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By Kristin Baird
Employee retention and patient satisfaction start with culture. There are no quick fixes for a dysfunctional work environment, but there are some immediate and bold actions required when bullies rear their ugly heads. Not long ago, I began working with a client whose senior leaders were fully committed to making their organization the employer and provider of choice. As we delved into the current culture, we realized that some of their key leaders were not aligned with the values or the vision for the culture of the future. Front line staff, managers and supervisors described these individuals as bullies who were unapproachable and at times downright terrifying. Knowing that this might be difficult to accept, I presented these findings to the CEO & COO with clear facts and specific examples. Having had many discussions like this in the past with other executives, I knew the discussion would go one of two ways. It could result in complete denial and defensiveness or swift action. “We won’t allow bullies here” To my relief, the CEO and COO listened and took swift action. They listened to the examples we provided and said, “We won’t allow bullies here.” Ultimately, the offending individuals were terminated. Although this action can be painful, it is necessary for organizational wellbeing and in preventing a culture of bullying. A Harvard Business Review article[i] by Manuel Priesemuth, states, “Studies have even shown that employees who experience abuse from a supervisor are also more inclined to “pass on” this type of treatment in a ripple effect.” THE HEART OF BULLYING Senior leaders lost credibility when their words weren’t matching their actions. This is the consequence for NOT acting over the years. If you say that you are committed to a culture of excellence, then you must align your behaviors and decisions with those words. In the example I cited above, the leaders did just that. I have a plaque in my house that reads, “The secret to having what you want is getting rid of what you don’t want.” So many times, we go through life in a comfort zone running business as usual. We don’t take the time to purge out the things we no longer want or that no longer serve us. Once we do, we make ample space for what we really want. Are you ready to assess what you have and purge what is no longer working? It may be the key to the culture you desire. Planning your next event? Get in touch with us at the Capitol City Speakers Bureau today to schedule your ideal speaker and make your event a success!
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By Kristin Baird
Moods are contagious. If you’ve ever been dragged into someone’s drama in the workplace, you know how damaging it can be to staff morale. One person gossiping or finding fault in others sends a ripple through the team. So it’s important to remember that allowing drama will ultimately erode the patient experience because it’s difficult to be upbeat and focused on patients when there’s drama brewing in the background. Patients sense discord. I remember once when my mom was a patient. She commented that the staff didn’t get along. Always the researcher, I asked, “How does that make you feel?” She replied, “It makes me feel uncomfortable and that I’m not the top priority.” Drama can take many forms. It can manifest as gossip, passive aggressive behavior, victim behavior, fighting and power struggles. Although it can be exhausting for the leader to try to manage, it’s essential because what you permit you promote. It’s the leader’s job then, to set boundaries and expectations as well as model behavior. After all, you are the keeper of the culture. Let your team know your expectations. Ask for their support in following a “no drama” code of conduct which means they don’t create or participate in the drama. Remind them that they can simply walk away or, they can go one step further and confront the individual engaged in toxic behavior. Engaged and fully engaged employees don’t create drama. So when you spot it in the ranks, deal with it swiftly before it spreads. You are the keeper of the culture. Planning your next event? Get in touch with us at the Capitol City Speakers Bureau today to schedule your ideal speaker and make your event a success! By Kristin Baird
A culture of accountability doesn’t just happen. It takes persistence well after you state your expectations. Parenting would be easy if you could tell your kids once, and only once, to do something and know for certain it would be done without checking. But that isn’t the case with parenting, nor is it the case in most leadership situations. You can’t just tell your team that you expect them to follow your service standards 100% of the time and know it will be done. “You can’t tell your team that you expect them to follow your service standards 100% of the time and know it will be done.” The staff knows which leaders will hold them accountable and which will not. When we do focus groups and ask staff about what is expected of them, we often hear, “It depends.” Drilling down further, we learn that follow through and accountability really depends on who leads the department. CREATING A MEMORABLE FOUNDATION FOR A CULTURE OF ACCOUNTABILITY I remember the first time I used the phrase, “It’s not what you EXPECT, but what you INSPECT that gets the RESPECT.” I was with a group of leaders and one of them said he felt it was a condescending phrase. I can see where it may be interpreted as condescending, or even militant. My intent in using this phrase is to establish a memorable foundation for a culture of accountability. You can tell the staff about service standards but if you don’t make regular rounds, observe, and give feedback, your stated expectations may not be taken seriously. So often, I have seen a leader who trains staff on a tactic, then doesn’t follow through to make sure that it’s consistently implemented. It could be on anything from scripting to hourly rounds or simply walking visitors to their destinations. The leader doesn’t ensure that it’s being done and then complains that the “program” or “model” doesn’t work. It’s not the tactic that didn’t work, it was the follow-through which is as important to the success as the initial training. Maybe more. Accountability can lead to greater profitability too. In a Forbes article, author John Hall states that accountability is good for the culture and bolsters the bottom line. When your team members know that you will hold them accountable, they know you are serious about quality, consistency, and maintaining a positive culture. In turn, they will show more respect for the work that is being done knowing that you care enough to follow-through. Planning your next event? Get in touch with us at the Capitol City Speakers Bureau today to schedule your ideal speaker and make your event a success! By Kristin Baird
