November 2000

Top Performers in Customer Satisfaction Share Their Strategies


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Face painting was one of many fun events at an employee picnic that reinforced the sense of community built by Franciscan Health System’s Spirit at Work initiative.



While all of Catholic Health Initiatives’ market-based organizations emphasize customer satisfaction, 15 scored significantly higher than the system-wide average for customer satisfaction during fiscal year 2000. Each of these organizations pursues customer satisfaction every day, but they do so in very different ways. Some use structured initiatives designed to ensure the satisfaction of patients and their families, employees and physicians, while others view customer satisfaction as a natural result of their approach to patient care. Their customer satisfaction strategies, with many unique elements as well as many similarities, are profiled here. #1 in customer satisfaction St. Clare Hospital, Lakewood, Wash. This year, Franciscan Health System’s Spirit at Work initiative for service excellence improved the customer satisfaction performance of all three of the market-based organization’s hospitals. The initiative – which is based on Catholic Health Initiatives’ Model for Health Ministry and Service Excellence, which includes an organizational assessment and consulting by Sage Consulting and employee and physician opinion surveys provided by The Gallup Organization – made St. Clare Hospital the top-performing hospital for customer satisfaction within Catholic Health Initiatives. "Spirit at Work has a lot to do with the way that each of our hospitals moved up in the customer satisfaction rankings this year," said Joseph Wilczek, president and chief executive officer of Franciscan Health System. "But St. Clare is a special case. We brought this existing community hospital into Franciscan Health System, and turned a hospital with a modest reputation in the community into a center of excellence. The strong team of managers that helped to steadily improve St. Clare since we acquired it is helping to take this hospital even further today. They continually focus on improving employee morale by getting out among the staff, listening to them and getting them involved in the Spirit at Work initiative." That leadership style is modeled by Syd Bersante, chief operating officer for St. Clare. "One of the major recommendations that came out of the organizational assessment was a need for increased leadership visibility," said Bersante. "It is important to our staff to see leaders in the process of living out our mission and core values on a daily basis. It makes them feel more connected to the organization and improves their satisfaction with their work, which is what drives patient satisfaction. So, our leadership team makes it a point to attend staff meetings and to go on rounds in patient care areas. And, we always send flowers to employees who utilize inpatient services at St. Clare." Another major opportunity, identified by the Gallup surveys, was more consistent recognition of employees who provide outstanding patient care. "We’ve focused a lot of energy in this area," said Bersante. "Departments that generate new ideas for service quality and individuals who deliver exceptional service to patients receive balloons or cookie bouquets. We hold celebrations, such as our annual employee picnic, that nurture a sense of community and family. We also promote our ‘Caught in the Act’ program, in which any staff member can document what another staff member has done to support St. Clare’s service standards." To keep new customer satisfaction ideas flowing, each department within St. Clare has a designated Spirit at Work representative who drives process improvements. "Our departments have taken many steps to improve satisfaction," said Bersante. Examples include presenting appropriate treats to inpatients who celebrate their birthdays in the hospital and playing soft music in waiting areas. "None of these things are daring, but when you combine them they have a positive effect on patient satisfaction," said Bersante. Now, the leadership and staff of St. Clare have turned their focus to maintaining their top position in customer satisfaction during the current fiscal year. "We’re still in the process of educating our staff on the Spirit at Work initiative, so we believe that we can only improve," said Bersante. "We’re also gathering patient and community input on the design of our 20-bed expansion project. We want opinions on how we can design and decorate the unit to make patient stays more comfortable and create a healing environment." Bersante also believes that St. Clare has a solid foundation for sustained improvement in patient satisfaction. "It takes a good leadership structure that supports a focus on patient care, plus consistent recognition to effect behavioral change within the staff," Bersante said. "St. Clare, and all of Franciscan Health System, have those elements in place." #2 in