White Plains (NY) Hospital Center has embraced its “Exceptional Every Day” motto to create a culture aimed at constantly improving the patient experience. Staff who sometimes are considered “behind the scenes” support are encouraged to feel more like part of the care team.
Such a cultural change has to be nurtured by senior leadership until everyone sees that the effort is sincere and produces measurable results, says Leigh Anne McMahon, DNP, MHA, RN, NEA-BC, vice president and chief nursing officer.
“Slowly, we saw the staff start using ‘exceptional every day’ when they talked about their own work, their units, and then we began seeing patients using those words when they talked about their experience here,” she says.
“That’s when we realized the brand was real. We feel passionate about being exceptional every day, and as new employees come in we want them to feel privileged to work here because they’re going to be exceptional every day,” McMahon adds.
The culture change included a number of initiatives to improve quality at the hospital, and one focus was environmental services, which typically did not score as well on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey as White Plains expected, given their superior performance by other measures.
Inculcating the “exceptional every day” philosophy helped the housekeeping staff achieve some of the organization’s best HCAHPS results, McMahon notes.
Responding to the question “How often were your room and bathroom kept clean?” in 2015, 72.1% of surveyed patients said “always,” but that figure climbed to 79.4% in 2016 and now is at 85%.
That improvement came after the hospital addressed poor morale, caused partly by union disputes, by focusing on the valuable role environmental services plays in quality and the overall patient experience.
The hospital emphasized the education of housekeeping management and staff, including the development of interpersonal and communication skills, team accountability, and respect.
“They were working very hard every day but they weren’t feeling exceptional. The key problem was that they weren’t connected to the idea that they were taking care of patients,” McMahon explains.
“We began to address that and I told them that they were all patient safety officers first, [and] that if the OR wasn’t clean it didn’t matter how good the surgeon was. We saw them get more interactive with the staff, feeling more a part of the care team, speaking up when they saw something that needed attention.”
When HCAHPS improvement goals were added to the contract for an environmental services contactor, it participated in the effort by providing outside training resources for managers and staff, as well as sharing industry best practices.
Hospital leaders tracked the progress of the housekeeping staff and recognized their achievements with quarterly celebrations for all three shifts, which McMahon says helped them embrace the idea of patient-centered care and see their value as part of the care team.
More Patient Interaction
The housekeeping staff also received new red uniform tops that made them stand out from other staff, helping patients and co-workers recognize their contribution, McMahon says.
Housekeeping staff typically are assigned to units and work with the same rooms and clinicians every day, helping them feel a part of the team, she says. They are included in all unit recognition, awards, and celebrations.
“We helped them understand more what it was like to be a patient in the hospital, and as they began to feel more like part of the team caring for that person, they started interacting more in a positive way,” McMahon says.
“They started knocking on doors before entering, talking with the patient, feeling more like they were helping that person rather than performing an environmental function and nothing else,” she says.
“We started hearing from patients who named the staff members and complimented them on making their stay a better experience.”
The hospital’s patient and family advisory council also advised that patients are not always aware that their rooms and bathrooms were cleaned each day, so White Plains changed the note cards that housekeepers left in the room when the patient was not present during the cleaning.
The cards previously said “Sorry we missed you,” but that was sometimes interpreted as meaning housekeepers came by but did not clean the room. The new card says “It was a pleasure to serve you.”
Housekeeping staff also began writing personal notes on the card, sometimes just a name and smiley face but sometimes a note of encouragement for the patient, McMahon says.
That prompted patients to write thank you notes to the housekeeping staff — particularly when they knew the names of individuals — which sometimes included suggestions for how to improve a patient’s experience.
(More information on the housekeeping experience can be found in a journal article authored by White Plains CEO Susan Fox. An abstract is available online at: https://bit.ly/2J1dxTb.)
The department leader who led the effort with the housekeeping staff was promoted and is now transforming the food service staff in the same way, McMahon says, helping them better understand their role in the patient experience.
“We’ve seen the courtesy scores of our hosts and hostesses in food service go up into the 80th percentile,” she says. “We’re seeing another group that did not feel very engaged start to feel important and like a valuable part of the care team. Now if they’re worried because this is the second tray they’ve picked up for this patient and she hasn’t eaten, they understand that they should say something to the nurse, that their concerns matter and people want to hear from them.”
- Leigh Anne McMahon, DNP, MHA, RN, NEA-BC, Vice President and Chief Nursing Officer, White Plains (NY) Hospital Center. Phone: (914) 681-1075. Email: firstname.lastname@example.org.