Customer Care News - Spring 2012 by Customer Care News

CustomerCare News The Promenade at Coconut Creek

by XXX xxxxx

Spring 2012

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Talent Management

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Simulation Game Helps Close the Gap Between Internal Customers And External Customers page 18

A Celebration Media Publication

Publisher’s Letter

ustomer Care News began researching and publishing in the spring of 2010

with the mission to probe deep into issues and trends in the customer ser-

vice/customer care industry. Our initial concentration was on people skills,

with our associate publisher Keith Levick, Ph.D., having 30 years of experience in this

area. We began to develop a working relationship with the Society of Consumer Affairs Professionals in Business (SOCAP International), which represents a thriving global pro-

fession of best-in-class customer care experts across all industries (for more information go

to www.socap.org). We quickly learned that the role of customer care has transitioned. In today’s ever-evolving world, items such as social media and technology are playing a big role in the changing face of customer service.

We have also seen that the customer care executive has established a chair at the C-Level within many companies, proving

that the work of providing customer care has become a value center and not a traditional cost center. We are going to establish

new departments within our publication and on our website to highlight these emerging changes and help uncover key stories related to industry leaders and their work.

In this edition we are also touching on an area of customer service not often thought about, but experienced by all of us at

some point in time — patient care. Whether we’ve endured a long-term hospital stay or simply a routine physical at the doctor’s

office, we have all been a “patient” at some point. And when it comes to our health, no level of service but excellent will do. As part of our dedication to helping businesses improve customer care, and ultimately customer satisfaction, we want to bring special attention to the area of patient care and satisfaction. To that end we have several articles in a special Patient Care section.

Additionally, we have recently teamed up with CCN Learning Resources to begin providing products and services for the

customer care industry. CCN Learning Resources is dedicated to improving customer care through education and best hiring practices and is positioned to help companies improve their customer satisfaction ratings by learning how to connect at a much healthier level with customers, staff and management through its offering of nearly 40 courses on topics such as Leading During Times of Change, Dealing with Difficult Customers, and Communication Skills for Leaders.

Through our partnership with CCN Learning Resources we are working to uncover the best products and services in the

industry. One product we first reviewed was Logi-Serve™, an industry assessment tool that changes everything you knew about

predicting customer-friendly applicants and employees. If you have products or services that help the industry, please send me a note and we will review them and report back to our readership.

Finally, we are very interested in growing our circulation. We will earn that by providing solutions and vital information

that customer care executives are most interested in. We invite you to sign up for our next issues by going to www.customercarenews.com/subscribe.

Dale Jaslove Publisher

djaslove@customercarenews.com

Spring 2012

www.customercarenews.com

CustomerCare Table of Contents Social Media News Spring 2012 Publisher Dale Jaslove

djaslove@customercarenews.com

Associate Publisher Keith Levick, Ph.D.

klevick@customercarenews.com

Editor-in-Chief Jamie Rawcliffe

jrawcliffe@customercarenews.com

Production Manager Chris Schramm

cschramm@customercarenews.com

Editorial & Materials Coordinator Anne Seebaldt aseebaldt@customercarenews.com

Editors/Writers Mella Barnes

mbarnes@customercarenews.com

Amy Pagett

apagett@customercarenews.com

Operations Manager Jennifer Barth

jbarth@customercarenews.com

Account Manager Fran Cohen

fcohen@customercarenews.com

Website Design Melissa Sherwood Contributing Writers Louise Anderson, CPIM; Aaron Bontrager, MBA, MHA; Christopher J.L. Cunningham, Ph.D.; Richard S. Levick, Esq.; Sanjay Saint, MD, MPH; Jason Wolcott Website Consultant www.sherwoodandblack.com Customer Care News 32000 Northwestern Hwy., Suite 128 Farmington Hills, MI 48334

Spring 2012

www.customercarenews.com Customer Care News is designed to provide accurate and authoritative information in regard to the subject matter covered. The publishers have taken all reasonable steps to verify the accuracy and completeness of information contained in Customer Care News. The publishers may not, however, be held responsible for any inaccuracies or omission of information in any article appearing in the Customer Care News. Entire contents copyright 2012 by Customer Care News. All rights reserved. Reproduction or use of editorial content in any manner without written permission is strictly prohibited.

09 Social Media and a New Era of Consumer Empowerment

Consumers are finding social media outlets effective in spreading the word about companies’ products and services

12 The Changing Face of Customer Service

With ever-evolving technology and the rise of social media, companies need to make critical changes

Technology 15 Energize Employees with Virtual Storytelling

Businesses can benefit from electronic

storytelling, both internally and externally

16 Logi-Serve™ Receives the 2012

Publisher’s Choice Product of the Year Award Web-based screening and development

assessment and talent management platform garners Logi-Serve, LLC. CCN’s 2012 Publisher’s Choice Product of the Year Award

People Skills 18 Simulation Game Helps Close the Gap Between Internal Customers And External Customers Associate Publisher Dr. Keith Levick sits

down with Bill Albert, president of Business Methodologies International, Ltd. (BMI), to explore the company’s simulated board

game that walks employees through running the business

Assessment 23 The Case for Competency-based Talent Management

Focusing on workers’ competencies can be a

beneficial approach for service organizations in assessing and managing their employees

Patient Care 27 Enhancing Patient Safety By

Preventing Catheter-associated Urinary Tract Infection

A research team from the University of

Michigan and Ann Arbor VA Medical

Center has been working on preventing a

common hospital-acquired infection and has found educating healthcare workers as well as patients is key

30 The Impact of Employee

Satisfaction on Patient Safety and Satisfaction Within the Hospital Setting A Michigan hospital’s surgical services

department has created a team to focus

on increasing employee engagement and

satisfaction as a way to also increase patient satisfaction

32 The Relationship between

Employee Satisfaction and Hospital Patient Experiences

The FORUM: Business Results Through People examines the connection between

employee satisfaction and patient care and

satisfaction based on research conducted at a major New York City hospital

Customer Care News

Associate Publisher’s Letter

hat comes to mind when thinking about customer service? Most people consider the importance of servicing and caring for the people they do business with — the people

who eat at their restaurant, purchase their products and/or the patient they treat. These

are the external customers. There is, however, another set of customers that often goes unnoticed — the internal customer. These are the people who work within the organization.

Companies spend hundreds of thousands of dollars and resources to attract new customers and retain

their current customer base. All the while, their most important customers, the employees who work along-

side one another, are seen as subordinates who are required to service the external customer properly. This

critical oversight or misunderstanding could have a devastating effect on the bottom line.

In today’s culture of service excellence, organizations can maintain a competitive edge by concentrating their efforts on servic-

ing their internal customers. This is not to suggest that companies should abandon their external customer initiatives. Rather, to be competitive, it is imperative that companies meet the needs of both the internal and external customers. If not, the ripple effect could lead to severe unintentional consequences.

Providing superior service begins with understanding the interplay between the internal customer and the external customer. It

is difficult to argue that the attitude, behavior and emotional intelligence of an employee have a direct effect on the external customer. Science has not only confirmed this correlation but has taken it to a new level. Neuroscience shows that one’s internal emotions are transmitted to other people. In other words, feelings are contagious. Think about the importance of these findings as related to customer service. When employees are micro-managed, treated as “subordinates,” told what to do, fight among themselves, etc., they are then required to greet the external customer with a smile.

One does not need to be a psychologist to understand the implications. If

In today’s culture of service excellence, organizations can maintain a competitive edge by concentrating their efforts on servicing their internal customers.

the internal customers’ needs go unmet, they will negatively impact the external

customer. The research is clear — in order to improve external service, a concerted effort is required to improve the quality of service for the company’s internal customers.

A critical question to ask yourself is this: If you serviced the external customer like your internal customers treat each other,

would you be in business today? As you mull around the answer to the question, enjoy this edition of Customer Care News.

Dr. Keith Levick

Associate Publisher

Spring 2012

klevick@customercarenews.com

Customer Care News

CCN Learning Resources, Enhanced Solutions in Customer Service Dedicated to Improving Customer Care Through Education and Best Hiring Practices

CCN Learning Resources has its roots in traditional corporate training, but what sets us apart is our continued connection to the business community through our publishing partner, Customer Care News magazine. At CCN Learning, we provide world-class education and training for companies in the area of customer care. Our Director, Dr. Keith Levick, brings to the table more than 30 years of experience in the coaching and training field. Currently, CCN Learning offers nearly 40 courses to help companies of all sizes improve their customer care, and subsequently their customer satisfaction scores. Courses are geared toward managers and supervisors as well as staff members. Below is a sampling of the courses that are offered: • Managing Multiple Generations

• Wowing the Customer

• Problem Solving & Decision Making

• Team Communication

• Managers to Leaders

• Dealing with Difficult Customers

• Leading During Times of Change

• Create a Motivation Environment

• Communication Skills for Leaders

• Healthcare Customer (Patient) Focus

For more information or a complete list of courses offered, call 888-438-9528 or go online to www.ccnlearningresources.com.

