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The Beryl Institute invites members to submit posts on patient experience related topics. For guidelines and information on submitting a post for consideration, please contact us at info@theberylinstitute.org.

 

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Employee Engagement and Leadership Rounding

Posted By Amy Vanderscheuren, MHA, Monday, February 18, 2019
Updated: Tuesday, December 18, 2018

In today’s highly competitive healthcare landscape, where health system leaders are challenged to achieve both clinical and operational excellence, while at the same time providing an exceptional patient experience, cultivating a decidedly engaged workforce has never been more important. Research shows that employee engagement directly impacts an organization’s bottom line: healthcare organizations with an engaged workforce – one that truly cares and consistently puts forth a discretionary effort – have fewer instances of hospital acquired conditions (HACs), better mortality rates, improved patient satisfaction scores and lower rates of turnover and absenteeism1. Inarguably, it behooves healthcare leaders to consciously invest in employee engagement.

Leadership Rounding, a structured activity, whereby executive, nurse and/or department leaders intentionally and purposefully engage with staff (and patients!) to collect firsthand, actionable insights, is an important and effective strategy for cultivating and improving employee engagement. A proven technique for connecting with staff in a meaningful way, informing leaders across the organization about patient care and other work-related challenges and highlighting the extraordinary work performed by frontline staff and managers, Leadership Rounding has the potential to transform an organization.

The benefits of Leadership Rounding for an organization are many: improved clinical outcomes and patient experience; higher rates of employee satisfaction and loyalty; ability to attract and retain talent; a recognized culture of continuous improvement; and increased employee engagement (which differs from employee satisfaction). Following are four ways Leadership Rounding directly contributes to cultivating and improving employee engagement.

  • Build trust and accountability
    Some estimates suggest that managers are responsible for 60% of all the reasons people quit their jobs, which is one reason manager-employee relationships are so important2. Leadership Rounding demonstrates that leaders care about their employees as people and shows employees that their leaders are interested in day-to-day operations and quality of work performed. Further, Leadership Rounding gives employees a voice, allowing them to share ideas about what is going well in their workspaces, what tools they may need to be more productive, and what they are most proud of at work – important aspects of forging relationships that are grounded in trust and accountability.
  • Improve communication
    Leadership Rounding enables two-way communication between leaders and staff and serves as a platform for collecting information and then closing the feedback loop. During these rounds, leaders have an opportunity to enforce key strategic messages, explain decision-making processes, correct misinformation, and note key behaviors. At the same time, Leadership Rounds also provide a conduit for employees to express their opinions and share their ideas for improvement.
  • Boost morale
    When leaders consistently connect with employees and show genuine interest in and appreciation for their contributions to the organization, staff (and leaders alike!) are energized and motivated to excel. Leadership rounding presents a level playing field, where leaders and employees can connect over their shared purpose: achieving the organization’s mission.
  • Recognize staff
    According to Dale Carnegie: “Nothing else so inspires and heartens people as words of appreciation.” And he’s right. One of the most powerful benefits of leadership rounding, particularly in relation to improving staff engagement, is identifying and publicly acknowledging employees who deserve recognition. Recognizing and appreciating employees for their good work confirms their work is valued by others, which leads to higher rates of job satisfaction and increased productivity (a happy worker is as much as 12% more productive than his unhappy counterpart!3). The value of employee recognition cannot be underestimated.

Leadership Rounding is a proven, best-practice strategy to collect vital information, reward and recognize, build relationships and validate key behaviors. Ultimately, leader rounds improve engagement levels for all stakeholders, leaders and employees alike!

Sources:

1. Kruse, Kevin (2015). The ROI of employee engagement in hospitals. Forbes. Retrieved from: https://www.forbes.com/sites/kevinkruse/2015/02/26/the-roi-of-employee-engagement-in-hospitals/#6642044554ce
2. Schwantes, Marcel (2017). Why do employees really quit their jobs? Research says it comes down to these top 8 reasons. Inc. Retrieved from: https://www.inc.com/why-do-employees-really-quit-their-jobs-research-says-it-comes-down-to-these-top-8-reasons.html
3. Craig, William (2017). 3 reasons why employee recognition will always matter. Forbes. Retrieved from: https://www.forbes.com/sites/williamcraig/2017/07/17/3-reasons-why-employee-recognition-will-always-matter/#315c68463c93

Amy Vanderscheuren, MHA is a Performance Improvement Coach for TruthPoint. She has been partnering with clinical and administrative leaders, frontline staff, and patients and families to improve clinical outcomes, the quality and safety of healthcare, and the patient experience for more than a decade.