Over the past year, family members were banned from hospitals and restricted during clinic visits. During that time, staff and providers became accustomed to focusing mainly on the patient, and not the bedside conversations with concerned family members. This was necessary for infection control. But now family members are back and expect to be involved with the same high-quality service shown pre-pandemic. During the peak of COVID restrictions, staff were not only caring for patients in beds, they were setting up virtual visits [i]and clinical updates for the good of patients and families. But now families are back and their expectations haven’t changed. They still expect to be informed, included, and respected. It is your job to engage families for higher quality safety and service. The Agency for Healthcare Research and Quality (AHRQ)[ii] encourages family involvement in patient care for better outcomes. They give four strategies for involving patient and family members. They include:
I haven’t always felt welcomed as a family member at the bedside. There was one time when my 86-year-old mother was admitted to the hospital with dangerously low sodium levels. I tried to be at the hospital early in order to meet with the doctor making rounds. I had already checked with the nurses about mom’s most recent lab work and learned the lab still hadn’t been up to draw blood. When the doctor arrived, she told me that they were not seeing any improvement based on my mom’s latest lab results. I pointed out that the lab values she was referencing were from 24 hours ago and that no blood had been drawn yet today. She got visibly angry with me. She pointed at my mom and said, “She wouldn’t know if blood was drawn today or not. These labs are from this morning.” Was this higher quality safety and service? Ouch. First, my mom was aware when people were jabbing needles into her arms. Second, the doctor totally dismissed me and was preparing to write orders based on old lab values. When I asked her to please check with the nurses, she stormed out of the room, and I could hear her screaming at the nurses. I wasn’t surprised when she didn’t come back to speak with me, but at least action was taken because of my involvement. New lab work was drawn which was significantly different from the previous day changing the mode of treatment. We had a good outcome, but that isn’t always the case. Angela Fieler wrote about her care team experience with her mother here. Had the doctor engaged me and focused on higher quality service and safety, I would have entrusted my mothers care to her team and felt valued. Patient and family members must be included in the care plans and deserve to be heard and respected. Planning your next event? Get in touch with us at the Capitol City Speakers Bureau today to schedule your ideal speaker and make your event a success! By Kristin Baird
Healthcare leaders want to see consistency. After all, that is the essence of a high reliability organization. It is important to hold everyone accountable for certain service behaviors to ensure that they happen consistently. The goal is that, with repetition, the behaviors become so engrained that everyone performs them almost without thinking about them. The term hardwiring has become industry jargon. There is a lot of merit in hardwiring behaviors, but it’s equally important to heartwire. Help people to see the why behind what you are asking of them and connect to the bigger goals, mission, vision, and values. I like to think about this as heart-wiring because as I’ve worked with people in various settings over the years, as a clinician, a leader, and now as a consultant, I’ve found that without a personal connection to purpose, service tactics can just feel like more work for employees. There are two key operating assumptions at work here:
HIRING Heartwiring starts during the hiring process. It involves careful selection of employees that mesh with the organization’s mission, vision, and values, as well as the department’s culture. Firstly, find out what draws the candidate to healthcare and how he/she makes a difference in the lives of patients. Similarly, have individual conversations that explore the candidates’ unique interests, hopes, and desires for the work they do and their career aspirations. Ask how they have driven high quality care and exceptional service experiences for customers in the past. Discuss what the mission, vision, and values of the organization is and how their role will contribute. COACHING Once hired, ongoing coaching and feedback will help to cement desired behaviors and actions throughout their employment. Coaching provides a series of continual conversations, connecting the work being performed to the bigger picture. Coaching helps employees see the connection between what they do and the organization’s success. RECOGNITION We all like to get kudos every now and then. Recognize the behaviors you want to see more of. Employees need to know they are valued and appreciated. Recognition lets them know that you see them and appreciate them. Tactics alone won’t engage the heart. In fact, tactics that don’t clearly connect to purpose sometimes fuel resentment. When laid out as an edict, they can be seen as just more tasks layered on an already over-stretched team. Help your team make the connection between the tactic, the purpose, and the organization’s mission, vision, and values. That way, they see how their work connects to the big picture. That’s heartwiring—that’s how you can ensure that each and every one of your employees not only knows what is expected of them, but believes that their actions make a difference. That’s how you ensure that employees know that, through their actions and behaviors, they are impacting the patient experience. Planning your next event? Get in touch with us at the Capitol City Speakers Bureau today to schedule your ideal speaker and make your event a success! By Kristin Baird