Social Media

Social Media and a New Era of Consumer Empowerment

ince the days of Adam Smith, we have operated

But since then, the digital revolution has brought about

under the assumption that capitalism and democ-

dramatic changes — and signs abound that a true democrati-

that empowers consumers to vote with their dollars is one

of social media, consumers of goods, services, and ideas have

racy always walk hand-in-hand. After all, a system

that ensures their needs are met. A free market inexorably ties

sellers’ interests to those of their buyers. When customers can

simply take their business across the street, companies either exceed value expectations or cede market share to someone who can.

Until recently, however, capitalism’s reality was more

autocratic. Consider the lone consumer who had a sub-par

buying experience. Ten years ago, there was no way to communicate the resulting dissatisfaction in a manner that would

zation of the free market system is underway. With the advent

been provided a force multiplier that has tilted the balance of

power in their favor. In the Information Age, ordinary consumers are visible, organized, and able to virally affect buying decisions with expansive reach and fiber-optic speed. That

results in marketplace influences that are increasingly of the

people, by the people, and for the people. Simply put, consumers have taken control of the narrative — and they are using it to exercise power as never before.

In just the past six months, we have seen consumers force

truly impact the purveyor of poor service. There was the

embarrassing reversals of Netflix’s decision to split its stream-

of which provided a venue large enough to build real strength

to attach a five dollar monthly fee to debit card usage; and

backyard fence, a dinner party, or the kids’ soccer games; none

democratic is that?

www.customercarenews.com

Spring 2012

in numbers. That meant the little guy had no real voice. How

ing and DVD-by-mail services; Bank of America’s decision Verizon’s decision to charge a two dollar fee for paying a bill

via phone or Internet. We have seen them force Apple® and

Victoria’s Secret to review supply chain policies after reports

online conversations that are impacting perceptions about

band together to affect changes in public policy on business

that match the visibility advantage they enjoy in traditional

of poor working conditions overseas. We have even seen them issues ranging from food safety to the environment.

In each of these cases, the reforms and reputational dam-

their products and services — and they need to do so in ways marketing venues.

Look at Southwest Airlines, whose blog actually encour-

age consumers wrought were the direct result of coordinated

ages customers to air issues or problems, thus containing them

leveraged blogs, Facebook, Twitter, YouTube, and countless

recognized and addressed. Look at Marriott, which trolls the

online efforts that swelled the ranks of the dissatisfied. They

other social media platforms to spread the word and inspire

action aimed at changing corporate behavior. At the same time, they took steps to ensure that their messages could be found amid all the clutter in the online space. With the

optimized content that search engines crave, they dominated

the portals by which more Americans access information than any other.

Consumers didn’t — and still don’t — possess the tra-

ditional marketing muscle that Corporate America employs

so adeptly. But there was no significant investment in print,

radio, or TV advertising because one simply wasn’t needed.

in a semi-controlled environment where they can be quickly

Twitter landscape for reports of customer service issues so that they can be rectified before they go viral (and often before

the tweeter even checks out of the hotel). Look at CocaCola, whose Facebook page boasts 38.3 million fans who act as brand ambassadors that can help quell criticism from

within consumers’ own ranks. Look at the countless companies that now rightly view Google as today’s Yellow Pages and

devise Search Engine Optimization (SEO) and Marketing

(SEM) campaigns that help them win the online race to be found.

All of the above not only represent industry standards in

Consumers recognize that the digital space represents the

Digital Age customer engagement; they represent strategies

power of social media, they told the story while the companies

panies and industries — regardless of size, budgets, or audi-

high ground in the battle for hearts and minds. Through the they targeted followed it. From such defensive public posi-

tions, it was all but useless for the companies to do anything but bow to consumers’ demands.

All of this supports the conclusion that companies need

to think differently about customer engagement strategies moving forward. They need to engage the all-important

that can be scaled and employed across a full range of comence demographics. More important, they provide concrete evidence that consumers need not exclusively dominate the

digital space if companies recognize that they too can take part in — and wield some measure of control over — the conversation as partners with their customers.

Social media has democratized the free market system in

ways that even Adam Smith could never have imagined. The

digital era is one where consumers can influence, organize, and act in their own self-interest with greater skill and efficiency

than ever before. The sooner that companies adapt to the new, level playing field, the greater the chances that they will thrive under the capitalist paradigm. CCN

Richard S. Levick, Esq., president and CEO of Levick Strategic

Communications, represents countries and companies in the highest-stakes global communications matters — from the Wall

Street crisis and the Gulf oil spill to Guantanamo Bay and the Catholic Church. Levick was honored for the past three years on NACD Directorship’s prestigious list of “The 100 Most Influential People in the Boardroom” and has been named to

multiple professional Halls of Fame for lifetime achievement. He

is the co-author of three books including The Communicators:

Spring 2012

Leadership in the Age of Crisis and is a regular commentator on television, in print, and on the most widely read business Richard S. Levick, Esq.

blogs. Follow Richard Levick on Twitter @richardlevick.

Customer Care News

The Changing Face of Customer Service With ever-evolving technology and the rise of social media, companies need to make critical changes

t was 10 years ago that I sat in a hotel room with

Taking a more in-depth look at this era of change, it is

my laptop plugged into the phone cord, fighting

inherently obvious how much the technology we are using in

to make sense of an assignment in an ever-evolving industry

advancements have affected how a customer care center has

with my first version of a PDA (a PalmPilot), trying

our lives has changed. What can go unnoticed is how these

— customer service. Just as foreign as the acrid air and con-

adapted to serve customers. Not only are companies look-

stant motor noise of India were the changing ideas of what

ing for different ways to interact with customers, but they

it meant to be a customer service expert. While the times

are also looking for valuable interactions and meaningful

have changed and business has become more efficient and

connections.

optimized, a decade later we all have a different perspective of

While this was just one of many trips to India, China

what it means to be a service leader but remain aware of how

or the Philippines, we found our mission was of a singular

important an interaction with a customer can be.

purpose: how many seats can you move “offshore?” Directed by companies looking to make spending cuts (sometimes up

to 40 percent), we were looking for anything that could move, and we all had the same objective. At the time it was considered a brilliant initiative to free up capital for other business

practices. While there are good reasons to leverage lower-cost

labor markets and we can debate the labor arbitrage pros/cons, one undeniable fact is that there was a fundamental lack of

vision in regard to customer facing interactions; in the pursuit

of outsourcing customer service efforts for cost-effectiveness, we minimized the value provided.

A few years later, with a well-worn luggage set and a

filled passport, it finally starts to click. Why are we answer-

ing customers’ calls just to make them more irritated? Taking

into account the absurdity of the notion, would it be better not to answer at all? Without the resources for an academic study, I’m only left to assume that my instincts have some

legitimacy and that something else is taking place during this

Spring 2012

Photos courtesy of JASON WOLCOTT

shift of resources. What’s more, customers “are” starting to

figure things out on their own. We continue to listen to calls and hear something eerily similar; in one manifestation or

another, the phrase “I already found this information online” is multiplying. As such, I now believe that as a direct response

to the shift of valuable customer service, we as consumers have begun to solve our own problems online.

As a business community, at some point in the past decade

we finally reached the proverbial tipping point. We as compa-

Customer Care News

nies and service leaders went too far. By minimizing the value of the interaction so low, consumers have resorted to handling

the problem on their own. Chief Financial Officers (CFOs) loved it; Chief Marketing Officers (CMOs) feared it.

In 2007, I left the corporate world on a mission to rede-

velop the way people think about not only customer service

but also online engagement. At this time the business com-

munity wasn’t using social media as everyday jargon, but the

presence of customers online wasn’t ignored. In response, millions are spent by companies placing “ads” in the right places of the web, and websites are redesigned and optimized around the clock.

During this timeline, though, the question still lingered

on how this channel can be utilized for superior customer service? Things have changed so much since the offshoring days; are there other service leaders who will see this untapped opportunity? Can we make a business of it?

The evolution of our company began to take shape in an

effort to answer these very questions. We began scraping the

web for customer comments, and analyzing them. The results confirmed my suspicions while at the same time showing the

Photos courtesy of JASON WOLCOTT

Internet had evolved beyond our expectations. Just as custom-

ers were helping fellow customers to circumvent tricky service, companies were getting cut out. Banner ads were ignored

while consumers looked for the community expert. It was an amazing experience to watch the customer service industry change in real time. The reality was clear: the opportunity of

this channel is to interact with customers where they want

and how they want. And the superior mantra is still the same: make sure you can add value to the conversation.

