Did you know the average happy adult smiles 40-50 times a day? And that healthcare employees greet customers with a warm smile only 83% of the time? The 11th video in The Patient Experience Toolbox series focuses on the importance of a warm smile and its impact on the overall patient experience.
Have you ever thought about what happens to your brain when you smile? Smiling stimulates our brain’s reward mechanisms in a way that even chocolate, a well-regarded pleasure-inducer, cannot match.
Smiling changes our brain chemistry because it keeps track of your smiles, kind of like a smile scorecard. So consider that patients can experience hundreds of greetings from your employees and that their perception of this acknowledgment has a cumulative effect.
Scientific research shows that the smile rates as the symbol with the highest positive emotional content according to scientist Andrew Newberg. He goes on to teach us how to create a genuine smile.
He says that before you engage in a conversation with someone else, visualize someone you deeply love, or recall an event that brought you deep satisfaction and joy. It’s such an easy exercise to do.
And since smiling reduces stress that your body and mind generates, similar to getting a good night’s sleep, it generates positive emotions within you.
So it stands to reason that we feel happier around children - they smile an average 400 times a day! In contrast, genuinely happy adults smile an average of 40-50 times a day and the rest of you about 20 times a day.
Based on a three month Patient Emotion Study, I recently completed for one of the country's largest healthcare systems, one of the top contributors to anxiety was anticipating whether the clinical staff would be nice or not.
If a patient is already nervous about meeting the doctor for the first time, the frontline employee represents the first impression of what is to come, and that could lead to calming the patient down or fueling their anxiety.
So imagine how a stressed patient who doesn’t feel well and is anxiously waiting at a desk feels after a minute or more, while employees are busy behind the desk ignoring him or her. With a genuine smile the frontline staff can set the stage for the entire experience.
Think of the power you have by using a genuine smile with your patients, co-workers and friends. That smile will add years to your life, enhance someone else’s life, and create a positive experience for you!
We know from our mystery shopping research that a poor greeting can have a substantial impact on the overall experience.
For example, on a large mystery shopping study for a Midwestern hospital, all of the mystery shops that were rated mediocre or below began with no immediate acknowledgement by an employee or a greeting without a smile.
Our mystery shopping benchmark data indicates that healthcare employees immediately acknowledge our shoppers 92% of the time. However the follow up behavior of offering a warm and friendly smile dropped to 83%.
While these scores may seem reasonable to some, we always recommend a goal of 100% for acknowledging customers.
Mother Teresa’s said it best, “We shall never know all the good that a simple smile can do.”
Gathering Competitive Intelligence in Support of the Patient Experience - the 10th in the Patient Experience Toolbox series - makes the case for understanding your competition's patient experience culture in order to fine tune your own.
Lets say you work in the C-Suite of a hospital and a relative says to you, "A couple of weeks ago I was in an accident and spent two nights at one of your competitor hospitals. Would you like to hear about it?" Without hesitation you say of course you would! You would listen carefully to your relative’s story and undoubtedly compare this experience to what you know about your own organization.
I’m assuming you would then ask a series of questions related to your own responsibilities, for instance, what was the relative’s perception of the quality of care or perhaps how the competition performed specific processes related to safety and noise.
Then the value of this opportunity sinks in and you dig a little deeper and ask her how she felt she was treated. How did they communicate with her? How did they seem to treat each other? Was their obvious teamwork? Did they seem distracted and unhappy, or were they cheerful and knowledgeable.
And perhaps most important, were they consistent in what they did or were they different from department to department, or nurse to nurse? In short, you?re wondering if they have managed to hard wire their patient engagement culture.
You’re thinking to yourself, wouldn’t it be great if we could get this kind of information on a regular basis? Well the answer is you can and we call it competitive mystery shopping.
Let me share a case study. For over ten years we conducted an intensive study with a large, metropolitan physician referral service that always included calling their top three competitors. We could always tell when the competition had a shake up in management or when a new initiative was underway because their scores would fluctuate widely, while our client used their mystery shopping scores to support an objective performance evaluation and remain constant and on top.
This information allowed our client to do three additional things: First, it reaffirmed that they were the best and it allowed them to use this information to motivate staff and support ongoing organizational marketing efforts.
Second, they used mystery shopping to keep abreast of whatever strategic changes competitors were making in real time.
And lastly, mystery shopping proved that the program delivered a competitive advantage, which was in turn used to support continued investments in the program.
If you’re still wondering why you would want to check out the competition, consider this, there is no better way to understand where your patient experience is weak compared to competitors, and there is no better way to share with staff where you are clearly better.
It also appeals to an employee’s competitive spirit when they realize how they stack up. You want to arm them with the incentive to say, “We are every bit as good as they are. We can do that. With a little tweak, we can be even better."
And the incredible thing about this type of competitive intelligence is that you can decide ahead of time what you specifically want to know and then measure it?
