Executive Summary
Leaders can help employees to improve by asking their colleagues for honest feedback using a survey, a discussion board, or comment box.
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Have a small group of experienced staff meet to convey concerns to managers.
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Give employees the opportunity to tell their side of the story.
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Survey employees on how well they know departmental processes.
“Does your work unit work well together?” “Does your work unit have a climate of trust?”
Patient access leaders at OSF Saint Francis Medical Center in Peoria, IL, received disappointing scores for these two questions on the department’s annual Employee Opinion Survey.
“I decided to put together an employee peer survey,” says patient access services manager Jacqueline Doerman. Doerman developed the questions with a colleague and administered the survey via email. [The Peer Evaluation Tool and sample results are included with the online issue. For assistance, contact customer service at [email protected] or (800) 688-2421.]
“It wasn’t mandatory, but we had a high amount of staff fill it out,” Doerman reports. “The results were put together in Microsoft Publisher, manually.”
Staff members praised their coworkers in many ways. Some items that needed improvement were brought to light, such as staff members not being ready to work at their desks at the start of the shifts. “Those staff would clock in, get a drink, or put food away before actually sitting down and registering patients,” Doerman says.
Staff members also received feedback on how they interacted with others and how they could improve their teamwork skills. “Some respondents were very candid about staff spending a lot of time on the phone or Internet, or not being at their desks when they should be,” says Doerman.
Action plans requried
Managers presented the survey results to every staff member individually. Regardless of their scores, they all had to write action plans on their goals and how they would achieve them.
“Some of the feedback was hard to hear, but it was very beneficial for all of them,” Doerman says.
Tammy Decker, CHAA, a patient access services manager at Texas Health Alliance Hospital, recently took a class in managing different personalities, and she realized that she wasn’t receiving feedback from employees who were not outgoing.
“I am very extroverted, and I needed to see that sometimes I was not getting the voice of my introverts,” she says.
Decker made these changes to obtain feedback from all patient access employees:
• Decker created a discussion board on the hospital’s internal website, so employees can post comments on various topics.
• Decker created a comment box.
“Staff can put feedback, concerns, shout-outs, and ideas in anonymously, by filling out an index card or by typing in on a piece of paper and slipping it in,” says Decker. The box is locked, and only a supervisor and Decker have a key to it.
“We get a mixture of comments, and they can do it without me knowing who they are if they chose to do so,” she says.
• The department created a small group called the “Think Tank” with top performers from each patient access area.
“They meet once a month to discuss processes, concerns, and innovative ways to enhance the team’s progress,” says Decker. The employees also act as advocates and informal representatives for their areas. “The other staff sometimes feel more comfortable speaking to a peer than to someone in leadership, so they seek out one of these individuals to assist them in being heard,” says Decker.
• She encourages staff members to speak up if they notice a problem.
“If they speak out about a concern, I provide them with a candy treat for speaking up!” says Decker. “I make sure staff understand that accountability is not punitive.” She reaches this understanding by taking action when staff report a concern.
“Your staff can tell you things all day long,” she says. “But if you are not listening with intent to act or provide feedback, then you are not really listening.” Here are some examples:
— After employees reported feeling unsafe because there were no panic buttons in any of the registration areas, Decker met with hospital risk managers and arranged for these buttons to be installed.
— Night shift registrars asked for a small refrigerator for their meals and drinks, as the cafeteria closed at 7 p.m.
“I was able to speak with my director and get this approved to purchase for the staff,” says Decker. “They have really been appreciative of that.”
— Emergency department registrars were concerned that all of the doors that went to patient rooms were badge access only and that there was no button to press to open them. “I worked with the hospital leaders and was able to get it approved to have one door have this access,” says Decker. “We can now let patients in without having to stop helping the current person in front of us checking in.”
• If staff report a concern with a colleague, Decker gives that employee a chance to share his or her side of the story.
“I let them know that I really want to understand the background in them making the decision that they made,” says Decker.
Next, she asks the employee how she can support them in making better choices, such as additional education.
“Once they realize that you are not automatically assuming they knowingly did something wrong, they tend to be more understanding and open,” Decker says.
• Decker surveyed employees about every single program and process in the department, and she had them mark one of these choices:
— I know this so well I could train it.
— I am pretty good but still have questions here and there.
— I can do this with the support of someone else.
— I can’t do this, or I have never been taught this.
Decker learned that some employees wanted hands-on practice instead of just emailed instructions. She also realized that the department wasn’t using the different strengths of its employees. “This was a major eye-opener for me,” Decker says. “Those that aren’t performing aren’t necessarily slow or lazy. Some just haven’t felt comfortable asking questions.”
She based upcoming staff meeting agendas and training topics on the feedback she received. “It also showed me who I could pair up for peer-to-peer training.” she says.
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Tammy Decker, CHAA, Manager, Patient Access Services, Texas Health Alliance Hospital. Email: [email protected].
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Jacqueline Doerman, Patient Access Services Manager, OSF Saint Francis Medical Center, Peoria, IL. Email: [email protected].
