Last week, my father-in-law had total knee replacement surgery. Thankfully, the operation went well, but as anyone who has been through one will tell you, the surgery itself is the easy part; it’s the rehab that will knock you on your tail.
A few days after the procedure, my father-in-law was discharged to a skilled nursing facility for his initial rehab. He was terrified.
Call it what you will: “skilled nursing facility,” “rehabilitation unit,” “post-acute care center.” To him, it was still a ”nursing home,” and he wanted no part of it.
Bear in mind, my father-in-law is a successful attorney who manages a large law firm. He exercises every day. He travels. He’s probably one of the most active and independent people I know. To him, nursing homes are for the old and infirm. They are where you go to die.
Even the fact that he was being admitted to one of the elite facilities in the area–a place that looks more like a 5 star resort than a healthcare facility–did little to assuage his fears.
I was excited to visit him! Everywhere I go, I pay close attention to the service standards, but it’s not often I have an excuse to visit a “Taj Mahal” long term care facility. I wanted to see what it was like and, more importantly, how it compared to Signature.
So this afternoon, my wife and I loaded up the kids and made our way out to the center.
It was stunningly beautiful. From the moment you enter the front doors, you see how much effort and money was expended on the physical environment. There is an enormous aquarium, a beautiful bird cage, and a theater/bar area that looks like something out of an HGTV extreme home makeover. The hallways were wide and clear, and the decor had more in common with a Marriott or Hyatt than a typical nursing home.
But we all know that physical environment is only part of the picture. I was eager to interact with some of the staff. So when my wife stopped off at the therapy gym to observe her father’s rehab session, I went straight to the room, hoping to encounter a CNA or housekeeper.
As fate would have it, I met “Laura” (name changed to protect the innocent), a member of the housekeeping staff. She was busily straightening the room, but she didn’t seem to mind when I asked her a few questions. Before long, we were having a great conversation about what it was like to work there.
The short version is: she loved it! She had nothing but positive things to say about the RNs, the administrator, the department heads, and the CNAs. I asked if there were any specific morale-building programs they used, and she said “No, not really. They buy us pizza every once in awhile, but that’s about it.” As I talked to her longer, I realized that her happiness was built on a much more solid foundation than free pizza or some flavor-of-the-month corporate program. She genuinely liked her co-workers and felt supported in her job. Her administrator walked the floor and asked employees for their opinions. People smiled at each other in the halls. The nurses were nice to the CNAs, and the administrator was nice to the nurses.
She told me a great story about a woman who had shown up at the facility recently wearing some pretty spiffy street clothes–usually a clear marker of someone from corporate. This woman was asking all kinds of questions about what it was like to work at there, how the staff was treated, etc. Laura finally asked her where she was from and why she was asking. “I’m thinking of sending my mother here,” the woman said, ” and I wanted to see how they treat you guys first. I figure if they don’t treat you well, there’s no way you can treat my my mother well.” Every family member should be so insightful!
Turns out Laura had a pretty interesting background herself. She had been a manager at a mid-sized manufcturing company. When the economy tanked in 2008, her manufacturing company went under. Now she was working as a housekeeper in a nursing home, and loving it. Why? Certainly not the money. It was about the sense of belonging and purpose she felt. My sense was that Laura would make an outstanding administrator someday if she chose to pursue that path.
After our conversation, I was feeling pretty inspired. Clearly this facility had it all figured out, right? Well here’s where it gets interesting. When my wife came back to the room with our oldest son, I could tell she was upset. “What happened?” I asked her. She told me that the therapist had been extremely rude, going so far as to ask her to leave the gym while her father was being rehabbed. Now, my wife is an OT with years of experience in geriatric care, so she knows her way around a rehab unit. She’s also one of the nicest people you’ll ever meet. She had wanted to be part of the family education process to ensure safe carryover of the therapy to home, but was instead hustled out of the gym by a therapist who had clearly not studied the care plan before treatment. She was so upset she was ready to pull her father out of the facility and place him elsewhere!
So there you have it. Two radically different customer experiences in the same facility, with the same patient, on the same day, in the same unit. That, in a nutshell, encapsulates the challenge we face as an industry. I was reminded of what Colleen Barrett had told me just last week, “customers evaluate the organization as a whole, not department by department.” One negative experience blows it for everyone.
So what is the solution? How can we possibly hope to ensure consistent quality and service excellence in such an environment? There is no silver bullet, but I believe that the answer is “culture.” We have to create a culture of service excellence that is so strong and appealing that every single Signature stakeholder wants to exceed expectations. We have to connect people to their purpose, to put the “why” back in healthcare (as Quint Studer so aptly puts it).
We have to provide the environment and resources that will allow people to do their best work every single day. That means engaged leadership that cares about customer service and quality. It means process mapping for consistency. It means good training and education. It means treating ALL stakeholders respectfully. It means leaders who are accountable not just for the bottom line, but for the quality of the experience for stakeholders, families, and residents.
We have to remember that this is sacred work and treat our facilities like holy ground.
I’d really love to hear from the field on this one. How do you think we’re doing today? What could we do better?