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How Can We Turn the Healthcare Flywheel Faster?


What are we doing wrong? We are rounding. We are having focus group meetings. We are desperately trying to make improvements and changes. We have been at this for a year now. Employees are still negative and are talking to us less and less. Physicians feel we are being too hard on the employees at times. Any advice?


First, make sure all leaders are consistently Rounding for Outcomes on staff. Consistency will send a message to leaders that rounding on staff is a priority.

Make sure managers have been specifically trained to round on employees. At Studer Group, we find that productive rounding occurs when managers ask five questions:

  • The first question is personal, to establish an emotional bank account (i.e., “Did you have an enjoyable vacation?” “Is your daughter over her illness?”).
  • The second is: “What’s going right?” (to establish a positive climate).
  • The third is: “Who else should I be rewarding and recognizing?” (which encourages staff to manage up).
  • The fourth is: “What systems and tools can be improved?”
  • The fifth is: “Do you have the tools and equipment to do your job?”

Using these key phrases will assure that you are Rounding for Outcomes.

Then follow up by responding to needs and capturing wins, making sure employees know that they have been heard. I have found that it’s rare for all employees to feel one way or the other. Try to drill down to individuals. Look at the negativity by unit leaders and managers— often, it’s the result of a lack of talent or skill set on the part of the supervisor. Sometimes, people are just negative by nature. The unsatisfied 5 percent can be, and usually are, the most vocal in attempting to derail the process. Avoid using generalities. If a leader says her staff is not responding to rounding, round with her again to make sure she is indeed Rounding for Outcomes as outlined above and is focusing on the positive staff first.

I might also suggest doing a mini employee survey to see if you can identify pockets of negativity. You will find that some unit leaders perform better than others. Learn from the high performers. Not all leaders are the same.