Now it’s 2012 and our company helps Fortune 500

Wolcott, third from left, pictured with other Service Execs in India at the Taj Mahal

companies proactively assist customers online. That’s right;

to “survive” in an incredibly active customer care world. The

and are asking how they can help. The outright proliferation

pany due to the sheer necessity for market survival.

companies are proactively looking for customers with issues of social media into our everyday lives has helped add fuel to

customer experience is finally being valued within every comWe as customer care experts must continue to adapt

the fire, and the new era of customer support is well underway.

to this level of change. Now is the time to have a seat at

experience means to their products and services, but it is clear

Presidents of Customer Experience than any other role. To

Companies are still scrambling to figure out what customer that the genie cannot be put back into the bottle. The cus-

tomer now has control, and companies must figure out if they can add value to stay part of the conversation.

In stark contrast to the situation 10 years ago, I now wear

the boardroom table. More companies are appointing Vice not have proactive online engagement as an agenda point in

each meeting would be a failure to learn from a decade’s worth of education provided to us by consumers themselves. CCN

sneakers and tee-shirts to the office in a rebuilding Detroit.

Jason Wolcott is the co-founder and CEO of 3CSI where he leads

to how a similar customer service provider structure might

to clients. 3CSI’s goal is to help companies provide greater value

I am “much” older than any of my employees as compared

company but instead a reflection of the adaptation necessary

www.customercarenews.com

Spring 2012

have been just 10 to 20 years ago. This is not unique to our

delivery of strategic customer relationship management solutions to their customers by fully leveraging new technologies and media channels. Wolcott can be reached at jwolcott@3csi.com.

The Promenade at Coconut Creek by XXX xxxxx

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porttitor imperdiet. Pellentesque sed neque lacus.

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risus. Aliquam et tortor sed est mollis dictum quis ac lacus.

augue et ante laoreet commodo. Nam nec sapien turpis. Cum

in sagittis felis tellus in purus. Suspendisse non tortor sapien.

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sociis natoque penatibus et magnis dis parturient montes, dunt dictum, urna nisi egestas sapien, nec laoreet magna orci at ligula. CCN

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Technology

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Spring 2012

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Customer Care News

Energize Employees with Virtual Storytelling

veryone likes a good story. Thanks to the tre-

mendous growth in digital communications, tools like e-mail, Facebook, YouTube and others

make it possible to spread stories across the globe at the speed

of byte and the convenience of a mouse click. The multi-

faceted opportunity that this growing phenomenon presents for business is often underestimated. While many organiza-

tions have realized the rich potential of using electronic tools to market their goods and services to customers, many of these

same organizations have yet to appreciate the potential benefits of electronic storytelling for energizing their workforce.

Storytelling in a work setting is a powerful way to spotlight

innovation and acknowledge activities that are done right. It can recognize the quiet, unsung heroes of an organization and

be the catalytic spark that inspires others to do likewise. It puts a human face on everyday successes. If you acknowledge

employees for doing the right things right, you connect their

Louise Anderson, CPIM

is to play up those stories that best illustrate support for your

Louise Anderson, CPIM, is president of Anderson Performance

You can stimulate improvements with digital storytelling

a member of the Performance Improvement Council (PIC),

individual contributions to your business strategy. The trick priorities and values.

and even magnify the call to action with the use of recognition

and incentives, all within the digital communications network of your organization. But, the most important element is the

storytelling itself. In our digital age, best practices and suc-

while they are still news. The key to successful storytelling is to do it often and applaud as many people as possible. CCN

www.customercarenews.com

a professional organization of performance marketing executives that is a strategic industry group of the Incentive

Marketing Association (IMA). The PIC is collectively focused

on helping companies optimize their investment in human capital through proven and innovative reward and recognition

Spring 2012

cesses can be captured quickly, shared online and discussed â&#x20AC;&#x201D;

Improvement Company in Hastings, Minn. Anderson is also

solutions. Anderson can be reached at 651-438-9825 or landerson@andersonperformance.com.

Logi-Serve™ Receives the 2012 Publisher’s Choice Product of the Year Award

n keeping with its mission to shed light on high

service ability and predicting performance outcomes. Logi-

customer care, Customer Care News has established the

by the 2011 National HR Technology Conference leadership.

achievers in the area of customer satisfaction and

Publisher’s Choice Product of the Year Award to recognize and

acknowledge the most outstanding customer service products on the market.

Logi-Serve

™

(LS) (www.logi-serve.com), a web-based

Serve™ “a game changing and breakthrough technology” and

“the most scientific and innovative system he has ever seen. We were dazzled by Logi-Serve’s Visual Logic™ storyboarding

system, which brings candidates into a very easy to use simu-

Year Award for its best-in-class and award-winning assessment

service situations. We were also very impressed by Logi-Serve’s

screening and development technology. Logi-Serve, LLC. received this coveted award for its pioneering Logi-Serve

™

Service Excellence (Logi-Serve) screening and development tool. Logi-Serve™ was built from the ground up to provide a more precise way to predict and develop service and sales excel-

lence and was selected for its scientifically validated and proven approach to improving

the

quality of hires and assisting in managing and developing employees

specifically around service excellence as well as customer and

lated role-playing experience to mirror common but difficult patent pending Triangulation™ science methodology to evaluate

service aptitude. As applied to assessment science, triangula-

tion is a powerful technique that validates data through crossverification of information from multiple sources. We hope

organizations of all sizes will use Logi-Serve™ to improve their

new hire selection and development and address market needs to significantly improve workforce performance and execution

around increasing customer loyalty as well as customer and patient satisfaction. Logi-Serve™ is a remarkable breakthrough product unmatched in the marketplace. We are pleased to pro-

vide our readership with Logi-Serve™ as our choice for 2012

Product of the Year.”

“We are so proud to be selected by Dr. Keith Levick, an

patient satisfaction. The Logi-Serve™ reporting engine provides

experienced and respected leader in service training and the

sions, and then more easily mentor and develop employees.

and CEO of Logi-Serve, LLC. “Keith and his staff of experts

reports that enable companies to make better selection deci-

Additionally, it offers a deep analytics engine that ties results to better business outcomes, including dollar estimates on expected added service value by people recommended by the system. Logi-Serve

Spring 2012

CCN Associate Publisher Dr. Keith Levick called Logi-

screening and development assessment and talent management

platform, has won the 2012 Publisher’s Choice Product of the

™

offers two innovative patent pending sys-

talent management discipline,” said Eric Krohner, President

at Customer Care News have a remarkable commitment and dedication to helping the business community reach their optimal potential.” CCN

tems including a Visual Logic™ storyboarding platform and a

For more information view the Logi-Serve website at

panies to assess people more quickly and precisely, pinpointing

sales@logi-serve.com.

Triangulation™ science testing methodology that allows com-

Serve™ was also ranked a Top 10 “Awesome New Technology”

www.logi-serve.com or call 1-800-698-0403 or e-mail

Customer Care News

People Skills

Photos courtesy of BILL ALBERT

Simulation Game Helps Close the Gap Between Internal Customers And External Customers

ustomer Care News is dedicated to helping businesses improve customer care, customer satisfaction and employee collaboration. To that end, Dr. Keith

Levick recently sat down with Bill Albert, president of Business Methodologies International, Ltd. (BMI), a company that helps

organizations generate profitable thinking through employee

engagement activities. Through these activities, the companyâ&#x20AC;&#x2122;s inner workings are explored and connections among internal Spring 2012

customers and external customers are highlighted, leading to a

greater understanding that ultimately affects the bottom line. 18

Customer Care News

CCN: Can you explain the employee engagement activities that you use in working with companies?

BA: We work directly with the decision makers within an

organization to clarify with them how their company or how

BA: Everything from manufacturing, service organizations, healthcare organizations, distribution companies, and retail-

type organizations — we have business simulations in all those areas.

their industry makes money. We then work with the finance

CCN: It appears to be a simulated board game that you take

they make money, and where the hiccups in the system would

better understand how the business runs, where the money

folks within said business to take a look specifically at how

be that would keep them from generating as much profit or as

much revenue as they believe or think their company ought

to achieve. And we put that in a board-based model. So we

the participants from beginning to end. And by the end they

goes, how the money is spent, running the department, financially, etc.?

actually then replicate the cash-f low process with all of the

BA: Yes, absolutely. And the bottom line is we’ve all been in

turn it into a financial gain.

tell us what it is that we ought to be doing. Most of us, at least

decision making touch points within the organization and we

CCN: So it’s a simulated board game? BA: Yes, it’s a simulated board game. What ends up happen-

ing is we gather the workers, the employees, the first-line

and second-line managers — all levels within an organi-

zation — and we bring them in for a set period of time and allow them to be the owners of the business. Literally

we allow the workforce to become the decision-making force in this simulated world. Same responsibilities of how to

spend money, where the cash is going, what type of investments they’re going to make, what they’re doing as far as

their employee base is concerned, product development, supply chain; all of these things are incorporated into this exercise.

