presented by: peter cunningham, m.d. sheri nemec creating a culture of service at austin medical...

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

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

Presented by:Peter Cunningham, M.D.Sheri Nemec

Creating a Culture of Service at

Austin Medical Center

Page 2: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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 !

Page 3: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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

Page 4: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Medical Practice - 2007 Likelihood of Recommending

All clinics are rolled-up into respective MHS main sites

90th Percentile Goal = 90th Rank

Each bar represents a Mayo Health System site

Page 5: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Inpatient - 2007Likelihood of Recommending

All satellite hospitals are rolled-up into respective MHS main sites

90th Percentile Goal = 90th Rank

Each bar represents a Mayo Health System site

Page 6: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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.

Page 7: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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

Page 8: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Creating a Strategic Plan for Service

Creating a Strategic Plan for Service

Page 9: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

2008 - Service Becomes Part of the AMC Strategic Plan

•Goal = Achieve top patient satisfaction– Be at or above the 90th percentile

in patient satisfaction when compared to our peers by 2013

– Annual goals set

Page 10: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Strategic Plan for Service = Creation of AMC Service

Team

Strategic Plan for Service = Creation of AMC Service

Team

Page 11: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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

Page 12: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Building Blocks of the Customer Service Infrastructure

Service AccountabilityService Accountability

On-line ResourcesOn-line Resources

Service Department Service Purpose and Promise Service Principles

Feedback Management System

Service Coaches Service Training

Hiring for Service SkillsHiring for Service Skills

Response GuidelinesMeasuring and Benchmarking

Service Behaviors

Page 13: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Service AccountabilityService Accountability

On-line ResourcesOn-line Resources

Service Department Service Purpose and Promise Service Principles

Feedback Management System

Service Coaches Service Training

Hiring for Service SkillsHiring 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

Page 14: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Service AccountabilityService Accountability

On-line ResourcesOn-line Resources

Service Department Service Purpose and Promise Service Principles

Feedback Management System

Service Coaches Service Training

Hiring for Service SkillsHiring 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

Page 15: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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

Page 16: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Service AccountabilityService Accountability

On-line ResourcesOn-line Resources

Service Department Service Purpose and Promise Service Principles

Feedback Management System

Service Coaches Service Training

Hiring for Service SkillsHiring 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)

Page 17: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Service Purpose and Promise

A mission statement for Service –

“Austin Medical Center will provide a compassionate,

respectful, and caring experience every time.”

Page 18: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Service Purpose and Promise

• A service credo –

“Caring Experiences, Every Time”

Page 19: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Service AccountabilityService Accountability

On-line ResourcesOn-line Resources

Service Department Service Purpose and Promise Service Principles

Feedback Management System

Service Coaches Service Training

Hiring for Service SkillsHiring for Service Skills

Response GuidelinesMeasuring and Benchmarking

Service Behaviors

AMC Service Principles AMC Service Principles

Page 20: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Service Principles(October 2007)

Care for Our Care for Our Patient and FamilyPatient and Family

(The needs of the (The needs of the patient come first)patient come first)

Care for Care for the Organizationthe Organization

Care for Care for Each OtherEach Other

Service Service PrinciplesPrinciples

Page 21: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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 AccountabilityService Accountability

On-line ResourcesOn-line Resources

Service Department Service Purpose and Promise Service Principles

Feedback Management System

Service Coaches Service Training

Hiring for Service SkillsHiring for Service Skills

Response GuidelinesMeasuring and Benchmarking

Service Behaviors

Page 22: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Service Behaviors

• 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

Page 23: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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

Page 24: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Service Behaviors

• Service behaviors that demonstrate

“Care for Our Organization”

• Honor our legacy• Be an ambassador• Demonstrate commitment

Page 25: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Feedback Management System(January 2008)

Service AccountabilityService Accountability

On-line ResourcesOn-line Resources

Service Department Service Purpose and Promise Service Principles

Feedback Management System

Service Coaches Service Training

Hiring for Service SkillsHiring for Service Skills

Response GuidelinesMeasuring and Benchmarking

Service Behaviors

Page 26: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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.

Page 27: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Measuring and Benchmarking(2006)

Service AccountabilityService Accountability

On-line ResourcesOn-line Resources

Service Department Service Purpose and Promise Service Principles

Feedback Management System

Service Coaches Service Training

Hiring for Service SkillsHiring for Service Skills

Response GuidelinesMeasuring and Benchmarking

Service Behaviors

Page 28: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Measurement/BenchmarkingPress 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

Page 29: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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

Page 30: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Response Guidelines(October 2007-January 2008)

Service AccountabilityService Accountability

On-line ResourcesOn-line Resources

Service Department Service Purpose and Promise Service Principles

Feedback Management System

Service Coaches Service Training

Hiring for Service SkillsHiring for Service Skills

Response GuidelinesMeasuring and Benchmarking

Service Behaviors

Page 31: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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.

Page 32: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

On-line Resources –Available for All Staff

Relating to Service(March 2009 – ongoing)

Service AccountabilityService Accountability

On-line ResourcesOn-line Resources

Service Department Service Purpose and Promise Service Principles

Feedback Management System

Service Coaches Service Training

Hiring for Service SkillsHiring for Service Skills

Response GuidelinesMeasuring and Benchmarking

Service Behaviors

Page 33: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

On-line Resources

Service

Excellence Intranet Page

Page 34: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Hiring for Service Skills:Getting the right people

on the bus(January 2008-March 2009)

Service AccountabilityService Accountability

On-line ResourcesOn-line Resources

Service Department Service Purpose and Promise Service Principles

Feedback Management System

Service Coaches Service Training

Hiring for Service SkillsHiring for Service Skills

Response GuidelinesMeasuring and Benchmarking

Service Behaviors

Page 35: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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

Page 36: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Service Accountability(January 2008 – January 2010)

Service AccountabilityService Accountability

On-line ResourcesOn-line Resources

Service Department Service Purpose and Promise Service Principles

Feedback Management System

Service Coaches Service Training

Hiring for Service SkillsHiring for Service Skills

Response GuidelinesMeasuring and Benchmarking

Service Behaviors

Page 37: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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

 

Page 38: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Service Coaches(January 2008 – ongoing)

Service AccountabilityService Accountability

On-line ResourcesOn-line Resources

Service Department Service Purpose and Promise Service Principles

Feedback Management System

Service Coaches Service Training

Hiring for Service SkillsHiring for Service Skills

Response GuidelinesMeasuring and Benchmarking

Service Behaviors

Page 39: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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

Page 40: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Service Training for All Staff(March 2008-June 2009)

Service AccountabilityService Accountability

On-line ResourcesOn-line Resources

Service Department Service Purpose and Promise Service Principles

Feedback Management System

Service Coaches Service Training

Hiring for Service SkillsHiring for Service Skills

Response GuidelinesMeasuring and Benchmarking

Service Behaviors

Page 41: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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

Page 42: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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

Page 43: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center
Page 44: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Patient Satisfaction Progress to Goal –

Medical Practice Overall

Q4 2009 data

Page 45: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Patient Satisfaction Progress to Goal – Inpatient Overall

Q4 2009 data

Page 46: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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

Page 47: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

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

Page 48: Presented by: Peter Cunningham, M.D. Sheri Nemec Creating a Culture of Service at Austin Medical Center

Questions?