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

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

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

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

6. Next Steps in our Journey… 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.

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 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 90 th percentile in patient satisfaction when compared to our peers by 2013 –Annual goals set

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

11. AMC Service Team 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

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

13. Service Accountability On-line Resources Service Department Service Purpose and Promise Service Principles Feedback Management System Service Coaches Service Training Hiring for Service Skills Response GuidelinesMeasuring and Benchmarking Service Behaviors 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 On-line Resources Service Department Service Purpose and Promise Service Principles Feedback Management System Service Coaches Service Training Hiring for Service Skills Response GuidelinesMeasuring and Benchmarking Service Behaviors A Closer Look at the Service Infrastructure Building Blocks 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. Service Accountability On-line Resources Service Department Service Purpose and Promise Service Principles Feedback Management System Service Coaches Service Training Hiring for Service Skills Response GuidelinesMeasuring and Benchmarking Service Behaviors Creation of AMC Service Purpose and Promise (October 2007) Creation of AMC Service Purpose and Promise (October 2007)

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

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

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

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

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

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

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

33. On-line Resources Service Excellence Intranet Page

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

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

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

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

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 – Inpatient Overall 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?