CCN: Typically what kind of people within the organization would attend this course? How would you define it, like a workshop?

BA: I guess you would consider it to be a workshop; I use

that term semi-loosely. Our programs last anywhere from four hours to two days depending on the sophistication level

of the audience. Our participants have ranged from folks that are blue collar contributors, who have little business acumen,

to folks that are C-Levels of the organization. It just simply depends on the model. So depending on what the financial

need is or what they’re trying to teach the workforce, and

who within their workforce they’re trying to teach, we have a financial business simulation that is appropriate for that

CCN: Do you cover all industries?

www.customercarenews.com

adult

learners,

learn by actually

diving in, getting our hands dirty and actually

working with or

within the system that we ultimately need to be

working in. We learn by doing. The

business

simulation process is exactly the

same as the work process.

The

types of workshops that we run

are not lecturebased workshops. They’re actually hands-on;

the

Bill Albert

employees going

through the program actually make the decisions on how their simulated company is going to run. And in some cases those simulations are competitive; in some cases those

simulations are just for education purposes. But the responsibility for learning is actually on the participants, not the facilitator.

CCN: Employees are obviously involved and active in this

Spring 2012

audience.

this situation. Most of us don’t learn by listening to someone

process as opposed to sitting and listening to a talking head.

BA: Absolutely. As I said earlier, we learn by doing. And this

simulation allows people to be fully engaged in running a business. And they have fun doing it! Unfortunately, in many

people that are trying to work harder or be busy for fear that they’re going to lose their jobs.

organizations people are bogged down with their daily tasks

But I think one of the things that gets overlooked by most

do impacts the bottom line.

nization; or, additionally, how their value drives employee

and focus on the moment not understanding how what they

CCN: What I’m hearing you say is that in the working environment today, with globalization, greater competition, and

certainly coming off a pretty severe recession in the past few

years, workers are so busy working that they’re almost myopic in how they see things. And/or many organizations are still in silos not knowing what other departments do or don’t do.

BA: I think that’s absolutely correct. Basically there’s a huge

workers is they don’t understand their true value to the orgasatisfaction and ultimately affects the external customer satisfaction. [Through this simulation] workers begin to better

understand the internal process, which increases their overall

knowledge of the organization. They begin to appreciate

other departments and workers and develop a satisfied feeling. Unfortunately, too many workers don’t have this type of appreciation, which negatively affects the organization.

CCN: Certainly every organization understands the impor-

learning gap in the United States. I think in the vast major-

tance of customer service. Many companies place a great deal

foremost, “what am I doing” and its relationship to all the

walks in your front door. However, it appears you’re talking

ity of organizations there’s a learning gap between, first and other people within an organization. So we do have a certain

myopic approach going back to your comment about glo-

about the importance of the internal customer. Oftentimes people do not perceive workers as one another’s customer.

They’re just people we work with. However, what I hear you

Spring 2012

Photos courtesy of BILL ALBERT

balization, coming out of recession, etc. We have too many

of emphasis on the external customer — the customer who

Customer Care News

saying is that if employees would see one another as internal

Remember, sales people get their commissions on what they

increase. Would you say that one of the objectives in your

sionals have to run the supply chain process and make the

customers, the level of employee satisfaction would greatly simulated board game is to enhance the internal customer service of the organization?

BA: It almost has to. Let me try to explain a couple key ways in which that takes place. First, it’s human nature that when

a person doesn’t understand something that they admit to

it. Most workers do not understand financial metrics, performance indicators, income statements and balance sheets, the responsibility of how cash moves through a system, and

what efficiency impacts cash f low. They don’t seem to be aware [that] when they are working more effectively, they’re

more efficient at what they do and actually save the company money. They just don’t connect those dots.

The second thing is managers post metrics on a wall and expect workers to tritely understand them. But when you

talk to the folks privately, they really don’t understand the impact of the metrics, and, what’s worse I think, is they don’t

really understand how they impact the metrics. I’m not sure an organization can maximize success if they don’t have a

workforce that understands the things that drive financial success both internally and externally.

CCN: With all these factors combined, many workers do not have a clue. And not having that awareness or understanding

could lead to, “You know what? We work our behinds off day

sell. So when you put them in a situation where sales profesdecisions around how much they’re going to buy in order to drive profitability they begin to get it. The simulated process is an amazing learning experience.

CCN: The simulation appears to be a holistic approach to understanding an organization.

BA: And that’s what this is. All areas of an organization will benefit from this simulation.

CCN: I can see a need for this in health care, especially as it relates to risk management and some other areas.

BA: Absolutely. We have done some interesting work for children’s hospitals. For hospitals, patient satisfaction, keeping safety and mortality rates down, etc. is critically important. And if the process is not running smoothly, the surgery is backed up, the OR staff is frustrated and stressed out,

and the patient is unhappy. In the end, patient satisfaction scores are down. Stressed-out workers tend to

But I think one of the things that gets overlooked by most workers is they don’t understand their true value to the organization

make more mistakes and administration becomes concerned about a lawsuit.

in and day out and you guys over there — I don’t know what

CCN: If there is one common “aha” experience that many of

functioning well. It affects morale. In other words it affects

what would that be?

you do!” The frustration builds and the team is no longer the internal customer service.

BA: You’re absolutely right. A couple months ago I was working with a really good-sized sales team, and we were taking

them through the “distribution simulation.” The sales folks traditionally sit back and say if they don’t see wall-to-wall

inventory “how do you expect me to sell anything, I don’t have any inventory to sell.” They tend to lack an understanding

of [other] factors such as the costs for inventory, the revenue stream for inventory, and the front end and back end of the

your participants walk out of the simulated workshop with,

BA: When people go through the program they get a chance

to better understand how valuable they are to the company, and to one another. They also see that what they do is linked

to all departments; that everyone really works for a common

purpose. They can see how all employees are one another’s

customers. The organizations are links of one big chain that ultimately have an effect on the financial success of the company.

CCN: It really drives or enhances internal customer service.

we’ve put hundreds of sales professionals through these simu-

BA: Absolutely. And that is passed to the external

view. However, when you put these guys in the simulation, and

lations, and put them in charge of running the supply chain, they develop a whole new appreciation of how things operate.

www.customercarenews.com

Spring 2012

operation. They’re only looking at it from their own point of

customer. It is a beautiful thing to see unfold — what a process! CCN

The Promenade at Coconut Creek by XXX xxxxx

orem ipsum dolor sit amet, consectetur adipiscing elit. Nullam a consequat quam. Morbi consequat

porttitor imperdiet. Pellentesque sed neque lacus.

Nulla facilisi. Nunc massa massa, facilisis ut vehicula eget, luctus

sit amet nisl. Vivamus est velit, interdum a cursus in, fermentum vel purus. Nullam urna ipsum, sodales vel sagittis ut, hendrerit

quis dui. Aliquam egestas mi vitae lectus fermentum iaculis. Ut malesuada, quam varius gravida volutpat, lorem neque elemen-

tum nunc, a vehicula nisl eros et ligula. Vivamus facilisis, massa

Photos by XXXXXXXXX www.xxxx.com

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nullam a consequat quam. Morbi consequat porttitor imperdiet.

et imperdiet congue, lectus tortor lobortis tortor, in eleifend ante velit eget

dolor. Curabitur ut sagittis risus.

In scelerisque sem varius enim malesuada blandit. Curabitur

rutrum est sit amet odio dapibus ultricies. Proin volutpat pretium blandit. Donec ultricies tempor neque at tristique. Sed at

Smithson linkes to knock off early, going on expensive golf junkets paid for by corporate lobbyists.

risus. Aliquam et tortor sed est mollis dictum quis ac lacus.

augue et ante laoreet commodo. Nam nec sapien turpis. Cum

in sagittis felis tellus in purus. Suspendisse non tortor sapien.

nascetur ridiculus mus. Integer fermentum, ipsum quis tinci-

magna sed ante rhoncus sodales in nec eros. Donec et libero

Etiam rutrum, velit et porta blandit, tortor eros ultrices eros, In at magna eu odio aliquam condimentum at eu est. Phasellus

quis quam dolor, id tempor ante. Nunc laoreet convallis ornare. Curabitur id nunc erat, a volutpat tellus. Cras eleifend ultricies

sociis natoque penatibus et magnis dis parturient montes, dunt dictum, urna nisi egestas sapien, nec laoreet magna orci at ligula. CCN

odio, a pharetra est tempus id.

