The EnsignPrize! home stretch

At Ensign’s 2011 annual meeting I spoke about some personal feelings re: hitting 10 years with the organization and in skilled nursing. It was a time of deep reflection. It was then that I developed some of the thoughts I’ve shared here about burn out, empathy, and a hunger to do more after surviving industry-common career crushing experiences. Some of those thoughts are found here.

As “luck” would have it, while I was in that very reflective mood, I was hit by some new, related ideas during a couple early morning rides. I love to listen to NPR podcasts during those runs/rides and back then I listened to a Freakonomics podcast that was like lighting a fuse in my mind. When I got to the office that morning, ideas started to crystalize, as seen on my whiteboard:

I don’t expect you can follow the train of thought there. But, with the help and input of my colleagues at Ensign, what started as some 10-year angst turned into the eprize! … our organization’s $150,000 competition to transform the industry by transforming the day-in-the-life of our residents. At that 2011 annual meeting, I shared with my friends and colleagues the story of how the idea of the eprize! was born and then challenged them to run with it. And … they did.

The executive directors and directors of nursing upped the ante to $150k and all agreed to put money into the ‘pot’ from their own facilities to fund the award. For more details about the competition and why we did it the way we did it, see this “halftime talk” I gave to the organization about it:

Well … the applications are finally in and uploaded onto the EnsignEprize.com website and the contestant facilities are lobbying their communities hard to have them ‘vote’ for their application. The eprize! award winner will be announced in early April. As I’ve read through and watch the videos of some of the applications I’ve gotten emotional to see the small and big improvements in the systems we use to care for our residents and patients with more dignity, humanity, and choice. I hope you take a minute to go to the website and see what we’ve been up to for the last year as a group. And, please, by all means … share this with your friends. Better yet, challenge your own organization to do something similar!

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I’m pretty sincere

This video teaches a powerful customer service point – probably without intending to at all.  As I set expectations for the type of experience our patients and residents deserve and WILL receive at my facility, I share this video when talking about the reality of having to meet that standard even when we’re having a ‘bad day.’

I know cars don’t start.  Boyfriends can be jerks.  Kids can be sick.  People can cut us off.  My team could be playing while I have to be at work.  Life can totally get in the way of well … Life.  But, as far as our residents are concerned, they cannot have any idea, none whatsoever, that we are not 100% focused on their happiness, treatment, and recovery.  Does this mean we shouldn’t share our lives with our residents?  Yes.  It means we shouldn’t place our worries and concerns on residents who have serious worries and concerns of their owns.  Like in the commercial above, if we’re having a bad day or we wished we weren’t at work, we cannot let our resident have a clue.  Like the girlfriend in the commercial, she has to know that her boyfriend is sincerely devoted to her.

Don’t get me wrong.  I’m not advocating deception.  I’m advocating a customer satisfaction truth that we are always on stage when we are around our residents and patients.  The ‘floor’ is our stage.  And, no matter how bad your life is today or what great reasons you have to not smile, when you’re on the floor, you’re on stage and, in order to give the resident the best experience and best care, they need to see us at our best.

Princess Story

Sometimes Usually a story is the best way to both teach a principle and persuade someone to believe it.  When I talk about ‘scripting’ in the facility – meaning there are words and phrases we shall and shall NOT say, I illustrate with a real-life story.  I also use this same story to talk about ‘being on stage.’

When my daughter was 5 years old we took her to Disneyland for the first time.  Like most 5 year old girls, she was totally ‘over’ Mickey Mouse.  Please.  She was there for one reason and one reason alone … to mix it up with her favorite princesses.  It’s all about the Disney Princesses.  Clothes, plates, utensils, tiaras, videos, etc.   It’s a racket.

We discovered that Pocahontas (yes, she’s an official Disney Princess.  Don’t fight it) was hanging out over by the Pirates of the Caribbean.  We clasped hands and booked it!  We were dodging and weaving through the mass of people … and, there she was.  We froze.  Oh my goodness.  She squeezed my hand.  She looked up at me.