When I think about employee engagement, I picture a continuum that, going left to right increases in adherence capability. Imagine you have lined up the following, left to right: A paper clip A sticky note A strip of Velcro A bottle of super glue LEVELS OF STICKYNESS Each one of these represent a team member’s level of engagement. The paperclip has the least commitment to the team, the job duties, and the organization. A small gust of wind (an irritation or shinier object) would send him flying off in any direction. This is your disengaged person. The sticky note can be affixed but easily peeled. These are the somewhat engaged employees. They are inconsistent in their engagement. One day they’re firmly engaged with the team and the organization, but when things go wrong or when they’re working with a paper clip (disengaged person) they can easily move in that direction on the continuum. Then we have the Velcro. Pretty solid adherence in the right location. They do a good job of staying the course of engagement, and overall perform the job well. These are your engaged employees. You can count on them to do the job consistently. And finally comes the superglue. These are your fully engaged team members that are rock-solid and have the greatest holding power. They show real ownership and commitment. They serve the organization, the team and the mission with a passion. Look around your team and ask yourself if you have paper clips and sticky notes among your Velcro and Superglue. They could be weakening the strength of the team and performance outcomes. Coaching is the key to filling your team with Velcro and Superglue, but the techniques vary by level of engagement. Leaders must learn how to spot and coach differently at each level of engagement to make your team as sticky as possible. Planning your next event? Get in touch with us at the Capitol City Speakers Bureau today to schedule your ideal speaker and make your event a success! By Kristin Baird
We live and work in uncertain times where change is a constant. With the amount of change and demands upon us, resilience is essential. Healthy cultures strive for resiliency at individual, unit, and organizational levels. People and organizations develop resilience. Becoming resilient will help you and others in your organization adapt to change and essentially learn to “roll with the punches.” Resilience, has a direct impact on creating a positive patient and co-worker experience. How? When staff are more resilient, they can adapt quickly to changing situations meaning that there is little disruption for the patient being served regardless of what is going on with staffing, management or other external and internal events. BUILDING STRENGTH IN AN ORGANIZATION To be more resilient, the leaders should communicate openly about circumstances and be prepared to talk with staff about their feelings about the situations. Leaders need to provide recognition, coaching and mentoring that reinforces the individual’s connection to meaningful work. When leaders come across as engaged, empowered and energized in the face of change, the staff are much more likely to reflect the same attitude. When the leader is pessimistic and voicing his or her own fears and anger, they can expect staff to escalate. MANAGING CHANGE Change is hard and middle managers are often the ones carrying the message of change to the front lines. This makes it important for managers to quickly assess the situation, create key talking points, and help staff stay centered on what is most important. It’s also imperative that leaders allow staff to voice fears and concerns and acknowledge their feelings yet redirect and reinforce positive actions. Resilient leaders hold the key to navigating healthcare’s sea of change. I was coaching a nurse leader a few weeks ago during a difficult time in her hospital. She asked how she could be inspirational and optimistic in the face of some unforeseen and unpleasant changes. We talked about the need to model resiliency. The message I gave her is one that works in many situations. That message is this: things may change all around us including regulations, reimbursement and staffing. But what doesn’t change is that every day, patients walk through our doors needing our help. They expect and deserve the best we can give them and we must be up to the challenge. They’re counting on us. Call it resilience, or optimism. Name it it mission-driven, brand-centered or patient focused. Call it what you like, but strive to deliver the message that regardless of what is happening around them, our patients need us and we will deliver on our promise to be there for them. Planning your next event? Get in touch with us at the Capitol City Speakers Bureau today to schedule your ideal speaker and make your event a success! By Kristin Baird
People often think good communication is how we speak and write, but listening is even more vital in good communication than what you say. This is especially true in the virtual world. Too often, we listen to respond rather than listening to understand. In that case, our minds travel away from the person and their message to formulating our response. Careful, active listening, or generous listening, is more vital now than ever as we support staff who are stressed. With in-person meetings restricted, and more virtual encounters becoming the norm, it is vital to remain conscious of your non-verbal cues on camera in order to demonstrate you are listening. When coaching people on improving listening during in-person encounters, we focus on:
At first, I thought she was multi-tasking and working on something else. Then I realized she had two screens. My image on one, and her camera aligned with the other. When I pointed it out, she was surprised because she thought she was looking right at me. The other common pitfall that can impede a personal connection is a lag in sound. It feels like people are talking over one another, or there is an awkward lag. HERE IS HOW YOU CAN APPLY ACTIVE LISTENING SKILLS IN VIRTUAL ENCOUNTERS:
It seems everyone is more stressed these days as we deal with months of pandemic-induced changes. Virtual options will help us remain connected safely, so let’s make them as close to face-to-face as possible. Think generous listening every time you enter a virtual meeting room. Planning your virtual event? Get in touch with us at the Capitol City Speakers Bureau today to book your healthcare speaker! By Kristin Baird
There’s little doubt that virtual visits are here to stay, and for good reason. Consumers appreciate the convenience and added level of safety while we navigate the pandemic. While patients have been thrilled to have the online option, there is no doubt that the bar for their patient experience will continue to rise with time. What was acceptable when virtual visits were a stopgap solution will not be tolerated for long. There are two major facets to the virtual experience. One is navigating the technology; the other is maintaining the provider/patient relationship. For decades we have worked with providers on bedside manner. It is vital that we set and sustain a high standard for their webside manner as well. HERE ARE SIX KEYS TO CREATING A GREAT PATIENT EXPERIENCE DURING VIRTUAL VISITS: PREPARE FOR THE VISIT PRIOR TO THE CONNECTION know the reason for the visit. RECAP SOMETHING PERTINENT FROM THE REGISTRATION INFORMATION Example – “I see from your note that you have been having headaches.” MAINTAIN EYE CONTACT look at the camera. This sounds obvious, but it is more natural to look at the image on the screen, which may not be aligned with the camera. DEMONSTRATE EMPATHY THROUGH WORDS AND FACIAL EXPRESSION Just because you are not in person, doesn’t mean you should forgo an expression of caring. VALIDATE CONCERNS This can be as simple as saying, “I can see why that would concern you.” SUMMARIZE AT THE CLOSE OF THE SESSION. This means:
The sooner your providers master their webside manner, the faster you will create positive word of mouth and solidify your presence in the virtual visit world. Planning your virtual event? Get in touch with us at the Capitol City Speakers Bureau today to book your healthcare speaker! Your culture determines many things, but today especially, it is a determinant of how well your organization will fare through the pandemic. What you say and what you do always matter.
When people face fatigue and become somewhat fragile, a leader’s actions become crucial in maintaining a positive culture and one of compassion. Over the past six months we’ve all been put to the test as we deal with new and demanding pressures imposed by COVID-19. Healthcare workers have been tested in their professional as well as personal lives. There has been well-deserved attention on our healthcare heroes honoring the service and sacrifice, but even superheroes need a break, a shoulder and even a good cry. Healthcare jobs are stressful on the best of days, but when you add the fear of contracting COVID with the additional burdens placed on working families, many of our brightest and best team members are stretched to the max. I recently had a discussion with a nurse manager whom I will call, Ellie. Ellie had been working 12 plus hours per day for months before leaving her position for good. “I was spent,” she told me. “I had to create an adult ICU in my children’s hospital in a matter of days. My team was amazing and rose to the challenge. We set up the ICU. Then we treated dozens of critical care patients for weeks. We did a fabulous job and had great outcomes with zero turnover in staff. But the truth is, I was burned out – mentally, physically and emotionally exhausted. I have four young children at home and just hit a point when I couldn’t do it anymore.” This nurse leader’s story isn’t that unusual. In crisis, healthcare workers are trained to step up, stay calm, and deal with the issue at hand. Ellie did just that, getting great results and earning kudos from the executive team. But at a cost. Day after day, leaders make rounds on their units and throughout their organizations. Those rounds provide an ideal opportunity to observe team members and identify subtle changes in behavior that indicate fatigue and even burnout. That is, only if the rounder engages in meaningful conversation instead of the proverbial drive-by consisting of, “How are you?” A question which will almost always receive the perfunctory response, “Fine.” Stop asking, “How are you?” or “How’s it going?” You know you won’t get into real feelings. Instead, ask the employee if she/he can take a few minutes to sit down with you. Use open-ended conversation starters such as, “Tell me about your day so far.” Then listen with your ears AND your eyes. Non-verbal cues speak louder than the words. According to an article in Nursing.org, there are specific signs and symptoms you should observe for including:
Leaders like Ellie often put on a brave face for the good of their staffs. While the leader may be checking in and taking good care of her team; who is checking in on the leader? It is vital that leaders look out for one another as well and practice the same self-care they would recommend for their staff nurses. Society loves our superheroes, but you’ll rarely see headlines celebrating the caregivers who take breaks, practice self-care and set limits. Remember that burnout is caused by many stressors beyond the work-related ones. We’re more isolated than ever before and restricted from many of the social activities we enjoy ranging from church services to sports, family gatherings and shopping. Many times, employees are caregivers for children and aging parents. Virtual learning for school-age children has created childcare and tutoring responsibilities that weren’t issues a year ago. The demands can build up over time pushing them to the tipping point. Leaders can help by:
Planning your virtual event? Get in touch with us at the Capitol City Speakers Bureau today to book your healthcare speaker! |
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