Aliquam accumsan auctor faucibus. Vestibulum ante ipsum

Assessment

primis in faucibus orci luctus et ultrices posuere cubilia Curae; Pellentesque varius lacus nec nibh porttitor et facilisis magna

egestas. Lorem ipsum dolor sit amet, consectetur adipiscing

Proin volutpat pretium blandit. Donec ultricies tempor neque

massa, non hendrerit arcu. Suspendisse potenti. Duis molestie

Donec et libero risus. Aliquam et tortor sed est mollis dictum quis

elit. Etiam rutrum interdum arcu mattis porta. Nulla eget purus dapibus pharetra. Morbi rhoncus urna eu massa pulvinar nec

aliquet justo vestibulum. Integer auctor, mi et egestas ultrices, nisi urna varius mi, quis consectetur nisl urna a dui.

Donec sed leo tortor. Cum sociis natoque penatibus et

at tristique. Sed at magna sed ante rhoncus sodales in nec eros. ac lacus. Etiam rutrum, velit et porta blandit, tortor eros ultrices

eros, in sagittis felis tellus in purus. Suspendisse non tortor sapien. In at magna eu odio aliquam condimentum at eu est.

magnis dis parturient montes, nascetur ridiculus mus. Curabitur

Spring 2012

molestie faucibus magna, et euismod sapien condimentum at. Fusce eu leo sit amet mauris elementum congue. Etiam dolor quam, volutpat at convallis et, feugiat sed tellus. Nunc eleifend

Customer Care News

The Case for Competency-based Talent Management

roviding first-rate service is complicated business. It involves both service providers (organizations and their employees) and service

receivers (the customers, patients, guests, etc.). With each service

event, the provider either demonstrates true competence or fails miser-

ably at meeting the needs and expectations of those being served. The inherent complexity of each service event, with its own set

of unique and variable inputs, process elements and outputs, means that existing “jobs” or “roles” must often change, merge and extend. This is

especially true as organizations Spring 2012

plan strategically for short-

term and long-term demand. www.customercarenews.com

As organizations exist in a constant state of flux, flex-

the job rather than characteristics or qualities of the person.

task-based methods for identifying and developing compe-

based approach should encourage many service organizations

ibility and ambiguity, they can no longer rely solely on job- or

Such an approach to talent management can help organizations identify and recognize top performers, while simultaneously pinpointing weaker performers in need of development.

tent and effective employees. Such

approaches to tal-

gies and practices.

Understanding competencies

the identification

ing assessment and business literature. Most definitions sug-

of a core set of necessary knowledge, skills, abilities and other

individuals that are closely associated with certain behavioral

usually

involve

assessment

characteristics that are empirically associated with the effective performance of critical job tasks in a specific job. This

approach works very well in situations where sampling of the job tasks is straightforward and where it is possible to easily track and quantify task performance.

What happens, however, when one’s job tasks vary so

substantially from day to day that there is not an easily iden-

Many definitions of competencies can be found in exist-

gest that competencies reflect underlying characteristics of tendencies or capabilities. These, in turn, are expected to lead

to competent performance within the work domain. In many

cases, a person’s competencies may align closely with his/her personality traits or underlying motives. A competency, therefore, represents something more than a basic knowledge, skill or ability requirement for a job.

Competency-based talent management is broadly appeal-

tifiable single set of required skills or capabilities? What if the

ing because it is so intuitively linked to the ultimate talent

ioral approaches? And what about

competent (i.e., effective or, better still, high-performing)

primary job tasks are accomplished via a wide variety of behav-

Recommended Readings • L awler, E. E. (1994). From job-based to competency-based organizations. Journal of Organizational Behavior, 15(1), 3-15. •R uss-Eft, D. (1995). Defining competencies: A critique. Human Resource Development Quarterly, 6(4), 329-335. • S hippmann, J. S., Ash, R. A., Carr, L., Hesketh, B., Pearlman, K., Battista, M., et al. (2000). The practice of competency modeling. Personnel Psychology, 53(3), 703740. •W oodruffe, C. (1993). What is meant by a competency? Leadership & Organization Development Journal, 14(1), 29-36.

Spring 2012

to seriously consider adjusting their talent management strate-

ent management

and

situations in which an employee’s performance metrics are not fully within that employee’s control, but rather are the result of a very com-

plex interaction between one person

and another, within a changing work context? These questions come up in many of today’s complex service

management goal: successfully building and maintaining a

workforce. The implication is that by hiring individuals who possess the right competencies (behavioral tendencies and capa-

bilities) an organization can increase the overall competence of its workforce and its ability to do the work at hand. The ability

to link competencies within individual workers to demonstrated competence on the job is especially appealing for organizations that have typically had difficulty quantifying performance quality. For instance, how does one define good service?

environments and highlight some of

A useful definition will vary greatly from one service event to

only on a job-task and job-fit based

approaches can all lead to equally positive service outcomes.

the challenges associated with relying approach to identifying new talent for a service-providing organization.

Questions like these have also led

many organizational decision makers

and assessment specialists to offer alternative approaches to measuring

another, and it is entirely possible that a variety of behavioral

Instead of attempting to define effective performance in terms of a well-defined task, the challenge in this type of situation

is in capturing those service-related behaviors that are most likely to lead to a positive customer reaction. This is where a focus on competencies can make sense.

In these situations it is also easy to see how competency-

and developing employee capabilities,

based talent management can facilitate and guide short- and

the broader organization. An increas-

organizations. Such an approach to talent management can

and identifying individuals’ fit within

ingly common approach involves

focusing on workers’ competencies. Working with competencies is dif-

ficult, however, due to the challenge of defining these competencies and

a tendency to focus on aspects of

Despite these challenges, the powerful utility of a competency-

long-term learning and development initiatives within service help organizations identify and recognize top performers, while simultaneously pinpointing weaker performers in need

of development. By adopting a shared competency model, an organization can develop opportunities for learning and growth that transcend particular jobs or roles because they are not inhibited by the narrow focus of more job-task-based

Customer Care News

methods. In this way, it can also be argued that competency-

based screening and development can help facilitate longerterm employee-organization fit by maximizing the likelihood that employees have more of the characteristics and behavioral

“tools” needed for success in a wide variety of roles within

an organization. In these ways, a focus on competencies can facilitate the translation of an organization’s strategic goals

into more immediate talent management action steps and milestones in areas such as hiring, development and succession planning.

Getting started

The availability of best-practice guidance regarding how

to incorporate competencies into existing talent manage-

ment plans is limited. It is important to note that competen-

cies do not have to replace (nor should they, necessarily) a

more traditional consideration of the critical technical skills, knowledge and abilities required for successful completion of

clearly defined job tasks. In fact, a balance of task-focused and personal-competency-focused approaches is likely to provide

an even deeper understanding of a candidate’s potential for demonstrating competence in the well-understood present and

the uncertain future. Here are some key highlights for evaluating a competency-based approach (the recommended readings provide more guidance and depth):

Christopher J. L. Cunningham, Ph.D.

• Identify and describe competencies in general and prac-

tical terms (to improve the likelihood that these defini-

• Maximize return on investment (ROI) in competency-

• Keep the behavioral nature of competencies in mind (to

agement functions (e.g., pay systems, reward options,

tions will apply broadly across the organization)

make it easier to observe competency-related behav-

iors when it is time to link a person’s competencies to performance-related outcomes)

• Limit the number of competencies to a manageable num-

based talent management by aligning most talent mandevelopment initiatives, etc.) around your core competency framework

Today’s complex work environments, and the pressure

ber (otherwise the resulting model will be too unwieldy

for companies to be more nimble and better able to respond

• Focus not only on competencies exhibited by current

require new approaches to talent management. A competency-

and less generalizable)

workers who are or have been effective, but also on competencies the organization expects to need in the future

• Seriously consider utilizing a generic set of competencies across multiple job positions or even in the bulk of job positions (otherwise you will spend incredible amounts

to changing customer requirements and market conditions, based talent management strategy can help service organizations adapt to these new realities and develop a workforce that

can help the company achieve its objectives now and in the future. CCN

of time generating models; time which could be better

Christopher J. L. Cunningham, Ph.D., is the Chief Science

• Gather data about competencies in question from those

He is also a UC Foundation Associate Professor of Industrial-

spent building your organization)

action (such as workers, supervisors, customers, etc.)

www.customercarenews.com

Spring 2012

who are most likely to be observing each competency in

Officer of Logi-Serve, LLC., based in Farmington Hills, Mich. Organizational Psychology at The University of Tennessee at Chattanooga. He can be reached at chris@logi-serve.com.

