My daughter and I were recently treated at one of the leading medical centers in New York City for heart-related issues. My daughter’s treatment for long QT syndrome, a life- threatening condition, involved the implantation of a combination pacemaker and cardioverter defibrillator. My care, a couple weeks prior to my daughter’s, was for a condition that had been misdiagnosed for more than 38 years—Wolff Parkinson White Syndrome, an accessory electrical pathway in the heart that causes arrhythmias. (The pathway has ablated.) We both received excellent care by the physicians and the staff during our stay. We were both poked and prodded every couple of hours, except when sleeping. An abundance of caregivers descended upon us during our stay: physicians, nurse practitioners, nurses, nursing assistants, dietary personnel and room service personnel.

Care and service was excellent—up until the point when we were ready to be discharged.  At discharge, care and service crawled to a halt. It literally took several hours to be discharged.  None of the care specialists mentioned above nor appropriate “discharge” people were anywhere to be found. It was as if the hospital’s process of care and service was non-existent and simply vanished when it came to signing out. In my case, I was able to convince the nursing staff that I understood my condition and that I was going to be fine, and pushed them for my discharge. In my daughter’s case, her condition warranted more attention.

Here is my point:  As patients become more aware and responsible for the payment of health care services provided to them—which is likely to occur based on the Affordable Care Act—consumers will demand customer service of the kind that provides them with better value. This includes service at all points in their acute care encounter, including discharge.

In the instance described above, service and care was excellent up until the point of discharge.  It then degenerated into a category more aptly described as substandard. In other industries, customers vote with their wallets. If they have a bad experience, they use someone else. Though the hospital industry hasn’t had that type of pressure before,  things are changing.

Recent studies in health care journals such as Healthcare Financial Management focus on several objectives in order for care providers like hospitals to build a value-based business model. Included in the list of objectives is superior customer service.  If institutions, including leaders in delivering state of the art, clinically effective care, are to remain competitive, the discharge portion of the patient experience requires more attention.