Creating a Culture of Service at Austin Medical Center

1. Creating a Culture of Service at Austin Medical Center Presented by:Peter Cunningham, M.D.Sheri Nemec

2. We tried many things to improve service over the years! Attitude training Teamwork training Smile training …and countless others ! FISH! Training Give ‘em a pickle!

3. Patient Satisfaction data arrives… • Mayo Health System initiates plan for all MHS sites to participate in survey process • July 2006 – AMC contracted with Press Ganey as patient satisfaction survey vendor • Began surveying Medical Practice, Inpatient and Emergency Department patients

4. 90th Percentile Goal = 90th Rank Medical Practice - 2007Likelihood of Recommending Each bar represents a Mayo Health System site All clinics are rolled-up into respective MHS main sites

5. 90th Percentile Goal = 90th Rank Inpatient - 2007Likelihood of Recommending Each bar represents a Mayo Health System site All satellite hospitals are rolled-up into respective MHS main sites

6. Data helped AMC realize that although we said service was important, it had not had the level of focus needed: Service and patient satisfaction needed to be elevated in importance. Creating a culture of service would require dedicated resources and support. Next Steps in our Journey…

7. Exploring Best Practices • Luther-Midelfort – MHS service strategy • Studer Group methodology – AIDET • All Mayo/MHS sites trained ED’s • High performing sites had: • service on strategic plan • Time and resources devoted • Alignment across organization

8. Creating a Strategic Plan for Service

9. 2008 - Service Becomes Part of the AMC Strategic Plan • Goal = Achieve top patient satisfaction • Be at or above the 90th percentile in patient satisfaction when compared to our peers by 2013 • Annual goals set

10. Strategic Plan for Service = Creation of AMC Service Team

11. Co-Chairs: VP Clinic Operations Team Member Roles: Physicians – 3 Hospital nurse Clinic nurse Vice President – 2 CAO Medical Director Physician Human Resources director Registration manager Staff Development manager AMC Service Team

12. Service Accountability Service Training Service Coaches On-line Resources Hiring for Service Skills Measuring and Benchmarking Response Guidelines Feedback Management System Service Behaviors Service Department Service Purpose and Promise Service Principles Building Blocks of the Customer Service Infrastructure

13. Service Accountability Service Training Service Coaches On-line Resources Hiring for Service Skills Measuring and Benchmarking Response Guidelines Feedback Management System Service Behaviors Service Department Service Purpose and Promise Service Principles • Service Team met every 2 weeks to create structure • Modeled after Luther-Midelfort MHS • Each block has service team member as leader • Set timelines for each block

14. Service Accountability Service Training Service Coaches On-line Resources Hiring for Service Skills Measuring and Benchmarking Response Guidelines Feedback Management System Service Behaviors Service Department Service Purpose and Promise Service Principles A Closer Look at the Service Infrastructure Building Blocks

15. Service Excellence Department(October 2007-January 2008) • Manager of Patient/Customer Relations • Support departments as they improve customer satisfaction/service • Feedback Management Process • Patient Satisfaction Survey process • Lead Service Training / Service Coaches • Assist service team with moving strategy forward

16. Creation of AMC Service Purpose and Promise (October 2007) Service Accountability Service Training Service Coaches On-line Resources Hiring for Service Skills Measuring and Benchmarking Response Guidelines Feedback Management System Service Behaviors Service Department Service Purpose and Promise Service Principles

17. Service Purpose and Promise A mission statement for Service – “Austin Medical Center will provide a compassionate, respectful, and caring experience every time.”

18. Service Purpose and Promise • A service credo – “Caring Experiences, Every Time”

19. AMC Service Principles Service Accountability Service Training Service Coaches On-line Resources Hiring for Service Skills Measuring and Benchmarking Response Guidelines Feedback Management System Service Behaviors Service Department Service Purpose and Promise Service Principles

20. Service Principles(October 2007) Care for the Organization Service Principles Care for Each Other Care for Our Patient and Family (The needs of the patient come first)

21. Service Accountability Service Training Service Coaches On-line Resources Hiring for Service Skills Measuring and Benchmarking Response Guidelines Feedback Management System Service Behaviors Service Department Service Purpose and Promise Service Principles Service Behaviors- The Visible Part of Service (Oct. 2007-Jan. 2008) Service Behaviors

22. Service Behaviors • Service behaviors that demonstrate “Care for Our Patient and Family” • Treat patients as you would want to be treated • Be informed • Respect and value their time, dignity, privacy • Sense people’s needs before they ask • Acknowledge people’s feelings • Introduce yourself • Involve the patient – nothing about me without me • Explain what is happening / Listen closely & clarify

23. Service Behaviors • Service behaviors that demonstrate“Care for Each Other” • Be respectful • Recognize the efforts of others • Take ownership – no blaming or finger pointing • Value each other’s differences • Help each other out • Listen to understand • Acknowledge people’s feelings

24. Service Behaviors • Service behaviors that demonstrate “Care for Our Organization” • Honor our legacy • Be an ambassador • Demonstrate commitment

25. Service Accountability Service Training Service Coaches On-line Resources Hiring for Service Skills Measuring and Benchmarking Response Guidelines Feedback Management System Service Behaviors Service Department Service Purpose and Promise Service Principles Feedback Management System(January 2008)

26. Feedback Management System • Purchased electronic system to standardize the process of reporting/documenting patient & family feedback. • Wanted ability to do analysis and trending of all concerns entered into the system. • Created a standardized process for reviewing, documenting and responding to complaints and grievances.