The Promenade at Coconut Creek by XXX xxxxx

orem ipsum dolor sit amet, consectetur adipiscing elit. Nullam a consequat quam. Morbi consequat

porttitor imperdiet. Pellentesque sed neque lacus.

Nulla facilisi. Nunc massa massa, facilisis ut vehicula eget, luctus

sit amet nisl. Vivamus est velit, interdum a cursus in, fermentum vel purus. Nullam urna ipsum, sodales vel sagittis ut, hendrerit

quis dui. Aliquam egestas mi vitae lectus fermentum iaculis. Ut malesuada, quam varius gravida volutpat, lorem neque elemen-

tum nunc, a vehicula nisl eros et ligula. Vivamus facilisis, massa

Photos by XXXXXXXXX www.xxxx.com

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nullam a consequat quam. Morbi consequat porttitor imperdiet.

et imperdiet congue, lectus tortor lobortis tortor, in eleifend ante velit eget

dolor. Curabitur ut sagittis risus.

In scelerisque sem varius enim malesuada blandit. Curabitur

rutrum est sit amet odio dapibus ultricies. Proin volutpat pretium blandit. Donec ultricies tempor neque at tristique. Sed at

Smithson linkes to knock off early, going on expensive golf junkets paid for by corporate lobbyists.

risus. Aliquam et tortor sed est mollis dictum quis ac lacus.

augue et ante laoreet commodo. Nam nec sapien turpis. Cum

in sagittis felis tellus in purus. Suspendisse non tortor sapien.

nascetur ridiculus mus. Integer fermentum, ipsum quis tinci-

magna sed ante rhoncus sodales in nec eros. Donec et libero

Etiam rutrum, velit et porta blandit, tortor eros ultrices eros, In at magna eu odio aliquam condimentum at eu est. Phasellus

quis quam dolor, id tempor ante. Nunc laoreet convallis ornare. Curabitur id nunc erat, a volutpat tellus. Cras eleifend ultricies

sociis natoque penatibus et magnis dis parturient montes, dunt dictum, urna nisi egestas sapien, nec laoreet magna orci at ligula. CCN

odio, a pharetra est tempus id.

Aliquam accumsan auctor faucibus. Vestibulum ante ipsum

primis in faucibus orci luctus et ultrices posuere cubilia Curae; Pellentesque varius lacus nec nibh porttitor et facilisis magna

Patient Care

egestas. Lorem ipsum dolor sit amet, consectetur adipiscing

Proin volutpat pretium blandit. Donec ultricies tempor neque

massa, non hendrerit arcu. Suspendisse potenti. Duis molestie

Donec et libero risus. Aliquam et tortor sed est mollis dictum quis

elit. Etiam rutrum interdum arcu mattis porta. Nulla eget purus dapibus pharetra. Morbi rhoncus urna eu massa pulvinar nec

aliquet justo vestibulum. Integer auctor, mi et egestas ultrices, nisi urna varius mi, quis consectetur nisl urna a dui.

Donec sed leo tortor. Cum sociis natoque penatibus et

at tristique. Sed at magna sed ante rhoncus sodales in nec eros. ac lacus. Etiam rutrum, velit et porta blandit, tortor eros ultrices

eros, in sagittis felis tellus in purus. Suspendisse non tortor sapien. In at magna eu odio aliquam condimentum at eu est.

magnis dis parturient montes, nascetur ridiculus mus. Curabitur

Spring 2012

molestie faucibus magna, et euismod sapien condimentum at. Fusce eu leo sit amet mauris elementum congue. Etiam dolor quam, volutpat at convallis et, feugiat sed tellus. Nunc eleifend

Customer Care News

Enhancing Patient Safety By Preventing Catheter-associated Urinary Tract Infection

nfections that occur during a hospital stay are called hospital-acquired infections. These infections are common, costly and potentially life threatening. Preventing

hospital-acquired infection is an important patient safety issue.

The Centers for Disease Control and Prevention (CDC) estimate that hospital-acquired infections affect approximately two

Spring 2012

million patients hospitalized annually in the United States and lead to at least $26 billion in direct costs per year. Researchers www.customercarenews.com

estimate that at least 20 percent of all hospital-acquired infections can be prevented, and more than half of those associated with

catheter use are considered preventable. Our research team from

the University of Michigan and Ann Arbor VA Medical Center has been working on preventing these infections.

Catheter-associated urinary tract infection prevention

Urinary catheters are used when a person cannot empty his

or her bladder either because something is blocking the urine flow or the bladder does not feel the need to empty; unfor-

tunately, urinary catheters can be harmful. Patients often find them uncomfortable, and they can cause a urinary tract infection (UTI), called a catheter-

associated UTI. Almost 25 percent of patients will

have a urinary catheter at some point during their

hospital stay. Despite the

Research is key to preventing hospital-acquired infections.

Unfortunately, this is not enough. In addition to creating and

sharing new knowledge about hospital-acquired infections, we

have been committed to making sure that our findings are used in practice. For example, we have been involved in national efforts to better understand the adoption of infection-prevention prac-

tices by individual hospitals and the factors that may promote or

inhibit the effective use of these practices. We have already identified several important facilitators (such as the use of collaboratives and the importance of committed champions) and barriers (such

as the presence of “active resisters” and “organizational constipa-

tors”) that leaders should consider when implementing new safety practices in hospitals.

UTI, several studies have

CatheterOut.org, which outlines options for reducing catheter-

third of the days that a

more than a decade ago by conducting numerous studies that

patient is catheterized, the

catheter is unnecessary. In a multicenter study, we found that

approximately 30 percent of doctors were unaware their patients were catheterized. Our findings may help explain why patients are catheterized for unjustified reasons: physicians are often unaware

the catheter is in place and therefore do not write an order to have the catheter removed.

Some interventions have been found to decrease the inci-

dence of catheter-associated UTI. The best strategy to prevent hospital-acquired, catheter-associated UTI is to avoid catheter-

ization itself. In those patients who truly require catheterization, however, the use of aseptic (sterile) insertion and proper maintenance of the catheter and drainage bag remain essential in pre-

venting catheter-associated UTI. Once placed, urinary catheters should be removed as soon as possible. Rather than rely on busy

physicians to remember which patients have urinary catheters, our research team has found that a reminder system significantly

One of the products of our efforts is an online tool,

associated UTI and urinary catheter use. We began our work helped define what should be done to prevent catheterassociated UTI. We then

investigated how hospitals are using research findings in everyday clinical practice. For example, in 2009 we surveyed more than

800 hospitals across the United States to learn more about which infection prevention practices have been implemented. We have studied approximately a dozen U.S. hospitals in-depth (from Maine to California) through detailed site visits to find out what

worked for them in reducing indwelling urinary catheter use and catheter-associated UTI, what did not work, and why. In the

course of our work, we have interviewed more than 150 health-

care workers from all levels of the organization, including chief executive officers (CEOs), chief nurse executives, chief medical

officers, infection preventionists, hospital epidemiologists, frontline nurses and doctors, nurse managers, and urologists.

While the website contains sections targeted to many types

decreases urinary catheter use. Also, alternatives to indwelling

of healthcare workers, the page “For Patients” gathers in a single

also published a study comparing condom catheters with indwell-

patients and their families. This includes:

catheters should be considered in appropriate patients. We have ing urinary catheters in male Veterans requiring short-term

urinary collection. We found that the use of condom catheters

Spring 2012

Translating research into practice

Catheterout.org

catheter-associated

found that about one-

reduces infection, and they were reported to be more comfortable and less painful than indwelling catheters. Clinicians and

catheter-associated UTI.

often severe consequences of

Condom Catheter

administrators should consider using these practices to prevent

place the information on the website that is of most interest to • A “Definitions” page, defining key catheter-associated UTI terms

• General background information on infectious complications of urinary catheters

Customer Care News

Catheter Placement

Catheter Re-insertion

Catheter Care

3 Catheter Removal • A list of “Key Prevention Strategies,” such as only using

Sanjay Saint, MD, MPH, a Professor of Internal Medicine

nary catheter; inserting the catheter aseptically; maintaining

University of Michigan Patient Safety Enhancement Program

urinary catheters when needed; avoiding the indwelling urithe catheter properly; removing unnecessary catheters; and using antimicrobial catheters

The site also provides patient and family education materi-

als. These include a brochure titled “What Patients and Family Members Need to Know About the Risks Associated with Urinary Catheters” for use in situations where there are patient or family requests for a urinary catheter without an appropriate

indication. Educating patients and their family members about urinary catheter risks can be an important way to reduce the

unnecessary use of urinary catheters. There is also a one-page

“FAQs about Catheter-Associated Urinary Tract Infections,” which provides patients with an overview of urinary catheters as

at the University of Michigan, is the Director of the VA/

and the Associate Chief of Medicine at the Ann Arbor VA

Medical Center. His research focuses on enhancing patient safety by preventing healthcare-associated infection and translating

research findings into practice. He has authored more than 200

peer-reviewed papers with more than 60 appearing in the New England Journal of Medicine, JAMA, or the Annals of Internal Medicine. Dr. Saint can be reached at saint@umich.edu. References

• Scott RD. The direct medical costs of healthcare-associated

Infections in U.S. hospitals and the benefits of prevention. Available at: http://www.cdc.gov/HAI/pdfs/hai/Scott_ CostPaper.pdf. Cited January 17, 2012.

well as catheter-associated UTI and how patients can safely care

• Meddings J, Rogers MA, Macy M, Saint S. Systematic review

Since it launched in early 2011, CatheterOut.org has attract-

associated urinary tract infections and urinary catheter use in

for their urinary catheter.

ed nearly 5,500 visits from more than 4,200 unique visitors in 87

countries. We have responded to queries from multiple organi-

zations via our online contact form, and recently ventured into social media, launching our Facebook page in fall 2011. We are

continually updating and adding to the website, and welcome any comments or questions visitors may have.

