Want to improve your scores? First, be reluctant to over simplify. A patient encounter with a health care system is complex. One day I followed a family from start to finish in a pediatric hematology-oncology clinic. I was looking for ways to improve the care experience. During my care experience tracer we encountered over 12 different people. And that doesn’t include any pre-visit interactions.
From start to finish took over 90 minutes starting with the parking attendant, then the greeter at the front entrance, and then the staff member in the elevator who smiled and said “Hi”. The clinic visit included the usual suspects: receptionist, medical assistant, nurse practitioner and physician. The clinic visit ended with an MA and a nurse drawing blood followed by a stop at the receptionist desk to make a follow-up appointment. The total experience ended with the valet parking attendant (different than the first guy).
For an encounter to be considered exceptional by a family every person needs to smile, be kind, attend to their needs in a timely and effective manner, and look like they love what they are doing and are especially pleased to be helping that particular family. Those last two points are often overlooked. They are perhaps the secret ingredients.
Burned out, overwhelmed, unhappy, unsupported, and under appreciated staff don’t take pride in their work or the work of the organization. These staff are a barrier to good satisfaction scores. They fall into three buckets: 1) those who won’t change, 2) those who aren’t engaged and have lost interest, but can be salvaged, and 3) those who don’t understand what is expected of them or how to deliver what’s expected.
The people in the first bucket need to be let go. They are usually a small number. Some will leave without being fired, because they just don’t fit into the culture. Others just need to be told to look for another job.
The people in the second bucket can be salvaged, but it’s not easy. Prevention is always the best medicine when it comes to eliminating burnout and poor engagement. Nevertheless, engagement rescue is often necessary, and it can be done. It starts with respecting where they are coming from, involving them in two-way dialogue, and giving them a shared vision (aka hope).
The people in the third bucket need supportive, positive and empowering training and managing. It doesn’t take a lot to increase their engagement, increase their understanding, and help them use those vital behaviors. There are multiple good tools and best practices out there. Its a matter of choosing those that are a good fit for the current situation and culture.
There is a fourth category of staff who affect negative scores that are worth mentioning as well. Those who do well most days, but when the going gets tough, they falter. Those in this fourth category like all of us need gentle reminders, but it’s often the system that needs help. Inadequate facilities, incorrect staffing models, mixed priorities, and lack of process management often create environments that make it very difficult for staff to deliver a great experience reliably every patient every time. Its the responsibility of management to enable and empower. Its the job of the staff to execute reliably and effectively.