Sustainable improvement in patient satisfaction/HCAHPS scores starts with intrinsic motivation.
The Accountable Care Act (ACA) and enlightened health care consumers have once again elevated the priority of improving patient satisfaction and endorsement. Old best practices such as rounding, key words at key times, employee and manager training are being dusted off and away we go once again.
So, what makes us believe that what we did before will improve patient satisfaction and endorsement scores this time around? If you are continuing to rely on gaining improvement using the same old, same old tactics, do not be surprised if you get the same old results. Perhaps something has been missing.
That “something”, may be waiting right outside your door. The answer lies inside…inside every employee.
Improvement in patient satisfaction or any initiative is not going to happen unless your employees want it to happen. You can try the carrot. You can try the stick. You can train and retrain them. You can round for miles and miles and miles. You can memorize your key words at key times till it rolls off their tongues like water off a duck. The bottom line is, gaining real improvement in patient satisfaction must start with instilling intrinsic motivation.
Don’t get me wrong, rounding, key words and training all have merit, but it’s a little like building a house and jumping right to building the roof first. We need to start in a different place. Gaining real improvement in your patient satisfaction scores will not happen if the motivation is not coming from deep inside each and every employee. Seth Godin, author of “Linchpin, Are You indispensible?” states; “People are not going to seek out a new path because you tell them they must,. . . People follow because they want to, not because you order them.”
So what is new here? Employee motivation is always on the hot list of any manager’s priority list. What is new, is the science behind instilling intrinsic motivation, and the unique opportunity we in healthcare have to capitalize on its core elements. Daniel H. Pink in his book “Drive. The Surprising Truth About What Motivates Us” relies heavily on the work of behavior researchers such as Edward L. Deci, Richard M. Ryan and others. Pink points out, “Human beings have an innate inner drive to be autonomous, self- determined and connected to one another. —when that drive is liberated, people achieve more and live richer lives.” Pink identifies three drivers of internal motivation, autonomy, mastery and purpose.
A connection to one another and a sense of purpose; science has identified these attributes as essential to establishing intrinsic motivation. So let’s start there. The demands imposed on health care over recent years to do more and more, with less and less, has beat down these essential elements of the internally driven health care worker. We “don’t have time” and other “must do’s” have taken the place of making meaningful connections with patients and families. A sense of purpose and human connection has taken a back seat to dotting all the “I’s” and crossing the “T’s”. The essential elements necessary for establishing and sustaining intrinsic motivation have been moved way down the list of day-to-day priorities. This dynamic can also be a contributing factor in the growth of a disengaged workforce and, in many cases, a general decline in employee and physician satisfaction, motivation, sense of mission and common purpose.
Unlike many business categories, health care offers the unique opportunity to truly make a difference in the lives of customers; our patients and their families. Ask a health care worker about the times in their life that they remember most and nine times out of ten a story about an experience with a patient or a patient’s family will be among their top experiences. They will describe in detail, years later, the special connection they made at a critical point in time. Health care workers have the unique opportunity to make similar connections every time they walk through the doors of their health care facility.
Human connection is a powerful thing. It not only fuels personal satisfaction, it brings us closer to personal fulfillment (remember Maslow, it’s at the top of his pyramid). It is instantly rewarding and self-motivating. We feel immediately good when we help others —even in small and seemingly insignificant ways. Positive connections fuel our desire for more and more connections. Not for the organization. Not for your boss or your bosses boss. But for yourself and the patient or family member you have made the connection with. THAT is the key. The health care environment provides an opportunity to make that connection around every corner, in every room in every hallway every minute of every day. Not just with patients but with family members as well.
The personal rewards of a compassionate exchange can be the catalyst not only for patient satisfaction and endorsement improvement but for improving employee engagement and organizational performance. The organization becomes the means for the health care worker to feed their own drive for personal fulfillment. When that happens, employees’ have an interest in ensuring success, because the organization has value beyond providing a paycheck.
The connections made between our patients and their families with our employees is the force that can drive sustainable improvement in employee engagement AND patient satisfaction. Think about it. If you have ever read the verbatim comments from a patient satisfaction survey, the comments about those connections (or lack of them) stand out. Remember that establishing a connection is not one-sided; for every action there is an equal and opposite reaction. The patient reaction side of the patient/employee connection manifests itself in patient satisfaction, loyalty and endorsement.
The April 2011 edition of HealthLeaders featured an article “When Average Isn’t Good Enough: Want to boost patient satisfaction? Start with employee engagement”. The article quotes Jim Hartner, chief scientist for workplace management and well-being at Gallup concerning a clear link between employee engagement and patient satisfaction. Mr. Hartner states; “As organizations improve their engagement levels, there is a positive linear relationship with growth in patient satisfaction and loyalty.” The article includes the experience of Adventist Hinsdale hospital who instituted a program in 2009. Since that time Adventist has seen Gallup engagement survey improvement from a ranking in the 40s to its current ranking in the 60th percentile. Adventist Hinsdale reports that as employee engagement scores rose, patient satisfaction highest rating scores rose by 9 percentage points from 54% to 63%. Ask for a reprint, it makes a compelling case for a focus on engagement.
Embarking on any initiative is an expensive proposition. Patient Satisfaction and endorsement improvement is no exception and there is a lot at stake. By first investing in an effort to improve engagement through intrinsic motivation we will establish a strong and sustainable foundation for our efforts. A foundation grounded not only in the goals of the organization but the will of employees. Patient satisfaction will improve because employees want it to, because they are rewarded by the patient connection and thrive on it. We can only manage that outcome to a point. However, we can establish the environment it needs to flourish.
It is time to re-ground ourselves, re-prioritize, return to our core values and empower employees to live the compassionate care statement found in the mission most health care institutions share. When employees experience fulfillment from personal connection and a sense of purpose, employee engagement and true and sustainable patient satisfaction improvement will be a natural by-product.
Pete Sitter is the Principal of Linchpin Marketing a brand development firm specializing in the healthcare, banking, insurance and non-profit categories. For healthcare organizations, Linchpin Marketing makes connections between patients and the healthcare brand, and employees with their organization. Linchpin Marketing’s INTERNALIZE program cultivates intrinsic motivation among employees through meaningful connections with patients and family members. The firms LINCHPINNING process is a patient engagement management program that evolves relationships between people and the organizations from awareness to advocacy and referral.