CatheterOut.org has helped us share our research about the

most common hospital-acquired infection in the United States. investigations will be able to help hospitals across the nation enhance their catheter-associated UTI prevention efforts. CCN

www.customercarenews.com

hospitalized patients. Clin Infect Dis. 2010;51(5):550-60.

• Saint S, Kaufman SR, Rogers MA, Baker PD, Ossenkop K, Lipsky BA. Condom versus indwelling urinary catheters: a randomized trial. J Am Geriatr Soc. 2006;54(7):1055-61.

• Chenoweth CE, Saint S. Urinary tract infections. Infect Dis Clin North Am. 2011;25(1):103-15.

• S aint

Kowalski

CP,

Banaszak-Holl

Forman

J, Damschroder L, Krein SL. How active resisters and

organizational constipators affect health care-acquired

Spring 2012

We hope that the information we have gathered through these

and meta-analysis: reminder systems to reduce catheter-

infection prevention efforts. Jt Comm J Qual Patient Saf. 2009;35(5):239-46.

The Impact of Employee Satisfaction on Patient Safety and Satisfaction Within the Hospital Setting

ntuitively, a hospital’s safety culture ought to be related

waits/delays, poor communication, poor care coordination, lack

nication among staff members and providing patient-

Approximately 40 percent of patients reported at least one inci-

to its service quality. Practices such as open commu-

centered care have an impact on both patient safety and patient satisfaction. This instinctively links patient safety and patient satisfaction to employee satisfaction. For example, nurses who

are satisfied and engaged and can spend sufficient time at the

bedside will presumably know their patients and their vulner-

abilities better and will be more prepared to identify and ward off potential harms.

In today’s healthcare environment, however, rarely are a hos-

pital’s safety culture and poor patient satisfaction caused by apa-

thetic staff and unwilling managers, but rather by a system that fails to support them. Leaders who create a work environment

and culture that are engaging and where people are proud to work, create engaged employees and in turn, satisfied patients.

Empirical connections between patient safety, patient satis-

of respect for personal preferences, or environmental issues. dent, and reporting incidents was associated with diminished patient satisfaction.

In its Health Care Satisfaction Report,

Press Ganey, Inc. stated “empirical evidence leads to the conclusion that increases of employee satisfaction are associated with

increases in patient satisfaction”. The Centers for Medicare & Medicaid Services (CMS) is aware of this empirical research and has developed a value-based purchasing (VBP) measure

set with performance-based financial incentives and public

reporting of quality information to comprehensively evaluate

all aspects of quality, including patient satisfaction and safety. With these changes to Medicare and Medicaid, the two largest

payment systems, employee attitudes and engagement can have a significant financial impact on a hospital’s bottom line.

With this in mind, Oakwood Annapolis Hospital’s surgical

faction and employee engagement appear in greater frequency

services department recently created a staff-driven, manage-

of service “incidents” — deficiencies in service quality such as

within the department to address the challenge of improving

ment-supported team composed of informal employee leaders

Spring 2012

in today’s literature. A recent study examined inpatients’ reports

Customer Care News

the culture and increasing the employee engagement within

that the administration create opportunities for staff members

the group:

better understanding of the staff members’ day-to-day responsi-

the department. The team created three guiding principles for

1. Clear scope of practice: This principle is geared toward

to “job shadow” others within the department in order to gain a bilities and how their actions affect the rest of the team.

When communicating to others about a delay in the pro-

establishing responsibilities, accountability and educa-

cess, supervisors and staff from the different units within the

staff can do against the perception of what they should

daily pre-shift “huddles” and listen to their concerns or provide

tion. It is intended to help the group articulate what the be doing.

2. Culture of mutual respect and recognition: This principle

is geared toward bridging the gaps and barriers caused by

existing culture and generational differences. It focused

surgical services department were invited to attend other units’ proactive feedback regarding equipment, staffing ratios or other areas where delays could be created.

Finally, to provide increased visibility and support to the

staff, administration implemented the following items:

• A monthly “Employee of the Quarter” program to recog-

nize and reward staff members who demonstrate patient

the group on cultivating sincere, authentic relationships

safety and satisfaction behaviors in their day-to-day work;

grounded in trust and respect with a shared appreciation

employees received a nominal award

of the nursing and support service jobs. It’s also a mecha-

• A semi-annual employee appreciation event with massages

nism for rewarding and recognizing all members of the

and relaxing food and drinks during their shift

team for their impact on the patient experience.

• An employee question box and “sounding board” where employees could submit anonymous questions pertaining

3. Continuous open communication: The group established

to department needs, and management would post their

a communication plan that disseminates key messages

response on the board for all staff to see

and decisions throughout the department, implementing mechanisms to measure and act on departmental staff satisfaction and feedback.

After creating the three guiding principles, the team moved

forward in addressing the barriers within the department. This portion of work led to the development of a baseline survey

instrument to measure the existing employee satisfaction and the staff members’ perception of the existing culture. Feedback from the survey identified several gaps between nursing and

support staff, nursing and support staff to physicians, and all staff to administration. Themes among the gaps were: • Freeing up staff time so they can do their job

While the team’s progress is still ongoing, early results

are encouraging. Through the team’s use of the guiding prin-

ciples to address the gaps from the survey, the surgical services

department has seen an increase in employee satisfaction and improvement in the culture. As the team’s action plan becomes

further hardwired into the culture of the department, the intrinsic rewards of the plan (increased staff recognition, increased

staff pride in the department and a greater belief in hospital

leadership) give the staff a greater voice in the decision-making

process and ultimately lead to increased patient safety and satisfaction. CCN

• Taking personal accountability when tasks were not

Aaron Bontrager, MBA, MHA, is the director of surgical ser-

• Communicating to others when and if there will be a delay

Wayne, Mich. Bontrager can be reached at 734-467-2536 or via

completed

in the process

• Providing increased visibility and support to the staff by administration

The team then began applying the guiding principles to

address the gaps identified in the survey and then communi-

the area of freeing up staff time and taking personal accountability when tasks were not completed, the team recommended

www.customercarenews.com

e-mail at aaron.bontrager@oakwood.org. 1

Weingart S.N., Pagoviceh O., Sands D.Z., et al. (2006,

April). Patient reported service quality on a medicine unit.

International Journal of Quality in HealthCare 18(2): 95-101. 2

Wolosin, R. (2005). Health Care Satisfaction

Report. Press Ganey, Inc. 3

Spring 2012

cated the solutions back to the surgical services team. To address

vices and outpatient services for Oakwood Annapolis Hospital in

Innovators’ Guide to Navigating CMS; Version 1.0, August

25, 2008 p. 52; Centers for Medicare & Medicaid Services.

The Relationship between Employee Satisfaction and Hospital Patient Experiences The following white paper from The FORUM: Business Results Through People examines the vital link in the hospital industry between employee satisfaction and the satisfaction and quality of patient care, based on extensive research conducted at a major New York City hospital. Although this study was initially completed in 2009, health care continues to grow and now represents more than 17 percent of the U.S. economy and will grow as the population ages and c o v e r a g e increases under Federal regulation. Health care is an enormously people-intense industry,

and

the importance of employees can hardly be underestimated. The changes taking place in health care require employees to be very engaged and to perform at the highest level in order to comply with increased regulation and ensure patient safety and satisfaction.

new treatments and better outcomes for patients. In an industry

where success is being driven more and more by patient satisfaction scorecards, reliable access to and retention of top talent is essential to meet the demand for quality patient care.

