By Allan Acton, Consultant (HCAHPS & Other Surveys), HealthStream
I had a powerful experience at a community hospital recently. I was reviewing results from a physician survey, and the ranking of the “would recommend this hospital to family and friends” question was very low – 17th percentile. The audience was a group of managers and department heads, but not physicians.
By way of background, this hospital has about 125 beds, and is in an economically depressed community. Further, their main competitors are two larger community hospitals and a teaching facility. It has no signature, differentiating programs and copes with an older physical plant. The administrative team has been in place about 5 years and has made many operational and nursing improvements. Even so, the medical staff, which is older and long-tenured, would not particularly recommend the hospital.
I started to dismiss this question as a geographic result; if physicians, their families, and friends don’t live in this community, how could they be expected to recommend this hospital? However, I asked the group what was behind this, and a lively discussion followed. Turns out, the employee survey results are also low on this topic, and many of them do live in the community. And, their HCAHPS scores are good concerning patient experience, but the overall rating and likelihood to recommend are much lower. So what gives, I asked.
The consensus opinion is that the hospital has failed to reposition itself as staff and services have improved. They have spent millions on upgrading systems and staff skill levels. But they have not effectively communicated that to the community, employees and physicians. (The medical staff has its own issues – reluctance to change, the absence of a hospitalist program, and other factors.) But the managers are very engaged. They feel the hospital is better than its competitors on most issues, but the facility is seen in the community as it was 5 or 10 years ago. (Indeed, the data bear this out: the hospital is seen by its physicians as equivalent to or better than the others, except on the question “Image in the community.” On image, it trailed all three competitors.) The discussion got to the point where the managers felt they needed to own the image or brand of the facility. “We are better than they know” was one comment. Another said, “We are in this together with the doctors and the patients. Our jobs depend on it.”
There are few forces more powerful in managing the image of a hospital than the commitment and engagement of its employees. Their communication, through both word and deed, that the hospital is a safe, high quality institution, where they are proud to be part of the care team, is essential to the organization’s success. The bully pulpit of engaged employees is a wonder to behold. This discussion was a classic example of a separation between job engagement and organizational engagement. The lack of organizational engagement clearly damages the perception of the hospital, as employees and physicians are not promoters and supporters of it. If the employees and the doctors don’t respect the hospital, they show it in a thousand ways, and who could blame patients for picking up on their attitudes?
At the end, this management team was enthusiastic about the need for their teams to be a force for promoting the hospital in the community, with patients and through other channels. The action they take to develop this newly realized opportunity will determine the success of their hospital. The senior management team needs to embrace the power of internal marketing and to leverage the strength of the middle managers to reposition the perception of the hospital with all stakeholders.
Key Message: You must value and respect yourself before you can expect others to.
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