This information will lead to a better understanding of what patients are responding favorably to, and the things that are contributing to a culture of excellence and increased market share.
In this the 9th Toolbox video blog, Brooke Billingsley says, "If managers fail to constantly emphasize the positive actions they are taking on behalf of their staff, they can be assured staff will remember all of the things he or she hasn’t done and view this as a lack of leadership."
As managers learn how to take their rightful place at the forefront of the patient experience movement, it’s important to make sure that when they communicate with staff, they go out of their way to verbalize the positive actions they are taking on behalf their team and patients.
Clifford Nass, Professor of Communication at Stanford University says that almost everyone remembers negative things more strongly and in more detail.
In fact, he says that we also tend to see people who say negative things as smarter and therefore give greater weight to critical reviews.
So if managers fail to constantly emphasize the positive actions they are taking on behalf of their staff, they can be assured staff will remember all of the things he or she hasn’t done and view this as a lack of leadership.
We think this is one of those instances where it is important to talk in the first person. “I did this for you.” it is a way to reinforce to staff in a fast-paced healthcare environment that the manager is listening and fully engaged.
Let me provide an example. In working with an orthopedic unit conducting deep dive audits with staff, we realized that among other issues, the staff perceived that the unit manager was not listening to their needs.
This manager’s passive style was clearly contributing to a lack of respect by staff and undermining her leadership.
In further conversations with the manager we discovered that she was making subtle changes but failed to take credit for them.
We saw this as an avoidable barrier, so we asked the manager if there were any changes expected in the near future such as equipment purchases or scheduling improvements – with an emphasis on things that had been requested by the team.
She told us there were, so we coached her on how to handle this for an upcoming staff meeting. We instructed her to be assertive in taking credit for the changes.
In her next unit roundup, she announced, “We will be getting three new blood pressure cuffs that I ordered because you indicated we needed them.”
The manager is now aligning with her team as they move together to improve the patient experience.
However, it is not enough to only communicate successes. It is also important to keep staff updated on the progress of requests or meaningful information the manager previously communicated.
Explaining is a critical form of communication, but only if it is not perceived as an excuse. An explanation is factual – while an excuse seeks to defend or justify.
Taking credit for action or faithfully keeping staff informed is the type of leadership necessary to keep teams focused on patients.
What if you asked patients to tell you what was most important to them before they started their hospital stay? In this Patient Experience Toolbox video, we think asking "If you could choose one thing that would contribute to your being calm and feeling cared for, what would that be?" is an effective way to proactively target patient expectations. It helps healthcare providers focus on achieving the patient's desires and increase loyalty.
How confident are you about your staff's ability to deliver great care? Well here is a real time idea that puts your confidence to the test. Consider asking patients when they are admitted, "If you could choose one thing that would contribute to your being calm and feeling cared for, what would that be?"
Registration personnel would record and acknowledge the patient's desires and add it to the patient's instructions. Nursing could then reinforce the patient's desire by saying, "I see you indicated at registration that you would like it as quiet as possible at night. I want you to know we will do everything in our power to make that happen."
You might ask yourself, why would we set ourselves up like that? The answer is that there is power in the asking. There is also tremendous value in showing that you care enough to ask.
And by having Registration ask the question, you give them a role in the patient experience that is often missing. You also gain a greater sense of who the patient is and what his values are.
Do healthcare providers run the risk of making patients even less satisfied if expectations aren't met? Maybe, but we think the focus it puts on achieving the patient's desires is worth the potential failure. After all, what are patients going to say? You are likely to hear - I want good food, I want the noise kept down, I want less interruption at night, or I want more communication from the doctor.
Aren't those also standard patient satisfaction questions? So the expectation of your organization is that these issues are already being met.
Think about it for a second - You're a nurse and it is communicated to you that it is important to Mr. Davis that it is quiet outside his room at night. It's even on the white board in his room. You now begin to see things from his perspective - "Mr. Davis said he wanted it quiet at night, and it clearly isn't. I need to see what I can do about that."
So you take a step further - You take action to remove staff congregating outside Mr. Davis' room before it becomes an issue for the patient. You ask Mr. Davis the next day, "How did you sleep last night? Was it quiet enough for you? There were a few staff talking outside your room so I asked them to do it somewhere else."
The idea of honoring a specific request is common in customer service. For instance, when I'm travelling and I know I'm going to have a long day ahead, I will often request a room away from elevators and heavy traffic. Most hotels are happy to accommodate because it reinforces loyalty.
Of course patients can change their minds and decide something else is now more important. And we all know that family and visitors can also influence patients with expectations of their own.
But when the experience is over, your staff is in a position to ask, "How did we do with your specific request regarding noise" instead of the generic "how was everything?" which signifies that they had no idea what was important to him.
Proactively targeting expectations beats surprises at the end every time.