According to an April 2008 study by Futurestep, “nowhere

is the (talent staffing) problem more severe than in the health care environment, where talent shortages put lives at risk.” As

the U.S. population ages, the healthcare industry continues to

grow in size and importance, now representing 17 percent of GDP. For seniors, 40 percent of their total economic consump-

tion is directed to healthcare spending. Within the next 10 years, overall healthcare spending as a percentage of GDP is likely to rise to 20 percent ($2.9 trillion).

Despite temporary hiring freezes in certain healthcare

markets, industry growth is expected to continue, and healthcare organizations will continue to find it difficult to recruit

and retain high-quality professionals. The reasons are twofold

— first, a growing proportion of the workforce is retiring or resigning, and secondly, there are an insufficient number of new graduates in the medical and healthcare administration fields.

The situation is especially acute in the nursing profession,

where shortages exist globally. According to the American

businesses, the benefits of having engaged, empowered, loyal

rate at acute-care hospitals is 21.3 percent, with higher turnover

employees can lead to increased retention, lower costs, enhanced reputation and a profitable business picture.

As the healthcare business becomes more competitive, every

advantage is important, but all too often, hospital administrators

Spring 2012

are increasingly feeling the pressure to manage costs and provide

Critical condition: the talent crisis facing health care

In the healthcare industry, as in other service-related

do not always consider employee performance and satisfaction as a competitive edge.

In this competitive environment, healthcare administrators

Organization of Nurse Executives, the average nurse turnover rates in critical care units. Much of the turnover is attributed to

job stress and burnout linked to reduced staffing. And, says a

Spherion report on healthcare staffing, “hospitals are diverting

patients, losing revenues and compromising patient care due to

inadequate staffing levels. The overall state of affairs has reached a critical point.”

Customer Care News

Additionally, healthcare organizations are looking beyond

financial performance measures, giving more focus on how to deliver higher quality care. While some improvements in care

quality can be reached through investments in technology and

infrastructure, the most dramatic improvements are achieved through people.

FORUM study unveils key findings

So, the key question is how do service-based organizations,

such as hospitals, determine their level of employee engagement,

programs may be distracting to meeting the demands for patient care.

• The expanded use of computers for diagnostic testing

and vital signs monitoring has eroded the patient’s feeling of being personally cared for. As the popularity of elec-

tronic health and prescription records expands, healthcare employees need to exercise “the personal touch” in caring for patients.

and what impact does it have on patients? To answer this ques-

• A key conclusion of the study is that, in addition to what

of Wisconsin and Frank Mulhern of Northwestern University

how the employees feel about what they do. Patient experi-

tion, researchers Jimmy Peltier and Andy Dahl of the University

conducted an exploratory study to investigate the relationship

between employee satisfaction and patient satisfaction at a major New York City hospital.

healthcare workers do, emphasis needs to be placed on ences will not be good if employees are not happy.

Getting started: how the study was conducted

The approach involved a review of current literature on

Key overall findings from the study include:

healthcare performance, primary data collection through an

• Hospital departments that have higher levels of employee

empirical analysis of employee and patient satisfaction data.

satisfaction provide better experiences for patients.

• Patients that have higher levels of satisfaction are most likely to recommend the hospital to others when they are

treated in the high employee satisfaction departments,

online forum and interviews with key hospital staff, and an

The literature review focused on employee engagement,

employee satisfaction, and patient satisfaction in healthcare settings, and provided a foundation for the key people-related issues facing health care.

In the empirical analysis, the primary objective was to assess

compared to those treated in the low employee satisfaction

the relationship between employee satisfaction and patient sat-

of marketing / promotion, is a primary driver in patient

the concepts can easily be applied to other service- or people-

departments. Word of mouth, more than any other source healthcare decisions.

• Individual employee recognition, as well as the need and value of increasing recognition of staff members in higher positions, were identified as key contributors to employee satisfaction.

• In addition, recognition at the hospital was not only

viewed as acknowledgement for a job well done, but also

as being able to participate in decision making, and being listened to by management and fellow professionals. This

practice results in “more respect and visibility,” which in turn enhances employee satisfaction.

isfaction. While the research was limited to a healthcare setting, based industries, such as retail and hospitality.

The research phase: feedback and ideas for improvement

The research consisted of two components. First, the team

established a 31-member advisory committee that participated

in an online forum about their perceptions about the quality

of service and the motivation, satisfaction and performance of employees. Secondly, the team conducted quantitative analysis

that matched employee satisfaction survey data with patient

satisfaction survey data to assess the relationship between employee satisfaction and patient experiences.

Key findings from the advisory committee forum include:

• Programs and activities at the hospital that are designed

• Advisory committee members identified the hospital’s

strategically, rather than offered as short-term efforts,

alty, retention and motivation. These include recognition

to contribute to employee satisfaction need to be viewed

the overall impact of the program. In addition, multiple

www.customercarenews.com

employee

milestones

and

Spring 2012

or efforts initiated on multiple fronts, which weakens

current “best practices” for increasing employee loyaccomplishments,

promoting a family-like atmosphere among long-term

employees, and support of financial bonds including salary and benefits.

• Areas identified for improvement include better com-

munication of goals, decisions, and information between

departments, greater empowerment and involvement in

decision making, and continuing to improve work relationships, especially between supervisors and their departments and between physicians and nurses.

• The behavior of physicians has a major impact on the level

of engagement with non-physician staff. Physicians who

are disrespectful, make negative comments or treat patients

as (in the words of one committee member) “non-human

intangible entities” lead to reduced engagement in nonphysician staff. When an employee feels like a valuable

Employee, patient satisfaction data “in sync”

The University of Wisconsin/Northwestern University

research team compared the results of the hospital employee and patient satisfaction surveys to determine whether there was

a link between the way employees feel about their jobs and the

quality of the patient experience. Researchers used a variety of statistical methods to evaluate the relationship.

But most importantly, they found, in a side-by-side

comparison of key questions from both surveys, that the

highest scores on the employee survey tracked positively with

the highest scores on the patient satisfaction/quality of care

survey. Researchers concluded that the patient, either consciously or not, infers that the care received is better merely because of the environment created by having more satisfied employees.

team member and feels respected by others, higher levels

Conclusion: people performance boosts healthcare quality,

• The consensus from the advisory committee was that the

more satisfied patients. A key aspect of this study is that health-

has had a positive impact on the quality of care and patient

of benefits of having satisfied employees, not to mention the

of engagement are likely.

level of employee engagement at the hospital is high and satisfaction.

Based on the literature review and input from the advisory

committee, the graphic below was designed to illustrate the link

between employee engagement levels, employee satisfaction, patient satisfaction and organizational financial performance.

business results

The upshot is clear — more satisfied employees lead to

care administrators can add “quality of patient care” to the list

other key benefits of increased retention, lower overall costs, and repeat visits and positive word-of-mouth recommendations by patients.

Hospitals compete aggressively to attract patients, particu-

larly for high-revenue services such as cardiac care. There are a

variety of dimensions that factor into the competitive landscape, including hospital location, technology, physician reputation and the hospital’s image in its service area. Based on the findings

of the study, one can now include the level of hospital employee satisfaction as a competitive factor. CCN

The FORUM: Business Results Through People, affiliated with Northwestern University, is an organization for thought leadership advocating that the most effective way business

leaders create and sustain organizational values is through

partnership with people. The FORUM invites leaders in the

healthcare industry to comment on this white paper and share

their experiences with employee engagement and how it is affecting patient care at their institution. To add your insights, please contact Managing Director Susan Peterson via email at sue@businessresultsthroughpeople.org. To view the full text

of the research paper, plus additional people-centered leader-

Spring 2012

ship research, go to www.businessresultsthroughpeople.org. The FORUM is located in Naperville, Ill. and can be reached via phone at 630-369-7780.

Customer Care News

BE C RI BS

Start Your Subscription Today Customer Care News magazine is dedicated to exploring the relationship between customer care, customer satisfaction and the bottom line. The more a company focuses on customer care, the more it reaps the rewards of higher customer satisfaction. Research shows that customer satisfaction is essential because of its impact on the many factors that affect a companyâ&#x20AC;&#x2122;s bottom line. It generates higher customer loyalty, repeat business and increased revenue. Happy customers lead to a happy bottom line and happy stakeholders. This should be the call of every company in America. Subscribe to Customer Care News to receive the latest information on trends and issues in customer care with articles from industry leaders and more. Each issue highlights leading industry providers of education and resources that can assist companies in improving their customer satisfaction scores, and thus improve their bottom line. There is no charge to subscribe to the magazineâ&#x20AC;&#x2122;s digital edition. Simply go to www.customercarenews.com/subscribe/.