As I continue to visit healthcare organizations and engage with leaders globally there are clear emerging trends at the heart of effective efforts to address the patient and family experience. In my recent series of blogs I suggest we must recognize the implications of patient perceptions as a focus of our patient experience efforts. I support this by reinforcing that culture is a critical choice for organizations to consider in terms of how they look to shape those perceptions. In fact we cannot overlook the centrality of culture to the very definition of patient experience overall. I add that it is on a strong cultural foundation that we can then ensure a sense of engagement for our staff and patients.
The missing piece in this important dialogue is that of building a foundation of accountability in our healthcare organizations. It has been identified as a top issue for healthcare leaders during my On the Road visits and at our Regional Roundtable gatherings. In looking at all the suggested paths and plans to accountability some general themes emerge.
Building a basis for accountability in organizations requires a number of committed actions. Without these organizations run the risk of falling short on their defined patient experience objectives. They include:
1. Establish focused standards/expectations – Determine and clearly define what you expect in behaviors and actions as you create a culture of accountability.
2. Set clear consequences for inaction and rewards and recognition for action – Be willing to reinforce expectations consistently and use as opportunities for learning.
3. Provide learning opportunities to understand and see expectations in action – Ensure staff at all levels are clear on expected behaviors and consequences.
4. Communicate expectations, reinforcing what and why consistently and continuously – Keep expectations top of mind and be clear that these are part of who you are as an organization in every encounter.
5. Observe and evaluate staff at all levels providing feedback and/or coaching as needed – Turn actual encounters, good or bad, into learning moments and opportunities to ensure people are clear on expected behaviors and actions.
6. Execute on consequences immediately and thoughtfully – Respond rapidly when people miss the mark (or when people excel) to ensure people are aware of the importance of your expectations.
7. Revisit expectations often to ensure they meet the needs and objectives of the organization – Remember standard and expectations are dynamic and change with your organization’s needs. They must stay in tune with who you are as an organization (your values) and where you intend to go (your vision).
Accountability has been tossed around more and more in conversations today in healthcare organizations as something that leaders want to see more of. The reality is that accountability is not just something you simply expect and it just miraculously appears, it is something you must intentionally create expectations for and reinforce. As with patient experience itself, accountability needs a plan in order to ensure effective execution.
I often speak of patient experience efforts as a choice; one that requires rigorous work. This is overcoming something I call the performance paradox, which helps us recognize that many things we see as simple, clear and understandable are not always easy, trouble-free and painless to do. Yet I would suggest we have no other choice. As a positive patient experience is something we owe to our patients and their families in our healthcare settings, creating and sustaining a culture of accountability is something we actually owe to our staff in supporting their ability to create unparalleled experience.
Jason A. Wolf, Ph.D.
The Beryl Institute