How confident are you about your staff's ability to deliver great care? Well here is a real time idea that puts your confidence to the test. Consider asking patients when they are admitted, "If you could choose one thing that would contribute to your being calm and feeling cared for, what would that be?"

Registration personnel would record and acknowledge the patient's desires and add it to the patient's instructions. Nursing could then reinforce the patient's desire by saying, "I see you indicated at registration that you would like it as quiet as possible at night. I want you to know we will do everything in our power to make that happen."

You might ask yourself, why would we set ourselves up like that? The answer is that there is power in the asking. There is also tremendous value in showing that you care enough to ask.

And by having Registration ask the question, you give them a role in the patient experience that is often missing. You also gain a greater sense of who the patient is and what his values are.

Do healthcare providers run the risk of making patients even less satisfied if expectations aren't met? Maybe, but we think the focus it puts on achieving the patient's desires is worth the potential failure. After all, what are patients going to say? You are likely to hear - I want good food, I want the noise kept down, I want less interruption at night, or I want more communication from the doctor.

Aren't those also standard patient satisfaction questions? So the expectation of your organization is that these issues are already being met.

Think about it for a second - You're a nurse and it is communicated to you that it is important to Mr. Davis that it is quiet outside his room at night. It's even on the white board in his room. You now begin to see things from his perspective - "Mr. Davis said he wanted it quiet at night, and it clearly isn't. I need to see what I can do about that."

So you take a step further - You take action to remove staff congregating outside Mr. Davis' room before it becomes an issue for the patient. You ask Mr. Davis the next day, "How did you sleep last night? Was it quiet enough for you? There were a few staff talking outside your room so I asked them to do it somewhere else."

The idea of honoring a specific request is common in customer service. For instance, when I'm travelling and I know I'm going to have a long day ahead, I will often request a room away from elevators and heavy traffic. Most hotels are happy to accommodate because it reinforces loyalty.

Of course patients can change their minds and decide something else is now more important. And we all know that family and visitors can also influence patients with expectations of their own.

But when the experience is over, your staff is in a position to ask, "How did we do with your specific request regarding noise" instead of the generic "how was everything?" which signifies that they had no idea what was important to him.

Proactively targeting expectations beats surprises at the end every time.