customer satisfaction Avista Adventist Hospital (part of Centura Health), Louisville, Colo. A blue line in the parking lot at Avista Adventist Hospital, part of Centura Health, is a sign of the staff’s respect for patients. "Our staff members park behind the blue line so that patients can park close to the hospital," says John Sackett, the hospital’s administrator. "It’s one way that we honor our patients. In addition, we don’t have casual dress days for the staff, because there are no casual interactions in a hospital. What we wear is descriptive of our roles. For example, all of our registered nurses wear the same uniform so that patients immediately know who they are." Avista Adventist also maintains a private, quiet environment for patients. "Every room is private, with a private bathroom, because we know that our patients value their privacy," Sackett said. "Also, we don’t do any overhead paging, except for code blue. We don’t even allow our staff to be paged in patient care areas – instead, all of our nurses carry mobile phones." #3 in customer satisfaction Memorial Hospital, Chattanooga, Tenn. The leaders of Memorial Hospital believe that patient satisfaction begins with employee selection. "We explain the importance of customer satisfaction to employees beginning in their first job interview," said Charlene Robertson, chief nursing officer at Memorial. "We hire people who feel that working here is not just a job, but a contribution to our health care ministry." Once hired, employees are primed to pay attention to all patient suggestions for quality improvement. "One patient may voice a concern that is felt by many," said Robertson. "For example, a patient expressed a concern that our surgery waiting area was not staffed after 4:00 p.m. Based on that comment, we now staff the area for longer hours to the satisfaction of many patients and families." The hospital’s annual report to the community shares patient satisfaction results with the patients themselves. "We’re very consistent about sharing this information with the community," said L. Clark Taylor, president and chief executive officer. "People need information like this in order to make decisions about their health care." #4 in customer satisfaction Mercy Medical Center, Roseburg, Ore. During fiscal year 2000, Mercy Medical Center formed a five-member Guest Relations group that received training from a famous name in customer satisfaction: Disney. "One of the things our training at the Disney Institute reinforced is that employees are customers, too, and we need to make sure they are satisfied," said Wally Gwaltney, patient advocate at Mercy. "If our employees are happy, our customers will be happier." A survey of employees revealed that they wanted an employee-only area for lunches and breaks. "We turned two conference rooms into an off-stage area for employees, where they can be away from the public," said Gwaltney. "It’s important for our employees to relax and refuel, because we’ve been running close to capacity ever since another hospital in town closed last February." In addition to employees, Gwaltney relies on the hospital’s volunteers to generate ideas for patient satisfaction, such as staffing the emergency department with patient representatives during the busy hours of 3:30 p.m. to midnight. #5 in customer satisfaction St. Mary’s Hospital, Nebraska City, Neb. St. Mary’s Hospital achieved excellent customer satisfaction results in spite of the disruption caused by a major remodeling project. Communicating with customers and creating a positive work environment contributed to their success. "Much of our facility was torn up with remodeling during the year, so we’re very proud of ranking as high as we did," said Daniel Kelly, president and chief executive officer. "We used a lot of signage to help people avoid construction areas and get to the right places, and the community is very excited about what we are doing." Still, Kelly said the hospital didn’t do anything out of the ordinary to promote customer satisfaction. "We simply went about the business of doing what we do best, which is taking care of people," he said. "I give all the credit to our great team members. I know that staff recruitment is difficult for many hospitals these days, but we’ve had good luck holding our team together and have turned a few qualified people away from employment. We’re known as a good place to work and a place where it’s OK to have fun at work. I think that atmosphere translates to customer satisfaction." #6 in customer satisfaction Mercy Hospital, Valley City, N.D. Though Mercy Hospital has no formal plan for patient satisfaction, a customer focus based on strong staff/patient relationships contributes to high ratings. "The staff simply sees it as part of their jobs to make sure every patient is provided with the highest quality of care every day," said Jane Bissel, president and chief executive officer. "Our staff members are wonderful, caring people. They work here for a reason – it’s a place where they can show their