When it comes to certain policies, it's all about the details.
In 2006, Pam Harmon, RN, legal nurse consultant and chief nursing officer at Fredonia (KS) Regional Hospital (FRH) took a closer look into her facility's employee code of conduct.
The Commitment to Coworkers policy, as the code of conduct was then known, only pertained to the nursing staff and did not deal with other staff members' attitudes. This went against a new facility policy because the code of conduct's new purpose was to include everyone—not just the nursing staff—and to change the attitude of every staff member in FRH.
Harmon took matters into her own hands, and with the help of an in-service committee, went about changing the information of FRH's employee code of conduct.
Harmon searched the Web to find a variety of examples from other facilities to get a broader perspective on her facility's options. Using key words, such as "standards of performance" and "code of conduct," Harmon gathered a few examples that she brought to an in-service committee meeting.
Harmon was also careful not to layer another facility's policy onto FRH, but rather selected items that were actually applicable to her facility.
"We took a lot of information from other facilities' examples, only taking what we felt necessary for Fredonia," says Harmon.
From these examples, Harmon and the in-service committee blended information to fit the FRH's needs, and came up with the standards of performance to include all the staff members.
"Throughout the development of the standards of performance, the in-service team and I decided which information would be important enough to feature in the document," says Harmon.
Improving the attitudes and the quality of patient care, along with the attitudes of the staff members, was the focus in Harmon and her committee's mind when reviewing all the information.
Eventually, Harmon and the committee determined what to focus on for the new standards of performance. These areas include:
- Attitude
- Personal appearance
- Communication
- Culture of safety
- Commitment to patients
- Commitment to co-workers
- Customer waiting
- Hallway etiquette
- Privacy
- Safety awareness
- Sense of ownership
"The old code of conduct was not as specific and did not pertain to every staff member in the facility," says Harmon.
The previous code of conduct was a one-page document that only addressed patient care staff, and there was no requirement to sign any documentation regarding the code.
Now, the standards of performance is a two-page document that everyone in the facility—from the CEO all the way down to new hires— has to sign.
"We have been talking about focusing on positive thinking, positive ways to approach people, and we as a committee feel if we could get something everyone could read, sign, and commit to, then we would have a better outcome and performance from all staff members," says Harmon.
The new standards of performance document is not only signed by everyone in the facility, but is also reissued annually, so that staff members are reminded of the commitment they have to themselves, the patients, and other FRH staff members.
The policy is also an important part of the hiring process and is one of the main points of information that FRH discusses with each potential employee. During the interview process, the expectations derived from the standards of performance are discussed in great length.
"We ask the potential candidate questions regarding the policy and handling particular situations so they are thinking about these things before they sign in to be a part of our facility," says Harmon.
No tolerance for negativism
With any new policy, there are staff members who do not take things seriously, and with FRH's new standards of performance, there were a few teaching moments.
"Over the three years, there have only been a few instances where employees did not abide by the standards of performance policy," says Harmon.
For a first offense, employees receive a verbal warning if they were not living up to the areas stated in the new policy. A second offense earns a written warning, and if the behavior continues, the staff member might even be put on suspension and eventually terminated from FRH.
"We developed a policy that has no tolerance for negativism and a goal of improving customer service by improving the attitude of all our staff," says Harmon.
Sarah Kearns is an editor for HCPro in the Quality and Patient Safety Group. Contact Sarah at skearns@hcpro.com.