that value is co-created or co-destroyed. In this case I think that we definitely ended up in “Reductive co-formation of value”. We had a good start with interactions at the first hospital and with the ambulance personal, but decreased during the process. The interactions ended up being a value co reducer. They seemed to have missed value co creation totally.

This was how we got met at the most famous children hospital in Sweden… For me, this creates a big uncertainty about the future. Sweden, seen as a rich country with a well functioning medical care – what is  happening? Which direction are we moving towards?

---

[1] Per Echeverri, Video: Value co-creation and value co-destruction in service encounters,hhk3.kau.se/uce/