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Round It Like You Mean It

Mid Atlantic

April 2013

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Objectives

• Expected Outcomes• Rounding for Outcomes

EmployeePatientNurse/Client/Others

• Impactful Thank You Notes• Stop Light Reports – Do’s and Don’ts

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Expected Outcomes

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Engage Enable Value & Grow

Standards Technology Focused Execution

Scorecards 3rd Party Metrics Cost/Value

Service LineGrowth

I Impact Strategic Framework: Think Forward

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80

HighlySatisfiedPatients

DissatisfiedPatients

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85

50 60 70

Highly SatisfiedEmployees

DissatisfiedEmployees

Source: Press Ganey, Relationship of Employee and Patient Satisfaction, 2003

Employee and Patient Satisfaction Correlation

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Objective Measures

Plan

Actual

Comments Rating

HospitalityCost and Productivity60%

Client Budget Achievement

Achieve >85% Qtrly OP-X Assessment scoresRequired Assessments Completion

Achieve > Top Quartile Patient Sat (Food & HCAPHS Top Box)

100% to Plan - Weekly/daily tracking and control of client productive and OT hours to meet 100% productivity as per the DPM (Daily Productivity Measure). Track any legitimate variances weekly. Monthly OPX Essential and Food Safety audits completed according to standard. --Meet a minimum of 85% compliance on monthly audits. --Develop action plan for improvement to correct issues and implement required standards 100% to Plan - Full utilization of I-Impact to create a culture of customer service as evidenced by Stoplight report and patient satisfaction score trends. --Complete Adopt a Floor assignments on a weekly basis. Address Nursing issues with Nurse Manager--Conduct patient focused rounding on assigned units a minimum of 1 time per week.

Performance Objectives

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Expected Outcomes–Rounding for Outcomes (Foundation)

– Rounding on employees– Rounding on patients – Rounding on Nurse/Client/Others

– Impactful Thank-You Notes– Stop Light Reports – Do’s and Don’t

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Rounding: Round It Like You Mean It

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More Than Activity—OutcomesMeaningful Information

• Recognition—verbal or thank-you notes • Follow up on needs for tools and resources• Follow up on identified issues• Coaching for performance• Communication of information

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Rounding: About Outcomes!Building Relationships1. What is working well?2. Are there any individuals who I

can recognize?3. Are there other teams

I should be recognizing?4. What systems can be

working better?5. Do you have the tools and

equipment to do your job?

Source: Hardwiring Excellence

Relationship Building

Harvest Wins and Focus on Positives

Process Improvement

and Safety

LEADERSHIP

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With Whom Should You Round?

Employee RoundingExisting Employees

New Employees

Managers

Internal CustomersNursing

C-Suite Leadership

Hospital Managers

External CustomersPatients

Patient Family Members

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Patient Rounding

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Patient RoundingStaff should view rounding on patients as a positive activity because of the feedback the leader shares with them from their patients.

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Patient Rounding Tips• Know the patient’s name.• Sit to help the patient feel you are listening (ask

permission first)

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Patient Rounding Tips• Empathize with the fact that the patient is ill and

may be scared. • Set the time expectation up front• Manage up yourself and the staff

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Patient Rounding Tips

This is not a quiz!

Do you know your

hostess’ name

Did we pull your

trash this morning?

Was the temperature of your meal satisfactory?

Do you have any concerns?

Was your bathroom cleaned to your satisfaction?

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Patient Rounding• Dig deeper into specific issues• Use phrases such as “please tell me more about

that” or “What can we do to make your stay better?”

• Use closing statements-when a leader says, “Is there anything I can do for you before I leave?” it tells the patient you care and their input is important

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Patient Rounding – Follow UpCommunicate outcomes with staff following any interaction with patients.

Information that is documented should include a patient identifier, feedback on areas of focus and staff to recognize, and items for follow-up

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Nurse/Customer Rounding

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Nurse/Customer Rounding – Initial

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Initial Nurse/Customer Rounding1. Goal – to make Personal Connection2. What’s new in your department3. What’s working well?4. Is there anyone I should recognize? Why?5. We were working on improving ------- for you

and your department. What has gone well? What can we do better?

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Introduce the Nurse/Customer Preference Card

Goal:Provide Excellent

Service

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Initial Nurse/Customer Rounding

What is one thing you would like us to address right now? Indicate when you will follow up with status For us to provide this service to you, here is what

we need from you… Is there anything I can help you with right now?

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What’s Next?On-Going Nurse Leader/Customer Rounding

Before you move on - Respect the Nurses’ world... Respect their time Respect their concerns Respect their area

Remember, the best way to get respect is to give respect.

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Initial Nurse Leader/Customer Rounding• Schedule the next Rounding meeting• Thank them for their time – try to make this seem

like it is not “more work” for the nurse/customer• Leave a copy with the Customer• Review with own staff and post in the department

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Next Rounding Visits• Follow steps above • Review Preference Card and how well you and

the staff are meeting the defined service expectation

• Follow up with: Are there any other process or supply issues? What are your thoughts on how we can improve?

• Schedule follow-up Rounding appointment

Every 6 months review and redefine Customer Expectations

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Let’s Move to Employee Rounding

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What Employees Want• To know the organization has purpose• To know the organization is moving in the right

direction• A good supervisor• Personal development• Efficient work systems• Tools and equipment or an explanation of their

absence • Appreciation• Good interdepartmental relationships• Good coworkers

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Rounding: About Outcomes!Building Relationships1. What is working well?2. Are there any individuals who I

can recognize?3. Are there other teams

I should be recognizing?4. What systems can be

working better?5. Do you have the tools and

equipment to do your job?

