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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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Using Shared Governance to Improve the Patient Experience

Posted By Gen Guanci, Thursday, January 4, 2018
Updated: Thursday, January 4, 2018

Those in health care know all too well that the patient experience is a top pain point for executives and therefore a top organizational priority. There is also no shortage of initiatives, programs and activities that focus on improving that experience. Committees and task forces are formed with participation from leaders across the entire organization. Education and action plans are developed and rolled out. Patient experience scores are closely watched for the anticipated improvement. Then, reality often sets it: There is no—or only minimal—improvement. How can that be? And what can be done about it?

What if you were to take the traditional approach to improving the patient experience—the approach where initiatives, programs and activities are developed by those outside the point of care and rolled out to those who must operationalize them—and flip it? Shared governance is a leadership model that does exactly that. In a shared governance culture, staff members are empowered to make decisions that meet a set of articulated expectations shared by leadership. Shared governance has proven to be a highly successful partner in crafting strategies that yield sustained improvements. Shared governance is built on a set of four overarching principles:

Partnership
Staff and leaders work together to improve practice and achieve the best outcomes.

Equity
Everyone contributes within the scope of her or his role as part of the team to achieve desired outcomes.

Accountability
Staff and leaders share ownership for the outcomes of work and are answerable to colleagues, the institution, and the community served.

Ownership
Participants accept that success is largely dependent on how well they do their jobs.

Using shared governance, groups of staff members (councils) are charged with the development of the specifics of the plan to address the opportunities for improvement. Let’s take the desire to have purposeful rounding be a standard of care. While the desired outcome is purposeful rounding, it would be up to the individual councils, groups, departments, or units to determine how this could be best operationalized in their area.  Here are some examples of what could happen when the people closest to the work in each department are empowered to make decisions about how to make rounding purposeful for their specific patient populations.

The Maternal-Child department determines that rounds will be done hourly between 6:00 a.m. and 11:00 p.m., then every two hours between 11:00 p.m. and 6:00 a.m.  They have made this decision to meet the needs of their patients to have a period of uninterrupted sleep.

The Surgical unit decides rounds will be a shared responsibility between the RN and the Clinical Assistants (CA).  RNs round on the even hours and CAs on the odd hours. For the same reasons as the Maternal-Child department, they too decide hourly rounding hourly will be done between 6:00 a.m. and 11:00 p.m., then every two hours between 11:00 p.m. and 6:00 a.m.

The Patient Experience council, made up of a mix of staff members from across the organization (i.e., environmental services, clinical, nutritional services, etc.) work together to develop a meaningful rounding experience for patients and staff members that includes addressing the best practices in rounding conversations. 

The expectation for each of the above groups was to craft a meaningful rounding experience that worked for the patient as well as the specifics of the individual units/departments. The plans, developed by staff members, are supported by colleagues as peer developed and rolled out the plans. Peers create the accountability with each other, and this in turn lessens the need for leadership to “manage” the plan. It also moves organizations from “us” and “them” to “we.” 

There is an ancient Chinese proverb that states “An owner in the business will not fight against it.” Using shared governance to craft a plan for sustainable improvement creates ownership at all levels of the organization.

Gen Guanci is a consultant with Creative Health Care Management where she works with organizations as they build a culture of excellence. Her work with Magnet® and Magnet® aspiring organizations focuses on improving the patient experience, work environment, clinical practice, and patient outcomes. Her expertise in shared governance has enable her to empower staff to generate outcomes that exceed national benchmarks.

Tags:  empowerment  expectations  governance  leadership model  ownership  Patient Experience  rounding 

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Rounds for Change

Posted By Irene Brennick, Monday, April 25, 2016

As a volunteer director, I often make patient rounds with my CNO. At my hospital, staff and volunteers alike make patient satisfaction a top priority. We frequently round on patients, not only to assess their needs, but to also find out what didn’t go right so we can learn from it, correct it and make things better for everyone. During one particular interaction, I discovered how easy it can be to change a patient’s perception of the hospital from negative to positive.

My CNO and I walked into a room and encountered a female patient and her husband. We inquired about their experience, and their response revealed an opportunity for improvement. The woman said she was admitted through the emergency room, sent to another unit and finally arrived at the room she was currently in.

The patient told us how sick and scared she was. Her experience in the ER was somewhat of a blur, but she remembered very clearly an abrupt nurse in one of the units. She said the nurse didn’t listen to her, and her husband echoed the lack of attentiveness on behalf of the nurse. Once she was brought to her private room, however, she said she had received nothing but the best treatment.

After she recounted her story, my CNO told the patient "I am very sorry to hear that, because what I hear is that the care is very good. I will investigate the situation, and again, I am sorry.” I too have always heard about the exceptional treatment people receive in our facility, and was quite surprised to hear anything negative at all regarding the care. This patient and her husband started to protest a bit stronger. They repeated their story about how the nurse treated them in the unit.

I thought to myself, remember it is the patient’s perception of care and sometimes we have to do our best to make the patient experience better. When this patient goes to fill out a patient satisfaction survey we want to have eliminated or decreased the negative impression of our hospital. Before we left the room, I looked closely into the woman’s eyes and simply said, "I’m sorry you believe you didn’t receive the treatment you deserved. It’s not ok, and we need to do better.”

I wanted to let the woman know that I too heard her. If I were a patient and felt I was not treated compassionately, I would be upset as well. What happened next was pretty amazing. As we started to get up and walk out, the woman said, "Well, people are only human and everyone has a bad day. I don’t want to get anyone in trouble and really my care was very good.” At that moment I knew, just by being heard and acknowledged, the woman went from being upset, to all smiles, as she chatted about how she was feeling much better and hoped to be discharged soon.

I learned that day that making rounds is very important and we must really listen to what our patients are telling us. If a patient claims to have had a bad experience, they had a bad experience. It is our job as hospital staff to make the situation better, rather than be defensive. It is much better to just listen to our patients. Their information is a gift, and we should acknowledge their concerns. We should apologize, investigate and correct. Only then, will our patients begin to forgive any imperfections that occurred during their stay, and they could even become our greatest advocates. We want our patients to have the best experience when in our facility.

Since 2003, Irene Brennick has managed over 700 volunteers at Los Robles Hospital in Thousand Oaks, California and puts on health and education events as their Director of Community Services. She has a total of 24 years of experience developing and implementing dynamic volunteer programs. She has also addressed tens of thousands of people and her story has been featured in the L.A. Times, Daily News, and on television and radio. Ms. Brennick also speaks on topics that include, finding one’s purpose in life, the importance of giving back through volunteerism, and how anyone can be an inspirational public speaker.

Tags:  compassion  leadership  listen  patient advocate  perception  rounding  volunteer 

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