27. Service Accountability Service Training Service Coaches On-line Resources Hiring for Service Skills Measuring and Benchmarking Response Guidelines Feedback Management System Service Behaviors Service Department Service Purpose and Promise Service Principles Measuring and Benchmarking(2006)

28. Measurement/BenchmarkingPress Ganey Survey • Prior to 2006 only had annual survey data available for medical practice providers • Gained ability to access timely patient satisfaction data 24/7 • Send weekly comments to leaders/staff • Leaders and coaches have full access to data • Leaders/coaches use data to create work plans and improve service • Providers receive data on regular basis

29. Measurement - Communicating Pt. Satisfaction Information • Quarterly satisfaction scores for all surveys are posted: • in the cafeteria (public access) • in all departments • on intranet site • Snapshots (standardized for use across MHS) shared with departments and providers

30. Service Accountability Service Training Service Coaches On-line Resources Hiring for Service Skills Measuring and Benchmarking Response Guidelines Feedback Management System Service Behaviors Service Department Service Purpose and Promise Service Principles Response Guidelines(October 2007-January 2008)

31. Verbal and Behavioral Response Guidelines • Service Team adapted guidelines to fit AMC culture • Departments customize to fit • Intent is to consistently respond to patients and families in a courteous, respectful & professional manner • Response guidelines includes using key behaviors, phrases and words • Created for high volume interactions- greetings, telephone, privacy, etc.

32. Service Accountability Service Training Service Coaches On-line Resources Hiring for Service Skills Measuring and Benchmarking Response Guidelines Feedback Management System Service Behaviors Service Department Service Purpose and Promise Service Principles On-line Resources –Available for All Staff Relating to Service(March 2009 – ongoing)

33. On-line Resources Service Excellence Intranet Page

34. Service Accountability Service Training Service Coaches On-line Resources Hiring for Service Skills Measuring and Benchmarking Response Guidelines Feedback Management System Service Behaviors Service Department Service Purpose and Promise Service Principles Hiring for Service Skills:Getting the right people on the bus(January 2008-March 2009)

35. Hiring for Service Skills • Interview process includes focused questions on service skills • Job descriptions include service behavior and skill competencies • Service expectations and building blocks training at new staff orientation

36. Service Accountability Service Training Service Coaches On-line Resources Hiring for Service Skills Measuring and Benchmarking Response Guidelines Feedback Management System Service Behaviors Service Department Service Purpose and Promise Service Principles Service Accountability(January 2008 – January 2010)

37. Service Accountability • Leader Rounding (staff) planned in 2009 and implemented in 2010 to support service behavior integration at the front line level • Staff evaluations include core competencies of service principles, service behaviors and skills taught at service classes

38. Service Accountability Service Training Service Coaches On-line Resources Hiring for Service Skills Measuring and Benchmarking Response Guidelines Feedback Management System Service Behaviors Service Department Service Purpose and Promise Service Principles Service Coaches(January 2008 – ongoing)

39. Service Coaches • Assist with education & application of concepts related to service within specific area of work/department • Share customer satisfaction results with department • Identify areas of service vulnerabilities & improvements within the work area • Model, support and promote service culture • Network and share best practices

40. Service Accountability Service Training Service Coaches On-line Resources Hiring for Service Skills Measuring and Benchmarking Response Guidelines Feedback Management System Service Behaviors Service Department Service Purpose and Promise Service Principles Service Training for All Staff(March 2008-June 2009)

41. Service Skills Training • Luther-Midelfort shared service class content (observed classes onsite at L-M as well) • Modified content to fit AMC culture and outcomes we wanted to achieve • 5 classes – each delivered over 1 quarter • Trained 30 internal staff as instructors • Each quarter offered 32 class sessions to train 950 staff • Created focus, alignment and momentum

42. Service Skills Classes • Orientation to Customer Service • First Impressions • Effective Communication (AIDET) • Service as a Team • Service Recovery Sustaining: • Review service skills via Service Coaches • Service classes for new staff - quarterly

44. Patient Satisfaction Progress to Goal –Medical Practice Overall Q4 2009 data

45. Patient Satisfaction Progress to Goal –InpatientOverall Q4 2009 data

46. Next Steps: Strategic Plan for Service 2010 • Create incentives that support achievement of AMC service goals • Evaluate and adapt recognition process to be inclusive to all staff • Develop process or approach to customer segmentation

47. Continue Partnership & Alignment at System Level • Continue to meet with system sites via service director meetings • Continue engagement of providers with leadership from Physician Champions • Work to spread best practices across system and regional sites • Staff engagement–PG Regional/ National conferences and local retreats

48. Questions?