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HL20: Laurent Gueris—Creating a Patient Experience Environment

 |  By jcantlupe@healthleadersmedia.com  
   December 03, 2013

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is the story of Laurent Gueris.

This profile was published in the December, 2013 issue of HealthLeaders magazine.

 

"When it comes to being courteous in a hospital by staff, there's no excuse. This is not a courthouse."

Laurent Gueris, as manager of environmental services, oversees cleaning and sanitation at the 283-staffed-bed Providence Little Company of Mary Medical Center in San Pedro, Calif. But a few years ago, Gueris noticed his staff walking in and out of patient rooms, quietly moving throughout the hospital while not making eye contact with the patients, barely looking at them. No "hello." No "how-are-you?"

Gueris wasn't happy about it. "When it comes to being courteous in a hospital by staff, there's no excuse. This is not a courthouse," he says.

Gueris tapped into that invisible presence, that silence, and wondered about its impact on patient satisfaction, one the measurements used by the government for hospital payments. Over time, he has worked with his 45-member staff to improve their interactions with patients, which he says had a surprising, yet profound impact on patient satisfaction.

Using role-playing, he "play-acted" staffers' interactions with patients and even videotaped their sessions. Those exercises brought out hospital employees' innate compassion and gave them confidence to open up to patients, Gueris says. "They could see themselves in a more powerful way," he says. "It's very powerful when you look in your own mirror," he says.

Patients have responded, dramatically improving Providence Little Company of Mary Medical Center's patient satisfaction scores, Gueris says. Over a three-year period, patient satisfaction involving housekeeping improved from 60% the first year to 70% the second and 90% the third, according to the hospital's latest figures in 2012.

Not only that, patients sent personal notes to the housekeeping staff, thanking them, mentioning them by name. Pretty unusual, Gueris says.

The satisfaction scores are included under the Hospital Consumer Assessment of Healthcare Providers and Systems survey, which asks patients about their satisfaction during their hospital. The survey mentions communications with doctors, staff responsiveness, hospital cleanliness and quietness, and overall rating of the hospital.

When the HCAHPS first asked patients about how their room was clean, and their satisfaction involving communication with staff, "That was always one of my goals, to shine" on those HCAHPS measurements about clean lines and communication with staff, Gueris says.

Before Gueris embarked on his venture to change housekeeping attitudes about patients—and their attitudes about housekeepers—the patient rooms may have seemed unnaturally quiet.

Gueris met every morning with his staff, and discussed their interaction—or lack thereof—with patients. He offered guidelines to how they could improve their interactions. Using a script, Gueris went over what the housekeeper should do and say: they should knock on the door, ask permission to come in, and introduce themselves as representatives from housekeeping. Gueris explained the importance of maintaining eye contact with the patients, flashing a smile, and talking to them.

Gueris sat down in a room and made believe he was a patient. He took on their persona, if necessary: He was angry. He was flirtatious. Some on his staff were taken aback, but Gueris explained that the practice sessions had to reflect reality.

"We did basic scripting," Gueris says. "We put on paper what they should say; every day each employee would practice that. As weeks went by, they were becoming more comfortable. I started to challenge them and ask questions and try to push buttons with facial expressions and body language, being extremely rude or flirty, asking for a phone number, just to embarrass them, put them on the spot."

After visiting his mother in a hospital in France, Gueris came home, and worked with the staff to videotape them in the playacting. After initially expressing concern, "they came on board and loved it," he says. The video was important because it allowed the housekeepers to see themselves in action. Some realized that, yes, they did have a smirk or a frown, and that, no, they didn't make eye contact like they thought they did.

Nancy Carlson, the CEO of Providence Little Company of Mary Medical Center, says she would stop by and marvel at the change in behaviors and attitudes among housekeeping staff. While Gueris has a heavy French accent, most of the housekeepers spoke Spanish. "They were afraid of interacting with patients and had no confidence in their ability to communicate," Carlson says. "They went to clean the room, and he saw this as an opportunity to help us with our patient experience. They've really taken off with this."

Carlson says she's thinking about extending the program that Gueris started to other parts of the hospital.

Gueris says he's thankful about the turnaround for the hospital staff and the patient satisfaction scores. Mostly, the idea is to help patients. "You don't come to the hospital by choice," Gueris says. "I've been a patient, and it's a very scary experience."

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Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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