No Employee Satisfaction, No Patient-Centered Culture

Nurse and staff satisfaction and engagement are vital to generating patient loyalty. Everything starts with tracking and analyzing the right metrics. Then comes strategy.

When hospital leaders set about creating strategies to improve the patient experience, it's easiest to focus on superficial changes—spacious lobbies with cheerful design features, sleek private suites, and designer hospital gowns.

While aesthetic improvements have been proven to make a positive impact on patients, they don't get to the crux of the issue for many hospitals and health systems: fostering a patient-centered culture.

Scripps Health and Ardent Health Services are two organizations excelling in this arena, focusing on staff satisfaction and engagement, as well as tracking a number of metrics as a means to improve the patient experience.

"Nurse and staff loyalty and engagement play the most important role in generating patient loyalty—it's where we begin," says Kevin Gwin, vice president of patient experience and communications for Ardent Health Services.

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 "I cannot ask our employees to change, if our relationship with them is not in the right place.  I must ensure we're staffed appropriately, they have the tools and equipment they need, they have trust in administration and their supervisor, they receive consistent, accurate communication and they feel recognized and valued before I ask more of them on the patient side."

It Starts with Staff
Staff satisfaction is a driver for any type of patient experience improvements, says Vic Buzachero, corporate senior vice president, innovation/HR/performance management, for Scripps Health.

"Staff that have their needs met can focus on the needs of the patient," he says. "Years ago, Sears conducted a definitive survey and study that indicated that customer satisfaction and sales increased with employee satisfaction."

The best way to gauge staff loyalty and satisfaction is through a good, old-fashioned employee survey, focusing on topics such as communication, engagement, trust, values, fairness, benefits, conflict management, employee recognition, and work environment. Gwin suggests holding small-group follow up conversations with employees to communication survey results and allow for an opportunity to hear feedback.

In addition to conducting an organization-wide survey, outcome measures such as turnover, worker's compensation injury rates, and absenteeism each reflect satisfaction, Buzachero says.

Strategies for Improvement
Three areas stand out as key to creating a patient-centered culture, Buzachero says.

"First is leadership that provides clear direction and 'walks the talk.' Second is the alignment of work and human resource systems and practices that focus, reinforce, and reward behaviors that support the patient experience, lastly is accountability," he says.

He describes it as "making sure that we all do what we say we are going to do with follow through, mitigation of unaligned action or behavior and constant process improvement."

Third is finding ways to isolate those efforts by service line. Pin-pointing the data by service line or room number or physician or a small group of nurses revolutionizes how leaders transform the culture, Gwin says. "You can now focus your efforts specifically on the processes and the areas of the hospital that are letting your patients down, as well as the people who are not meeting your patients' expectations," he says.

"This changes the whole game; Instead of focusing on the whole house, you can target educate, target coach and target recognize. You can identify your hospital's champion physicians, nurses, and staff and use them to educate and coach the others."     

An Example of the Service Line Approach
Gwin has used this service line approach as the organization has worked to reduce noise levels, a key patient experience factor.

"I can score each room on quiet at night'—write the score on a post-it-note, place each note on each patient door and walk around the hospital and see exactly where our noise issues are," he says. "And I can immediately begin to address them—ice machine here, squeaky door there, loud elevator, even louder nursing station. If I can't figure it out, I can call back the patients in those rooms and learn more."

At Scripps, leadership uses a success sharing program to reward staff when HCHAPS goals are met, giving out incentivized payouts.

"Not only do staff focus on the outcomes, our executive leadership closely watches them so that we can make sure we focus our time there to reach our targets," Buzachero says.

Methods like these are the most effective way to transform culture and improve service excellence, Gwin says.

"It's convincing when patients are really heard, and their voices reconnect our people to their purpose," he says. "We can demonstrate how we're changing lives, so we have to finely tune our ability to coach behavior change. The data will show us what's working and what's not. This is how you generate loyalty."

Webcast: Join leaders from Scripps and Ardent Health as they reveal how they are implementing patient-centric cultures and making seismic progress in patient experience improvement in a webcast on Nov. 21, from 1:00–2:30 PM ET.