Source: Hardwiring Excellence

Relationship Building

Harvest Wins and Focus on Positives

Process Improvement

and Safety

LEADERSHIP

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Employee Rounding OUTCOMES:

• Strengthens supervisory relationship with employees. • Know the organization has purpose and is moving in the right

direction.• Have opportunity for personal development.• Become “owners” through their input in creation of more efficient

work systems.• Have proper tools and equipment to reduce frustration and be

more productive.• Receive genuine, timely, and specific appreciation and recognition.• Build good interdepartmental relationships.• Strengthen teamwork .• Enjoy working with good coworkers.

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Rounding on Employee FAQ’s1. How frequently do I round on my employees?

– Expectation is quarterly on all employees that report to you.2. If I round too every quarter, won’t employees cease to take it

seriously?– No, if you are proficient at rounding, you can add focus questions to make it

even more meaningful.3. Can I delegate rounding on employees?

– Yes and No. It is good to delegate some rounding, but remember that the goal of rounding is to build the relationship with the direct supervisor which is defined as the person who completes the evaluation.

4. Do I have to use a rounding log?– Yes, it is an important component to building the habit, harvesting R&R,

following up on issues, ideas, and tool and equipment needs.

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Proper Use of Rounding Tools

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Common Response to Rounding Log

• Tool• Information• Recognition• Follow-up• Personal

resource

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Rounding Tools – To TrackName and DatePersonal Connection

Staff or Departments to Send Thank You Notes and Why

Follow-up Needed on Tools or Systems Issues

Coaching 

Follow-up Taken

1.

  

   

2.   

 

3.   

       

4.   

       

5.   

       

6.   

       

7.   

       

Ivanna Work – 4/19/13

Send note to Johnny Mop for helping Ivanna with the closet.

TYN None Sent note – 4/22/13

Roger O. Thornhill – 4/23/13

George Kaplan for lending microfiber mops.

Look into the lack of microfiber mops.

Coach employees and supervisors on earlier alert when out of microfiber mops

***Blank until completed ***

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Anatomy of a Thank You

Dear Johnny,

Thank you for your hard work. It is greatly appreciated.

Debbie

What’s wrong with this Thank You Note?

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Anatomy of a Proper Thank You

Who Managed Up

Dear Johnny Mop,Ivanna told me about how helpful you were to her with the getting her closet cleaned out last week. Thank you for being a great role model for teamwork. Ivanna said she would work with you any day!Sincerely,Debbie

Specific

Timely

Handwritten

Win-Win-Win for Ivanna, Johnny and Debbie

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Key Elements

• Handwritten

• Include specific behavior

• Sent to employee’s home

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Why Home?

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Steps to TY Notes

2. Implement a System―Determine how many and how often

• Department director with 100 employees• Target–100 Thank you notes during the year • Please note that every employee does not have to

receive a note, some can receive more than one.• Director has four managers• How many thank you notes should each manager

manage up monthly?

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Tough Questions1. Will this seem forced?

2. Will thank you notes become insincere because we are asking everyone to use them?

3. Do I write notes or just ones I ask people to write?

4. How many is too many?

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Let’s Talk About Communicating Results

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Communicate at All Levels

Communication Suggestions• Carry wins back to your team• Spotlight performers—Do not be afraid to acknowledge

high performers• Bring staff to your meetings• Celebrate the success of others

Opportunities for Communication• Staff meetings• One-on-one meetings• Employee forums• Huddles• Rounding• Communication boards

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Stop Light Report- EVS – 10/1/12

Completed: These are opportunities that we approved and answered right away.

1. Help with discharges: 2nd shift start times adjusted to provide additional labor one hour earlier during dayshift.

Work in Progress: These are opportunities that we could not answer right away but are working on.

1. Cart repair.2. More staff approved off per day for vacation.

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Stop Light Report- EVS – 4/1/13

Completed: These are opportunities that we approved and answered right away.

1. Help with discharges: 2nd shift start times adjusted to provide additional labor one hour earlier during dayshift.2. Our carts are always a mess after use by co-workers: Entire room designated for off shift carts and carts being inspected weekly for program compliance3. Key Assignments: Process complete and all assigned including spares for any Agency Labor

Work in Progress: These are opportunities that we could not answer right away but are working on.

1. Cart repair: On-Going, EVS Equipment manager identified and maintenance log created related to lock repair.2. More staff approved off per day for vacation: Will work on this on a case by case basis. 3. We need more Bowl Care Chemical: We are transitioning from the RTU to the Concentrated Enverros Bowl Cleaner which you can access through your chemical dispensers in your closets.

Unable to provide: We can’t do it now… and why!

1. Give us our original start times back: Start times were adjusted to ensure we had proper labor coverage at the proper times. Your hard work and flexibility is paying off and we are experiencing better response times to patient room discharges.

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“The greatest problem in communication is the illusion that it

has been accomplished.” ~ George Bernard Shaw

Communicating Results

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Advertise the Stop Light Report

Huddles

Employee Meetings

Coaching Sessions

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~ Quint Studer ~

Never Underestimate the Difference You Can

Make

Never Underestimate the Difference You Can

Make

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Q&A