compassion for patients, who are often their friends and neighbors." Still, the staff has made patient satisfaction an agenda item at every staff meeting for the past two years. "We do talk about it and about things that we can do to ensure that the quality of care stays high even when our census goes up," said Bissel. "I think that we’re also good at integrative care. We don’t have a formal program for it, but our approach is to address total patient needs in mind, body and spirit." #7 in customer satisfaction Carrington Health Center, Carrington, N.D. According to Brian McDermott, president and chief executive officer of Carrington Health Center, the facility puts its customers first. "The patient is number one here," he said. "We are a small rural facility with an excellent staff that treats patients like friends and neighbors." The hospital rewards staff members who deliver excellent performance and demonstrate the core values with its monthly Spirit Award. "Anyone who comes into our facility, including employees and patients, can nominate an employee for the award," said McDermott. "We give out as many as are deserved, sometimes six or more in a month." Unlike many other communities in North Dakota, Carrington’s population is increasing and the hospital is just as progressive, providing numerous outpatient services and visiting specialists so that customers can receive a wider variety of health care services at home. Patients also love the food. "Almost all of our food is still homemade, and our patients and visitors rave about it," said McDermott. "It’s nothing fancy – just basic American food with a little Norwegian twist – but it’s the best in the area." #8 in customer satisfaction Mercy Hospital, Devils Lake, N.D. With many long-term employees and physicians, Mercy Hospital provides a stable, comforting environment for patients, most of whom are well known to the staff. "We are continuing the touching and healing ministry of our foundresses, and we are blessed with staff members who are truly caring and comfortable with high-touch care," said Marlene Krein, president and chief executive officer. "When we interview candidates for positions in the hospital, we are always up front about who we are. We talk about our values and our mission, and we find that those who are not comfortable with our approach to care take themselves out of the process." Krein said that an important factor in patient satisfaction is the support that staff members provide to each other. "We all know each other, we share what’s going on in our personal lives, and we serve each other through good and bad times," she said. "All of our doors are always open to each other. We’re in this together, along with our patients." #9 in customer satisfaction Saint Joseph Hospital East, Lexington, Ky. and #14 in customer satisfaction Saint Joseph Hospital, Lexington, Ky. Each quarter, Saint Joseph’s Patient Satisfaction Council evaluates customer satisfaction by service category. "When they identify an area that needs improvement, they create and implement a performance improvement plan," said William Hendrickson, president and chief executive officer. "Their planning and follow-through is one big reason for our high levels of patient satisfaction." Another is the understanding that Saint Joseph staff members have of the importance of customer satisfaction. "These results are really attributable to the people who work here," said Hendrickson. "Of course, you have to have an overall organizational structure that supports and promotes patient satisfaction." Hendrickson also noted that it will take significant effort and dedication on the part of the Saint Joseph staff to maintain their customer satisfaction ranking within Catholic Health Initiatives, let alone improve. "It’s difficult to move up in the rankings when you already rank high, but we’re going to try," he said. #10 in customer satisfaction St. Joseph Medical Center, Tacoma, Wash. At St. Joseph Medical Center, patients arriving at the front entrance enjoy valet parking services. "It’s a special service for the convenience of patients, but it’s also for their sense of security," said Joseph Wilczek, president and chief executive officer of Franciscan Health System, which includes St. Joseph. "St. Joseph is in a neighborhood that did not have a reputation for safety several years ago, and while community leaders and law enforcement have turned this area around, that perception remains with some of our customers." The valet parking also helps establish relationships with patients and their families from the moment they arrive. "This is a large urban hospital with a shorter average length of stay, so it can be harder to establish strong patient relationships," said Wilczek. "Still, St. Joseph is known for compassionate care and a tradition of high-touch care." The hospital has large specialty units, including the largest dialysis center in the state and a cardiac unit that performs 700 open heart surgeries every year. "Our staff not only delivers