About A. Woodward & Associates Our company’s primary focus is to help clients develop healthy patient and staff relationships. Our consulting services are customized to your organization, and your specific needs. Areas of expertise include customer service, patient satisfaction and employee engagement. A. Woodward & Associates was established in 1999 by Anita B. Woodward, MBA, FACHE. Based in Cleveland, Ohio, we have clients in all parts of the country. Anita has over 20 years of healthcare management, customer service, and human resource experience, and her associates have a variety of complementary skills and experiences.
April 2008 Newsletter
Setting Limits When Behavior Becomes Abusive Increasingly, both management and front line staff in our client hospitals and physician groups are asking us how to set limits. We are hearing that behaviors are getting worse, and staff do not know how to cope. Handling abusive behavior saps the energy from staff; energy they need to remain emotionally engaged with and responsive to patients and colleagues. This article will help them cope.
When to Set Limits This is an important question; one worthy of discussing with staff. There is a difference between abusive behavior, and behavior that simply makes us uncomfortable. People in our healthcare system are experiencing incredible stress. Patients and families are frightened, powerless, and often in pain. Internal customers are overworked and often frustrated by dysfunctional systems. These factors can lead to difficult behaviors – crankiness, touchiness, self-centeredness, sarcasm, and even yelling. It is hard to take any of these behaviors; they make us uncomfortable, anxious, and sometimes cranky ourselves. However, as we like to remind our clients, we are the paid professionals, and one thing we are paid to do is act professionally, even when it is hard. As paid professionals, we must be prepared to cope with others’ difficult behaviors, and not to respond in kind. But we are not paid to take abuse. Abuse is when people cross the line, and begin such things as name-calling, using strings of profanities, throwing things or threatening people. You will need to help your staff recognize the difference between abusive behavior and behavior that is not. (There are many techniques for helping people identify and handle such behaviors. Please contact us if we can help you choose and teach some.) It is time to set limits when the line between difficult behavior and abuse has been crossed.
Who is Guilty of Abuse? Typically, we think of patients and families as the abusers, and that can often be the case. However, they are not the only guilty parties. We have all heard stories about surgeons throwing things and name-calling, and we may have been the victim of an abusive co-worker in our own department too. The following techniques can be used to combat abuse from anyone at work.
How to Set Limits In three words, we set limits firmly, politely, and professionally. As the paid professionals, we must keep our composure. As tempting as it is to lash out at an abuser, such behavior usually makes things worse. Firmly means we: Sit or stand up straight Look the abuser in the eye, if we are face-to-face Speak firmly, not meekly or with fright State what we need, being specific about the objectionable behavior(s) Follow through, if necessary An example would be, "Mr. Jones, I really want to help you with this, but I cannot continue this conversation if you continue to call me names." It is important to be specific about the behavior you want stopped, as people who are angry are often not really thinking clearly, and they may not realize what part of their behavior you find objectionable. Politely and professionally means we: Do not raise our voices or shout Do not "cop an attitude" ourselves, either in body language or tone of voice Do not use sarcasm, tears, threats or other difficult behavior ourselves Continue to show respect for the person engaged in the difficult behavior It is tough to do this. We feel emotions when people are abusive to us, and our "fight or flight" instinct kicks in. Setting limits involves overcoming that instinct, and behaving like a paid professional. With the right training, support and reinforcement, we can, indeed, set limits in a firm, polite and professional way.
Follow-Through Once our request has been made, the abuser often immediately changes his or her behavior; sometimes even apologizing. If they do not, it is important that we follow through. Again, we must remain firm, polite and professional. If we are on the phone and the bad behavior continues, we must end the call. If we are talking in person, we must end the conversation. Sample scripts and related notes are below. "Mr. Jones, I hope we can talk again when you are calmer. For now, I need to end this call. Good bye." Next, hang up the phone gently. No slamming receivers allowed. "Mr. Jones, I hope we can talk again when you are calmer. Please call me if you would like to do that. But for now, I have to leave." Next, stand up, turn, and walk away. No sighing, head-tossing, door slamming or other expressions of annoyance. "Mr. Jones, I hope we can talk again when you are calmer. Please call me if you would like to do that. But for now, I need to ask you to leave." Next, stand up calmly, open door and step just to outside of door if in office. If difficult person is at a counter, simply stand, look at person, and wait. They will almost always leave without it being necessary for you to repeat your request.
A Note for Managers As previously mentioned, it is not easy to deal with abusive behavior. Your staff need three things from you: training, support and reinforcement. Whatever you do, if people follow these guidelines, it will be important for you to back them up, even if the abuser was a big donor or surgeon. Also, as people learn, expect them to make mistakes. Be prepared to coach, praise incremental steps, and keep your expectations clear. Please contact us if you would like more information about this topic, or other aspects of organizational culture that get in the way of people giving optimal customer service to patients and each other. Reach us by email or phone: 216-631-1852.
Honors Woodward Becomes Consultant to Consumer Advocacy Group The Ohio Society for Healthcare Consumer Advocacy has recently engaged Anita B. Woodward, President of A. Woodward & Associates, as a permanent consultant. In that capacity, she will provide a variety of services and support to the board and organization. As a long-time member and friend of the group, Ms. Woodward was honored to accept this role. Upcoming Speaking Engagements Anita Woodward will be speaking at the following conferences this quarter. Please stop by to visit, and let her know how we can make our e-newsletter and our consulting services more useful to you. April 9-11, 2008, Society for Healthcare Consumer Advocacy (SHCA) of the American Hospital Association. This is SHCA's annual meeting, to be held in St. Louis, MO. Anita will be co-presenting with Carol Santalucia, Director of World Class Service, Division of Nursing, for the Cleveland Clinic Foundation. Their topic is "Gaining Senior Leadership Support for Your Ideas and Projects." For more information or to register, go to www.ashes.org, or call 312-422-3700. June 10-12, 2008, Michigan Association of Healthcare Advocates annual meeting at the Grand Hotel on Mackinac Island, MI. Anita's topic is "Making Meetings More Productive." For more information, go to the MAHA website or contact Mary Lou McFadden, VP of Education.
Real Life Customer Service Case The following situation really occurred. Consider using it as a case study for quick discussions in staff meetings. An elderly man was in the chain grocery store with a list of items to buy. He looked confused by the whole process. Escorting him was a store employee, who cheerfully helped him find the items. At one point, she used his cell phone to call his wife and clarify something on the list that he was unsure of. She read many labels to the wife until the right item was identified. What is your initial reaction to hearing this story? How does this relate to the customer service in your department? What impression did people observing this behavior have? What might the impact on customer loyalty be? How could you and your department provide knock-your-socks-off service?
Case studies and story ideas wanted! We are looking for good case studies to share, and we always want to publish articles that answer your questions or help with your challenges. Please email us with your ideas. Thanks.
About This Newsletter This newsletter is published for clients and colleagues of A. Woodward & Associates, and for others who are interested in customer service, employee relations, and organizational communication, especially in healthcare organizations. If you would like to add someone to our subscriber list, please contact us at anita@anitawoodward.com (or simply reply to this email). Be sure to provide the subscriber's name and organization. If this newsletter is reaching you in error, we apologize. To unsubscribe, please email us and put "Unsubscribe" in the subject line.