Organization Must Haves

Question For approximately six months we have been posting the names of managers who are late in submitting evaluations. We have experienced fair success with this tactic. When you implemented it, did you find that you experienced peaks and valleys in compliance? Answer No, I did not experience lack of compliance. Managers knew that the [...]

Question I’ve read your articles on evaluations, but I’m curious about whether you personally endorse raises that are tied to those evaluations. Or do you believe that pay and evaluations are two separate entities? Answer This is an area that has great pluses and minuses on each side. Here is my current thinking: I believe [...]

Question Our Leadership Team decided to roll out the following key words to the entire organization: “Is there anything else I can do for you? I have the time.” There has been significant resistance, with comments ranging from, “It doesn’t feel natural,” to, “You are asking me to lie to the patients by saying I [...]

Question Our facility is small (38 beds), so bed turnover is very important. There are times when we desperately need a bed and we have a patient who is ready to go home, but wants to stay for dinner . . . or one who is waiting for a ride home . . . or [...]

Question What would you suggest as a key phrase to say to patients who may have had to wait to have their call lights answered? Answer Here are some suggestions: Consider an acknowledgment as you enter, such as: “I see that your call light is on. I apologize for my delay. (No excuses.) How may [...]

Question Some of our patient care managers suggest that our scores are not improving because we are not communicating with our patients’ family members. How do we convince our staff that communicating with families is just as important as communicating to patients? Answer Communication with family members is vital. In fact, one CEO I know [...]

Question We have introduced key words for phone answering and have encountered major pushback from OR staff regarding internal phone calls. How do I show value in saying, “Good morning, this is the (Name of Hospital) operating room, Patty speaking” when the caller is a fellow employee? Answer Explain that just as customers have first [...]

Question We are in the process of implementing key words at key times to reinforce to patients that we want to give them “very good” service/care. Do you have any suggestions for measuring staff participation in using the key words? Answer The ultimate measure of compliance, of course, is the result on your patient satisfaction [...]

Question We need better buy in at our facility for key words. How do we show team members the value of this practice? Answer I suggest you not call it scripting but “key words at key times.” Explain to the staff that the purpose is not to get them to change their behavior, but to [...]

Question Are there any key words available for discharge phone calls? We are working on this “Must Have” and would like some ideas to incorporate into ours. Answer Key points are: Empathy. “We are calling to see how you are.” Clinical questions regarding medications, follow-up appointments, and so forth. “We like to recognize staff and [...]

Question We are currently attempting to call all patients who have visited our emergency department. Our success rate at reaching these individuals is about 18 percent. Is there a benchmark by which we can compare ourselves with other hospitals to determine whether this is about average? Answer I think 100 percent attempted calls to eligible [...]

Question JCAHO now says discharge phone calls should be documented in the medical record. I am concerned that this will reduce the number of calls. Any ideas on how to keep JCAHO happy and not overburden nurses, so they will continue to make the calls? Also, what are the implications for HIPAA? Answer One method [...]

Question Is there a way to prevent multiple calls to patients after discharge? Not only do the nursing units do follow-up calls, but so do our trauma coordinator, the hospital programs, and therapy. Answer You have the right idea to be concerned about patients and their families getting multiple calls after discharge. This can be [...]

Question All nurses on our staff are to complete approximately five callbacks per shift. How can this rule be enforced? When we are very busy, the nurses just don’t get them done. Answer Here are a couple of suggestions: First, we suggest using a format with questions specific to the key words on the patient [...]

Question Is there a preferred list of exit interview questions that your organization uses? Answer We recommend: When you were initially hired, why did you want to work here? What kind of assignments did you most enjoy during your time with us? Did you receive adequate training while you were here? Can you tell me [...]

Question We are implementing a 90-day follow-up meeting with new employees to find out how their time has been at the facility and what we could do differently to be more “employee friendly.” Can you suggest any questions we should ask during this meeting? Answer Yes. I recommend that you ask: How has your experience [...]

Question I am currently in the process of hiring a new assistant nurse manager (ANM). The current ANM and I interviewed each candidate, and there was also a separate peer group interview involving five staff members. The problem is that my top candidate is the last choice of the peer group. How can we handle [...]

Question I am looking for the ratio of thank you notes to direct reports. My leadership steering committee seems to think one note per quarter per employee from the manager is okay. What have you found works best? Answer Look at the number of staff. I feel every good employee should get at least one [...]

Question Has there been any “downside” to sending notes of thanks to an employee’s home? Answer No, there is not a downside. I believe that at times even low performers deserve a thank you note. When a leader has counseled a low performer who is trying to improve, a specific thank you that emphasizes actions [...]

Question I have worked at my organization for more than 15 years. I received a few thank you notes from my administrator, but they were for trivial matters such as cleaning a coffee machine and running folders to a meeting. These are small things I do every day. I get the impression that the notes [...]

Question I have been trying to implement patient rounding in multiple outpatient departments on multiple floors. These departments function like MD clinics. Patients are behind closed doors within 15 minutes of their arrival. Families accompany them most of the time. Do you have suggestions on how I might best spend my time? Answer In an [...]

Question I am a manager for the prep and hold area, OR, and PACU. I have recently encountered some difficulty with the rounding process in my prep and hold area. Even the first question about rounding on patients seems premature, since the patients have been in the hospital only for a few hours and in [...]

Question I manage a critical care unit with 35 beds. Census is usually 27 to 32. Most of these patients are not alert enough to understand anything I say to them. Trying to round on patients when family members are present is so “hit and miss.” What is the best way to approach rounding in [...]

Question I am one of the hospital operations coordinators (nursing supervisor) at a hospital in Baltimore. I attended the Studer Group Institute in November. We would like to start Rounding for Outcomes but are struggling to work this into our role. Any suggestions? What should we be looking for? How and what should we be [...]

Question I was just reading your article on effective leader rounding, specifically noting your comment that it is imperative that leaders who provide service to other departments round in those areas. I am the marketing/PR coordinator at our facility and a leader. My question to you is: How does my one-person department fit into this [...]

Question We continue to experience ongoing evidence, through patient satisfaction comments or real-time nonverbal communications, that our patients do not appreciate the manager rounding. Our managers discuss our goals to provide good care, discuss and/or show the survey, or inquire about the patient’s stay. How do we improve this process? Or how do we change [...]

Question My staff has become hostile that we would dare make patient rounds to find out what kind of care people are receiving. They think we are checking up on them and encouraging patients to complain and get them in trouble. Obviously, this is not our goal. How can we explain our purpose to the [...]

Question My direct reports include leaders for environmental services and food and nutrition. When these two department directors round and review their department scorecards, the departments they rounded on are always positive in their comments. However, when the CEO rounds, everyone opens up with examples of low performance. How can we fix this discrepancy? Answer [...]

Question Our senior leaders have been rounding on employees for about a year, and now the senior leaders are interested in rounding with our patients. Do you have some advice on the best approach, and are there some benchmark hospitals that have done this with success? Answer Yes, many hospitals have been successful with senior [...]

Question For months we have been rounding on a weekly basis with our senior leaders, and response seems to be regressing. People were positive at first. Now I am hearing comments from staff that it is insincere and that we are doing it only because we are required to. Should we cut back on rounding? [...]

Question I want to do senior leader rounding more often but have always felt uncomfortable about it. I feel I’m intruding on staff who may be very busy dealing with patients, etc. Could you help me with key words or any other tips? Answer First, hold your department leaders accountable for scheduling you. Once the [...]