specialized care to the patients in these units, they go beyond taking care of a patient’s disease to care for the whole person," said Wilczek. "They show respect for their patients and for each other – and that’s really the basic definition of our Spirit at Work initiative." #11 in customer satisfaction Good Samaritan Health Systems, Kearney, Neb. When patients and staff at Good Samaritan Health Systems hear the Brahms lullaby played softly over the speaker system, they know that a baby has just been born in the hospital’s maternity unit. "It gives staff a sense of pride and patients a sense of comfort to know that we just helped to bring a new person into the world," said Steve Loveless, administrative director of value enhancement at Good Samaritan. Playing the lullaby is one of the creative ideas that employees at Good Samaritan have come up with to enhance customer satisfaction. "We are just beginning to implement a service excellence initiative here, but we have to do it carefully," said Loveless. "Our staff has always been committed to providing the best patient care, and as we are in a small community, their patients are usually their friends and neighbors. So, while we want to create an initiative that will support the staff’s customersatisfaction efforts, we need to introduce it in a way that doesn’t imply t hat staff wasn’t committed to doing a terrific job before – just that we can do even better with a supportive structure for patient satisfaction." #12 in customer satisfaction St. Joseph Medical Center, Towson, Md. The staff of St. Joseph Medical Center is happy to be in the top 15 facilities for patient satisfaction within Catholic Health Initiatives, but their goal is to be in the top five. "We’re analyzing our patient satisfaction scores to identify opportunities for improvement," said James Cullen, president and chief executive officer. "We’re working with the Catholic Health Initiatives Customer and Market Strategy Team to move ahead with a service excellence initiative." Cullen believes that the initiative will focus on inpatient care units, as the hospital’s outpatient, emergency and ambulatory surgery units currently perform extremely well in customer satisfaction. "We’ve already done quite a bit to improve satisfaction in our Women’s Services area," he said. "We worked with the staff to keep their skills up to date and built a new maternity unit. It was all worthwhile because we noted a marked increase in patient satisfaction in that area." #13 in customer satisfaction St. John’s Regional Medical Center, Joplin, Mo. When St. John’s Regional Medical Center began a financial turnaround in late 1998, its leaders planned carefully to maintain high levels of customer satisfaction. "We were going to make some significant changes, and we knew that as employee morale worsened, patient satisfaction might naturally drop," said Gary Rowe, president and chief executive officer. "However, we found that the character of the staff here is so great that patient satisfaction briefly dipped just slightly and then rebounded very strongly." Rowe says that St. John’s staff believes in Catholic Health Initiatives’ model for patient satisfaction monitoring. "The monitoring program enables us to objectively determine areas of strength and opportunities to improve patient satisfaction," he said. "It identifies which aspects of patient service, if properly addressed, have the greatest potential for positive change. We put all of the patient satisfaction reports on our intranet so that everyone can see them." In addition, St. John’s incentive compensation plan is tied to improvement in patient satisfaction. "We can’t gain or maintain market share without strong employee, physician and patient satisfaction," said Rowe. #15 in customer satisfaction St. Agnes Medical Center, Philadelphia, Pa. The leaders of St. Agnes Medical Center constantly talk about patient satisfaction, not because of the hospital’s excellent standing in the Catholic Health Initiatives rankings but because it is part of the facility’s roots. "We have a tradition of strong relationships between caregivers and patients," said Marge Sullivan, OSF, president and chief executive officer. "We try to permeate the organization with the spirit of our foundresses, whose philosophy was to treat people well and with great care." Members of the hospital’s leadership team are often on the patient care floors to pitch in and help care for patients. Staff members often walk visitors to their destinations rather than giving verbal directions, introducing themselves and making a connection as they walk. "In every communication, we reinforce that the staff must treat patients as family members," said Sister Marge. "If they look at the person in bed as they would their mother or brother, they will deliver the special care for which St. Agnes is noted." The staff also responds promptly to patient concerns. "If we get a complaint today, we respond today," said Sister Marge. "And when we get a thank you from a patient, we respond in kind."