Patients vs. Passengers: On any given day...

As I write this (Saturday, July 20), I’m sitting in Hartsfield–Jackson Atlanta International Airport, the busiest airport in the world.? It was supposed to be neither an origin nor a destination for my travels this week…rather a connecting point…a stop along the way.? The airport commonly known as ATL is even busier these past few days thanks to an IT issue from both Microsoft and Crowdstrike, a cybersecurity organization. Both organizations pride themselves on “uptime”, so it’s ironic that a combination of their glitches created the largest travel issue in years.?

Combined, American, United and Delta paused all their flights Friday morning and ultimately canceled more than 3,000 flights into, out of or within the United States along with having more than 11,000 flights delayed, according to FlightAware.com.? As one of tens of thousands of passengers impacted by these circumstances, I couldn’t help but draw parallels between the travel world and healthcare.? Passengers vs. patients…airports vs hospitals and clinics…flights vs procedures and patient encounters.

My last flight of the week was scheduled for late Friday after I had spoken at an oncology organization’s leadership conference. I began Friday day talking with a colleague who had been booked and rebooked on (or canceled and bumped from) about a half dozen flights just trying to get home after a week of travel.?? I heard a glimmer of hope in her voice as she told me that a flight had emerged that looked like it was going to make it.? I put the travel world out of mind as I prepared to deliver my keynote address on “Building Trust” to the oncology group in Ft. Myers.? Friday afternoon as I made my way to the airport, I received the first of what would become frequent delay notifications. My first thought was “at least I know about it before I get to the airport” and “wouldn’t it be great if all healthcare organizations had a similar system to alert patients when things are running behind schedule?”. My first view in the airport entrance was that of a TV reporter shooting a story for the 6 o’clock news about all the delays and cancellations.? Not a good indicator of things to come. As more delays rolled through my airline app, the more it became obvious that I would likely miss my connecting flight home.? Having traveled professionally almost each week for 20+ years, I’ve learned that allowing undue stress at the airport isn’t only not healthy for me, it creates stress for others.? As I approached the gate for my delayed flight, I watched a fellow passenger who likely doesn’t travel as often venting pretty loudly at the gate agent.? It wasn’t without meaning…she had a family funeral she needed to attend the next day and by the end of the conversation, both the passenger and the gate agent were in tears.?

Immediately I was struck by the thought of what happens when our patients experience unexpected waits and delays.? They present to us at their most vulnerable moments and look to us to provide healing (and sometimes lifesaving intervention) within the timeframes we promise.? I thought of physicians (especially surgeons) who show up every day expecting things to run on time (like an airline schedule) and sometimes experience angst of their own when schedules are behind, when equipment might be down or missing (again…think aircraft)…and I think of our hospital and clinic staff who have to play the role of messenger to the patients about waits and delays.? As I watched the sea of humanity making their way down the ATL concourses after midnight I was struck by so many passenger vs. patient analogies.? When I went to catch the “Plane Train” as its known at ATL, I noticed hundreds of passengers already sleeping or bedding down for the night next to the moving walkways…and I thought of the term “hall beds” in our emergency departments.? These passengers (airport patients) had nowhere to go…hotels rooms near the airport (think beds on Med-Surg) were long gone.? The looks on their faces were that of being resigned to their fate for the night. I couldn’t help but notice the similarity to patients (and families) when the ED is busy and the floors are full.?

It reminded me of the importance of explaining waits and delays…not to drive a patient experience score but to reduce anxiety.

I was one of the lucky passengers who had a hotel reservation…downtown Atlanta at a fairly new property…I assumed I’d take the Uber or Lyft ride, check in and try to get a good night’s sleep.? Well…myself and 500 other travelers who arrived almost simultaneously all thought that.? The hotel front desk was overwhelmed by the number.? The line stretched out the front door and along the entry walkway of the hotel. Roughly 500 of us by quick count and only 4 front desk attendants.? I made a note of the faces in the line…almost sheer defeat.? We all thought we were at the end of our long days when, in fact, our beds were still another 90 minutes away. The difference between the airport and the hotel experience was noticeable…the front desk team never broke stride. They all wore their best smiles. Another of their hotel colleagues “rounded” on us in the line with bottles of water and updates as to how long it would be based upon where we were in line.? She also did an incredible job managing up the front desk team:?“You’re in great hands…they’re our very best…they’re all pros at handling long lines.”? This morning as I checked out of the hotel, I noticed one of them was still working the front desk.? I shared with her how impressive their work was at 2 am.? You might have thought I gave her winning lottery tickets by how her face lit up and the smile that she returned to me.?

Back to the airport this morning…passengers who were supposed to board their cruises, a group heading to a family reunion, a young lady in tears with an infant just trying to get home. The scene and the conversation reminded me of waiting rooms and common areas in healthcare: everyone has a story.? Some stories are more dire than others…but none are more or less important than others. I thought of how fortunate we are when we take the time to learn our patients’ stories…when we help them be heard.

We’ve known for years that reducing a patient’s anxiety builds their trust.? When they trust us, they listen. When they listen, they become more compliant. When they become more compliant, they help create better clinical outcomes for themselves.?

That’s why I was so thankful for Beau.? Beau is a Delta Air Lines team member.? Beau took care of me today and in doing so, not only did everything he could to get me home, but explained everything he was doing behind the monitor as opposed to just clicking away on his keyboard.? Ask any professional traveler and they’ll agree that the “fingers clicking on the keyboards” sound can be like fingernails on chalkboards…if the person doing the clicking isn’t talking to you. He told me what he could do and what he couldn’t…he managed my expectations.? He never made a promise about something in which he wasn’t completely confident.? And in the end, the flight he helped me get on wasn’t the most optimal (about 4.5 hours from my home airport), but it was a solution, and it was one that got me home after 6 days on the road.? Many of our patients have long roads.? Let’s try our hardest to learn from other industries as to how we can help them navigate their journeys.

Be well, good health and safe travels.

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