About A. Woodward & Associates

Our company’s primary focus is to create a more humane healthcare system by helping clients develop healthy patient and staff relationships. Our consulting services are customized to your organization, and your specific needs. Areas of expertise include service excellence, the patient experience and employee morale and engagement. A. Woodward & Associates was established in 1999 by Anita B. Woodward, MBA, FACHE. We have clients in all parts of the country. Anita has over 25 years of healthcare management, service excellence, and human resource experience, and her associates have a variety of complementary skills and experiences.

Effective Training in
Service Recovery Techniques

Service Recovery. Most of us know what that term means to us in healthcare: on the spot recognition and resolution of patient (or internal customer) complaints, by whomever discovers there is a problem.

We have written about this topic before — in July 2008 and January 2006 — and you are welcome to go to our website and read the previous articles. We have recently been asked to write a bit more about how to do effective training on Service Recovery, so that staff can successfully handle problems. If you would like more information about Service Recovery, such as why it is important or how to set up, implement, and sustain an effective method, please feel free to contact us by email.

Training really is critical. Most hospital employees and physicians have never been trained in how to handle complaints, and the thought of doing so makes most of us uncomfortable. Thus, one goal of training is to give people the confidence they can do this successfully. In order to achieve that goal, we must also give people the skills to handle complaints. Finally, we must motivate people to want to take this on. You can refer to the earlier articles for tips on how to motivate.

Training can give people both the skills and the confidence. To be successful, training must include:

• An overview of why you are doing this — the motivation can come here
• A clear explanation of the process people should follow in handling complaints, including steps to take, what to say, any limits on their authority in resolving complaints, and how to document what they have done
• Plenty of opportunity to practice using role play, and ideally, a chance to observe others role playing and to discuss what they saw

First, the why's. For the front line employee, the "what's in it for me" is not obvious. Several "why's" do exist, and should be discussed:

• It is the right thing to do. We would want staff to handle a problem one of our own loved ones was having. Engaging staff in talking about times they have had problems as patients or with a loved one who was a patient is a good way to bring this point home.
• It makes doing the job easier. Patients or co-workers harboring hurt feelings or anger become more difficult, and that makes everyone’s job a little harder.
• It keeps us employed. If patients have problems that are not handled, and they then see your competitor hospital has good patient satisfaction scores, they may defect to that competitor.
• CMS (Centers for Medicare and Medicaid Services) requires that patient complaints be handled a certain way. If they are not handled "on the spot, by staff present," then regulations require a very cumbersome process be followed. This is more labor-intensive, and can be less satisfying to patients.
• Finally, research shows patients who have complaints that are handled promptly and effectively are more satisfied and loyal. Now that hospitals are being paid differently by Medicare based on patient satisfaction scores, this is critically important. The dollars at risk could mean the difference between raises and no raises, new equipment and no new equipment.

Hopefully at least one of these "why's" will be meaningful to every person in your facility.

As to the skills and confidence, that should begin with your choice of a process that you want people to learn to follow. Many models exist, so you have options. Whichever model you choose, you will want to design training that will be relevant and helpful. Remember to consider what you will allow front line staff to do in order to solve a customer problem. Set few limits and trust that once staff understands the reason and the process, they will use good judgment. Do create a simple system for documentation; if it is too complicated, it will not be used.

Finally, the best way to give people skills and confidence is to let them have plenty of practice. Your training should include plenty of role play using the steps in the model you have chosen. Our advice is to design scenarios that are typical of things that happen in your hospital. Don't forget to include a scenario about an internal customer's complaints. We like to have people in triads, and give them at least three scenarios.

Each scenario includes a customer, an employee trying to help, and an observer. The scenario only outlines the beginning of the story. The action starts with the customer, who can take the story wherever s/he wants. The employee tries to help, using the steps in your model, and the observer makes quick notes about what is done well, and what could be improved upon. After 3-5 minutes playing the scene, the observer gives feedback to the person playing the helpful employee. Then the triad members switch roles and play a different scenario. The process is repeated three times, so that each person gets to be the customer, the observer, and the helpful employee.

An example of a scenario we have used is:
Mr. Washington has been waiting a very long time for his test/procedure/to be seen by his physician. You are the receptionist in the waiting room, and you notice that he is starting to frown, look at his watch, and sigh loudly.

One of our clients recently decided to try adding a scene that was role-played in front of the room for the whole training group. Two people were asked, in advance, to play out a scene. After the scene, the whole class could offer feedback on what they saw that went well, what could have been better, and so on. This approach gives people an opportunity to really watch, in a no-stress way, the complaint-handling process. Although observing others is a great approach, always give people the time to practice. It is mostly through struggling through the steps in your model and saying the types of words they would say in real life that people have the confidence to try this in the face of a real complaint.

Please email us if we can help you in any way with Service Recovery.

Scripting to Explain Observation Status to Patients

There were recently some messages posted on the Society for Healthcare Consumer Advocacy's listserv about the difficulties of explaining to patients why they would be billed for drugs given to them when they are in the hospital in Observation status. The discussion revolved around the patient dissatisfaction that results when drugs they normally take on their own at home are so expensive when they are Observation patients in our hospitals.

Have you found a good way to script your staff to explain this that successfully reduces patient complaints and dissatisfaction? If so, please share your methods with us, and with your permission, we will include them in the next issue of our newsletter.

Case Study

The following situation really occurred. Consider using it as a case study for quick discussions in staff meetings.

An anxious couple was in the hospital elevator, on their way to visit a relative just admitted through the ER after an accident. They rode the elevator with several hospital employees who were talking to each other. The employee conversation revolved around what a tough day it had been, and how glad they would be when their shift ended. One employee commented that she should have called off, as she really didn’t feel like being there.

• What impact do you think this elevator ride had on the visitors? Why?
• What could have been done better?
• Do people at your hospital understand the difference between "onstage" and "offstage" behavior?

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.