Tags:  accountability  communication  morale  relationships  rounding  trust 

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Patient Experience Sits at the Center of Nursing

Posted By Susan E. Mazer, Friday, October 21, 2016
Updated: Friday, October 21, 2016

The patient experience is neither new nor revolutionary in healthcare. 

Florence Nightingale, 1820-1910

In fact, it goes all the way back to the work of Florence Nightingale who, in response to what she saw in the Crimean War, realized so much suffering could be relieved with the standardization of nursing practices. 

In her first and most famous monograph, Notes on Nursing, Nightingale claimed that suffering should not be presumed as part of the disease. Rather she wrote that “the symptoms or the sufferings generally considered to be inevitable and incident to the disease are very often not symptoms of the disease at all, but of something quite different -- of the want of fresh air, or of light, or of warmth, or of quiet, or of cleanliness, or of punctuality and care in the administration of diet, of each or of all of these.” 

From experience and observation, Nightingale knew how rudeness and inconsideration on the part of physicians and nurses could cause patient suffering. The task of the nurse was to protect the patient.

She warned that the vital energy needed by the patient to go through the reparative process should not be wasted nor distracted. Nightingale considered all disease to be reparative, coming on over many years and finally showing itself in a serious of symptoms observable and obvious to both patient and nurse.

There’s no doubt that nursing is where the patient experience initiative began and is what should guide it today.

Our healthcare system has thrown out the idea that nursing might be where we could best learn about the patient experience. And yet nurses have always been the strongest clinical advocates for patients. They understand the source of pain and suffering first because of their intimate relationship with patients.

In truth, the patient experience began to deteriorate when our healthcare system became consumed with medications and technologies. Patients then became the last people to be consulted about their condition and their needs. And, nurses became medicalized as the whole system sought to make all symptoms ripe for medical diagnosis and treatment.

However, Nightingale defined nursing as managing symptoms of suffering that were neither medical nor complex -- symptoms that could be solved by manipulating the environment or paying attention to the patient’s spoken needs. Or, symptoms that reveal other issues that would undermine that patient’s own capacity to heal.

My relationship and work with nurses, which began in 1980 when I designed educational programs on the use of music as therapy, has given me perspective on the considerations prioritized by Nightingale. Dallas Smith and I wrote and presented a docudrama (now a podcast), “Florence Nightingale: In her Own Words,” that brought to life her frustrations with the system that inspired her work. Nightingale’s writings were and are consistent with her absolute commitment to the humanity of the patient, to the uniqueness of each individual and the specificity of their situation.

Additional study of nursing theory has also helped me understand and respect the transpersonal relationship that nurses have with their patients and the way that nursing holds the tradition and expertise of the patient experience.

Dr. Jean Watson, Professor Emeritus and Nurse Theorist, moved Nightingale’s work further in identifying the unique role of nurses in her Theory of Human Caring (or Caring Science). Her Caritas principles, which are the guide to her Nursing Practice Model, call upon nurses to be authentic in their caring for their patients, to treat themselves and others with loving-kindness and equanimity, and allow for the depth of physical and spiritual wholeness in themselves and their patients.

Our relationship with Dr. Watson has taken Dallas and I to Qatar and Jordan, working with nurses in the Middle East who are committed to human caring across borders and political conflict. There, where some Palestinian nurses are not paid for nine months, and where Israeli nurses take in Syrian children and love them as they heal their physical and emotional wounds, human caring has taken on profound meaning.

The bottom line for nurses is to respect patients and their autonomy regardless of their acuity, capacity, or personality. Then allow patients to do as much as they can for themselves and to not get lost in a system where patients are often just medical records.

