Get the 'quiet ones' to speak their mind

Heidi Dunbar, manager of admitting/emergency department coordinator at Seattle Children's Hospital, says that although it's often very hard to find time for them, monthly staff meetings are always worth the time they take. "About 90% of staff come to meetings, which means they are getting something out of them," she says. "We have a very open environment, and people always have interesting things to say that you would never imagine."

However, at times, the same people talked constantly while others remained silent. "You have bashful people and ones who never stop talking," says Dunbar. "Somebody may be a fabulous worker but will never complain. They are the ones who one day will just quit and you don't know why. And when that happens, you just want to ask them, 'Why didn't you ever say something?'"

To give everybody equal time, Dunbar came up with the idea of a "talking stick" with a carved face, which is passed around. When someone is holding the stick, they get to talk and no one can interrupt them.

Given the chance, someone may blurt out that something is driving them crazy. Many times, the problem has a very simple fix. "It is amazing what your tipping point can be. It may be a very small thing, such as not having enough pens," says Dunbar. "It's unbelievable how, at times, a simple, tiny thing can solve a problem."

Dunbar also makes a point of walking around the department to be sure she interacts, even if briefly, with every single staff person from time to time. "You need to go around to each employee because the squeaky wheel gets the oil," she says. "You need to hit every person at least every five or six weeks. Otherwise you just get the vocal ones coming at you all the time."

One complaint that Dunbar learned about using this method involved chairs. Staff were sitting in high director's chairs with a slippery surface. They had to position their feet so they didn't slide off the seat, which was uncomfortable. So Dunbar went around the hospital searching for more comfortable chairs and finally found some in the clinical registration area with a different fabric. Since staff in that department went home at 5 p.m., Dunbar would carry the chairs to the ED registration staff so they could sit in them for the night. Since staff really liked these particular chairs, Dunbar ordered enough for everyone. "After several staff tried the borrowed chair, they loved it," she says. "Also, the complaints about the chairs and about an uncomfortable work space stopped."