Nurses and physicians aren’t the only ones impacting patient satisfaction scores. Direct care providers like nursing assistants, dietary service workers, environmental services, transporters, and other front line workers have a big impact on the patient experience. These often-overlooked work groups can make or break the patient experience. But, some senior leaders do recognize this and make sure their teams are aware of their impact on this very important healthcare mission.
In fact, when the HCAHPS program was implemented, most hospitals started re-thinking talent acquisition at the front line. They realized they needed staff who could focus on the patient and family. It was no longer sufficient to just be reliable and dependable. Staff needed to be service-oriented. The goal was not just to complete their tasks but to always meet the needs of patients.
Even if you hire better front line workers, there is no guarantee that the patient experience will improve.
Why? Mid-level managers and professional-level co-workers don’t always appreciate the important role these people play.
To put it bluntly, front line workers are often treated with disrespect, which strips them of meaningful psychological status and discourages employees who were once highly motivated. Often, despite the vision of senior leadership, managers merely want “good soldiers” who are rule-followers. They are encouraged to stay within their set tasks and not to engage patients unless they must. Managers consider a good service worker one who is present at the start of his/her shift, and completes predetermined tasks diligently, and follows direction. Senior leaders know what drives patient satisfaction at this level: contextual performance and organizational citizenship behaviors, but the disconnect that occurs when these behaviors are discouraged at the direct management level.
Ted Kinney, Ph.D, Director of Research and Development at Select International, has worked with some of the top health systems in the country. He notes, “This [disconnect] creates an important selection problem. How do you hire people? Do you hire them for how they are going to be managed (bring in low growth need strength individuals) or do you hire for the senior leaders’ aspirational state (bring in high growth need strength individuals)? If you decide to hire for the senior leader’s vision, it is critical that there are concurrent cultural interventions put in place so that high growth need strength associates will receive the cultural support that they need.”
Get to the root of engagement in these front-line workers.
We know that an individual’s direct supervisor is the most influential variable in whether someone is engaged in their job and whether they’ll stay. If they feel valued and feel that their supervisor appreciates their role in the patient’s experience, they will thrive – and stay. Accordingly, it’s not enough to hire better front line staff - it’s just as important to hire better managers and supervisors. Not surprisingly, this is a new focus of healthcare organizations – getting better at attracting, selecting, and retaining managers who not only complete administrative/management tasks but who can build and engage their teams – creating a culture where everyone has a role in improving the patient experience.Here are 4 ways the talent acquisition team can ensure everyone is working to increase patient satisfaction:
Make sure that leadership understands that improving healthcare hiring at a single level of the organization will have a limited impact.
Define the behavioral competencies of new managers/leaders to ensure recognition and empowerment of front-line workers.
Communicate these expectations to managers clearly and build them into your performance management systems.
Incorporate these competencies into the hiring process for managers and directors and use objective data to hire those who fit the vision to minimize hiring mistakes.
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