Controlling the uncontrollable: 3 lessons for healthcare leaders from O'Hare Airport's gate agents

Next time you're at the airport, take a closer look at the gate agents.

Between extreme flight delays, last-minute cancellations and late or absent passengers, the gate agents are likely working to reign in factors entirely out of their control to satisfy an audience primed for dissatisfaction.

"People say, 'I want this.' 'I want that.' 'Do the impossible for me.' It really is a tough job," Suleman Tariq, a United Airlines gate agent supervisor, told The Wall Street Journal, in a report illustrating the work of United's gate agents at Chicago's O'Hare International Airport.

United merged with Continental Airlines in 2010 to form the largest airline in the world, but such a title does not come without problems. Integrating the two companies presented challenges even years later, such as glitches with the booking and technology systems, flight delays and monthly customer complaints that outnumbered those for all other airlines combined.  

Gate agents are the professionals between the place where a customer is and the place they want to be, and United's gate attendants have been striving to improve the company's standing for years. The thankless job of an airline gate agent shares a few parallels with those who work tirelessly in the healthcare industry too, especially when it feels the "big" problems are out of your control.

1. Good strategy means aligning short-term decisions with bigger long-term goals. Like healthcare professionals, gate agents face days full of minute-by-minute deadlines. Which passengers will be left behind? Who will get a seat with spare legroom? As small as they may seem in the scheme of things, these decisions — all the millions of them —ultimately contribute to operational health, like on-time flights, and passenger satisfaction. Improvement is a continuous goal.

Hospital executives may often wonder how industry-wide tensions and issues discussed in the board room — such as the shift from fee-for-service to value-based payment or post-merger integration issues — trickle down and affect individual jobs, roles and employees. Reading about the United gate agents sheds light on how "organizational" problems can drive the behaviors of individual people and vice versa.

The story also illustrates how strategy doesn't trump reality. When United merged with Continental, it promised 5,500 daily flights, eight major hubs and nearly 400 destinations. Those figures — undoubtedly impressive on paper — mean little to the tired traveler who must spend the night in an airport due to a cancelled flight. The same can be said in healthcare: A hospital or health system is only as good as its least satisfied patient.

2. There is no such thing as too much information. Gate agents face a series of never-ending questions. While most are simple, such as, 'Will a meal be served on board?', some passengers only have more questions when provided information on seating, standby lists and delays. To help gate agents, O'Hare's United terminals are testing three computer prototypes with swivel arms, so passengers can see for themselves the latest flight delay information and updated seat maps, according to WSJ.

Last week, when a United flight from Chicago to London made an extended pitstop in Canada, passengers were most disappointed by the lack of available information. When passengers were rounded up after a night in military barracks, passenger Lois Harper told CNN, "That's when it hit us that there was no one from United Airlines there to represent their company and to inform us of really what we were going to expect next," she said. "That was the biggest disappointment of all."

In healthcare, providing information in a complete, timely and transparent fashion is critical in almost every relationship, but most important in the physician-patient relationship. Studies have shown a disconnect in this relationship can have serious repercussions. One study shows patients frequently misunderstand health risks after speaking with their physicians, while another suggests symptoms can actually worsen if physicians do not effectively communicate understanding or belief in patients. Clinicians must strive to provide as much information as possible, and then like O'Hare's gate agents, be ready to provide more. A survey from Nuance showed 40 percent of patients feel rushed during physician appointments, suggesting clinicians need to give patients ample time to ask questions.

In addition to health information, many patients are also looking for more transparency in the healthcare payment process. In a PwC survey, approximately 47 percent of respondents considered in poor or fair health said they didn't understand the cost of their care before services were rendered. All consumers stressed in the survey they wanted more time with physicians, pharmacists and providers to discuss costs.

3. Good hospitality means anticipating issues before they occur. Based on the J.D.Power 2015 North America Airline Satisfaction Study, United hasn't done too well in the past year in terms of customer service. The airline carrier ranked last in passenger satisfaction among the traditional North American carriers, after Alaska Airlines, Delta Air Lines, American Airlines, Air Canada and US Airways.

Despite this ranking, United and its gate agents are working doubly to provide customer satisfaction, and according to WSJ, gate agents say terminal life is getting better. Part of this work rests on the shoulders of the gate agents, to seek out potential issues and resolve them before customers realize there is a problem.

For many physicians and hospital executives, this dance may sound familiar. Healthcare professionals also must create the best possible outcomes with limited time and resources, despite the factors that are out of their control.

Working to improve healthcare in the U.S. will require long-term strategy, transparent information and forward-looking decisions. On this journey, turbulence is more or less guaranteed, making front-line workers so critically important to the patient experience and the reputation of your organization.


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