All organisations talk about service, but for healthcare organisations, service is
everything. Fostering an exceptional service culture throughout your
healthcare organisation can be a challenge, but it can be done.
In my book, Raising the Bar on Service Excellence, I talk about what it takes
to get the people within the organisation to this level. I depict the process as a
triangle that involves the head, the hands, and the heart. Do they know what
to do (the head or knowledge)? Do they know how to do it (the hands or skill)?
And, finally, do they want to do it (the heart or attitude and desire)? If they do,
you’ve got a winning combination!
Here are three essentials for making it happen.
1). Hiring for behaviour. Healthcare leaders have typically focused on
technical skills when hiring, and that’s certainly understandable. We
want staff members who have the competencies to perform their
duties, whether these duties are clinical or administrative. One of the
biggest arguments about hiring practices when it comes to culture is
whether we hire more for skill or total fit. We can teach staff how to
perform their job duties if necessary. What we can’t teach them is how
to be caring, compassionate, service-driven human beings. Those are
the traits we need to screen for during the hiring process. Behaviour-based
interviews can help. Here’s how it works:
a. Identify the required skill. Perhaps it’s the ability to defuse
highly-emotional situations with angry patients or family
b. Create questions designed to screen for the skill. That requires
the candidate to recall an actual experience. sk this question:
“Tell me about a time when you had to handle a situation with
a difficult patient or an angry family member. What was the
situation and how did you handle it?”
c. Listen carefully to the response. You will be looking for a calm,
matter-of-fact perspective and signs of empathy. You can look
for signs that the candidate empathised with the angry
individual. For instance, they may say: “I could understand why
the person was angry….” Listen for cues that the individual
took ownership for the situation and initiative to resolve the
problem. Watch for red flags that indicate blaming,
judgmental behaviour, or we/they mentality.
d. Ask the interviewee what he/she might have done differently
in hindsight. One of the red flags I’m alert for when hiring is
when somebody says: “Well, I can’t really think of anything I
would have done differently.”
Another good, behavior-based question that I like to use is: “Tell me about your favourite job of all time; what made you
love it so much?” The response will give you a sense of what
really motivates this person—is it the opportunity to serve
others and make a difference? Is it the opportunity for
intellectual challenge? Or could it be the opportunity to work
as part of a highly functioning team?
When we’re hiring new staff members, our goal is for them to
be part of a service-driven culture. So it’s important to get a
sense of who they are and how they behave in certain
situations that can give us a glimpse of their personalities.
2).Training and orienting new hires. When a new employee is hired, they
are immediately influenced by the actions and behaviours of those
around them—particularly their immediate supervisors and their
colleagues. Culture isn’t something that’s described in your policy
manual. Culture is “the way we do things around here,” and it will
manifest itself in the behaviours, processes, and interactions that your
new hires will experience from the first moment they arrive on your
One of the things that I frequently observe is that senior leaders and
those involved in the hiring and orientation process will have great
intentions in terms of bringing the new employee on board and
introducing him or her to the culture. They spend time during
orientation talking about the mission, vision, and values. But, when the
employee gets back to the unit to which they’ve been assigned, what
they see does not match the picture that was painted for them. That
disconnect is often a reality shock that leaves the new hire questioning
the leadership’s credibility and wondering what other surprises are in
store. So make sure that you are what you say you are.
It is critical that your middle managers (the ones who will actually be
working with employees on a day-to-day basis) are modelling,
rewarding, and supporting the types of behaviours and actions that you
want to see exhibited in your healthcare organisation. They need to be
providing both positive and constructive feedback and modeling the
behaviours that define your service-oriented culture.
That can take time. Sometimes, in healthcare, we’re so anxious to get
a warm body into the department that we don’t spend enough time
orienting the new hire. I was shocked when I was researching my last
book to see the difference between orientation in healthcare
environments and other environments. The Container Store, for
instance, orients new employees for six weeks before they get out on
the floor. Starbucks employees go through 40 hours of orientation—16
of those 40 hours are dedicated to customer service. What does the
orientation process look like in your healthcare organisation?
3) Behavioural reinforcement and continuous development. So you’ve hired a service-oriented employee and provided training to ensure the
employee exhibits the service behaviours that exemplify your culture.
How do you make sure that you can maintain these behaviours?
Performance appraisals provide a formal opportunity for feedback, but
they usually only occur once, maybe twice, a year. That’s not enough.
The ideal service culture is one where people are self-policing—they’re
catching each other doing positive things, and they’re reinforcing
those positive behaviours. They’re also noticing things that could be
done better or differently, and they’re correcting those behaviours.
It can take a long time to get to this level. One of the biggest impacts
on making it happen is having managers who do daily rounds, engaging
with their employees to identify the stars and give them a thumbs up,
to thank, to reinforce, and, yes, sometimes to correct and coach.
These are three of the leadership essentials—the hiring, the training and
orientation, and the behavioural reinforcement. When you have these three
things in synch, then you’ve got a great foundation for a phenomenal culture.
© Baird Group, 2010
Nurse, author, and consultant Kristin Baird, "Healthcare’s Customer Service Guru," is the author of Raising the Bar on Service Excellence: The Health Care Leader’s Guide to Putting Passion into Practice (Golden Lamp Press, 2008), Reclaiming the Passion: Stories that Celebrate the Essence of Nursing (Golden Lamp Press, 2004), and Customer Service In Healthcare: A Grassroots Approach to Creating a Culture of Service Excellence (Jossey Bass, 2000).