May Solveig Fagermoen, Ph.D., R.N., associate professor at the Institute of Nursing Science at the University of Oslo, Norway writes, “In nursing, respect must be, or rather is, grounded in the inherent worth of individuals as human beings regardless of their capacities and characteristics (a nonsecular position). … a person is respected not because of his individuality, we do respect him in his individuality. We take his interests, purposes, and degree of autonomy itself into account in the particular way we treat him.”

If the patient experience demands respect from physicians and nurses, identifies the patient’s right to expect and need for quiet and cleanliness, and if it presses to not have patients wait for any reason, then the practical map of how to do this lies in Nightingale’s work and ultimately in nurses.

And, if there is absolute respect for the suffering that you could not know, the anxiety you do not want to cause, and a sense of professional accountability for each patient, then the patient experience sits at the center of nursing, in each nurse, in every hospital.

 

Susan E. Mazer, Ph.D. is the President and CEO of Healing HealthCare Systems®, Inc., which produces The C.A.R.E. Channel. In her work in healthcare, she has authored and facilitated educational training for nurses and physicians. Dr. Mazer has published articles in numerous national publications and is a frequent speaker at healthcare industry conferences.

Tags:  accountability  healing  nurse  Nurse Leadership  relational healthcare  relationship 

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You Can’t “Policy” People’s Hearts

Posted By Kristin Baird, Tuesday, August 27, 2013
Updated: Friday, August 23, 2013

Staff texting at work? There needs to be a policy. Employees parking in prime patient areas? Make a policy. People walking past trash? Create a policy. The problem is, policies are only as effective as their enforcement and do nothing to engage the heart.

I was recently talking with a group of senior leaders about their current culture. They were clearly frustrated and felt they had come to a standstill. Things were not where they needed to be with regards to both patient satisfaction and employee engagement. They all agreed that accountability was their biggest issue. 

The group talked openly about specific behaviors that were problematic. As I probed into their frustrations, a clear picture began to emerge. Each time one of them would identify a problem, someone would declare the need for a policy. And each time, the rest of the group would agree that a policy was the way to go. I observed this happen five times during the first hour. I was curious to see if the suggestion of a policy was an isolated incident or a pattern. It was clearly a pattern.

Indeed, accountability was a problem, but the leaders’ accepted solution was always to create a policy rather than address the behaviors directly when proved to be misaligned with values or standards.

Let me be clear. There is a place for policies. Without them, we would have havoc. But when striving for a culture of excellence, leaders need more than policies. You can’t "policy” people’s hearts. I, personally, would rather foster a culture where people take ownership and do things because it’s the right thing to do rather than because it’s the policy. 

Transformational leadership is a style that engages people’s hearts and helps them feel part of the cause. To me, this is what is often missing in the quest for service excellence. A lot of time is put into establishing policies and executing tactics from a checklist of best practices, but not enough effort is put into engaging people’s hearts.

Healthcare is a service industry. The work that happens each and every day is perfect for cultivating a link to the heart. People working in healthcare are typically caring individuals with a desire to make a difference. The leader’s role is to harness this passion and help make the connection between the "job” and the individual’s sense of purpose. Tell stories. Review the history of the organization and the vision. Talk regularly about the mission, vision, and values, and help leaders at all levels learn to speak the language of these mission, vision, and values.

When the leader’s focus is on doing the right things for the right reasons, the heart of the organization swells with pride and purpose. It’s not the policies that will resonate with people’s hearts, it’s the passion. Remember that creating and sustaining a culture of excellence takes vision, structure, and, above all, a heart for service.

Kristin BairdKristin Baird is President/CEO of the Baird Group, a healthcare consulting and mystery shopping firm. The Baird Group works to improve healthcare organizations’ patient experiences from start to finish, providing a thorough assessment, qualitative and quantitative data analysis, training, and strategies to help bridge the gap between brand promise and the current reality. For more information on today’s guest blogger, visit baird-group.com

Tags:  accountability  culture  employee engagement  leadership  patient experience  policy  service 

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