Pocahontas ‘on stage’ for my daughter (and son)

There were a few girls in line to meet the princess and take a picture beside her.  My daughter couldn’t move.  She was too scared.  I leaned down and gave her some encouragement.  I promised her she could do it and that I’d take a picture for her.  I told her how sweet Pocahontas is …

She gradually made it to the line and expectantly stared forward.  Finally, her turn.  The Indian Princess greeted her, put her arm around her (and my son who was pretty oblivious to the whole coming of age moment for his bigger sister) and posed for the picture.  The princess asked my daughter’s name and thanked her for meeting her.

My daughter rushed to me and I showed her the picture.  We walked away holding hands and I knew what she was thinking … ‘my dad is the best dad in the whole world!’  Ok, maybe not.  She was probably marveling at her luck to meet the real Pocahontas.

[end of story]

Now, what in the world does that have to do with quality care in a nursing home?  In fact, it is helps me show one of the most important aspects of providing great care … that all of us in a SNF are always ‘on stage’ …

Can you imagine if Pocahontas acted like some of our staff?

Right after I take the photo, Princess P comments to another Disney employee (character)

‘Man, can you believe it?  Snow White called off AGAIN!  I’ve got to go be Snow White tonight.’ OR …

‘There’s too many visitors today.’  OR …

‘I’m going on break.’

Do you see the comparison?  How many times have our residents overheard something similar?

I’ll share a secret with you now … as long as you don’t share it with the wrong people (like my little girl).  Pocahontas is not real.  She’s an employee of Disneyland. Each of us is “on stage.”  Just as Pocahontas was/is.  While on stage, we have to act a certain way.   The little girl would not put up with that.  We are each Pocahontas for our residents.  We must act, speak, and look a certain way while on the floor/stage.  It’s up to us to DEFINE what is expected in terms of our actions, words, and appearance.  If you don’t define it how can you achieve it?

Of course, on those bad days that we all have, we have to “act” a little more than on the good days.  (Here’s a classic video I use to demonstrate this).  Nevertheless, we’ve got to make each resident/visitor interaction count with EVERYONE.

2 Questions

If you’re looking to transform your facility’s culture, 2 questions will turbo charge the change … regardless of where you’re trying to take your organization.  Training your staff (and rewarding and holding them accountable) to consistently ask these 2 questions will have an IMMEDIATE impact on your residents, patients, and outside community … guaranteed!

The impact of training your entire staff to ask these 2 questions CONSISTENTLY will yield the following results:

  • Improved resident/patient satisfaction
  • Reduced call lights
  • Reduced call light wait time
  • Prevented accidents
  • Increased Census

It’s a win-win and a no-brainer.  2 Questions to turbo charge your culture change efforts.  Good luck!

I [Heart] Hotwire

So what do leaders in long-term care have to learn from Hotwire?  I just found out during my trip to Texas.  I went to Texas (Dallas & Houston) to introduce our company to 2 skilled nursing facilities that we were about to acquire (another post on those culture integration/introduction meetings later).  My flights were booked for me correctly and I booked my hotel/car weeks later, the day before the trip.  I got my cities mixed up.  I landed in Dallas and started walking to the car rental and then suddenly had a flash of panic hit me when I realized that I’m supposed to continue on to Houston.  I looked at my itinerary and discovered that, luckily, my next flight was in 30 minutes.  I rushed to the other terminal.  I had about 15 minutes before boarding.  I called Hotwire.

I explained my situation.  I admitted that I made the mistake when I booked the hotel & car for the wrong cities.  What are my options?

  • ‘No problem, Mr. Sedgwick, I can take care of that.’
  • How so?
  • With your permission I’ll cancel your reservations, book your hotel & car for the correct dates and cities, and waive the reservation cancellation fee.
  • So … this isn’t going to cost me any penalty or fee?  You’ll just make it right for me?
  • Yes.  You’re a loyal customer of ours and we’d like to keep it that way.

She did.  I am.  And, you should be too.  Does travelocity, orbitz, expedia, etc. treat you like that?  I don’t know … and, I have no interest or intention to find out.  I’m Hotwired for life.

How does that relate to healthcare?  One of the main problems with long-term care approaches to customer service is that, systemically speaking, our policies are usually drafted to reflect or agree with the regulations.  So, we end up with very cold guidelines.  Have you heard this exchange?

  • My mom lost her earrings.
  • When?
  • I don’t know.  I can’t find them anywhere.  They were expensive.
  • Were they on the inventory list?
  • I don’t know.
  • Well, I’m afraid if they’re not on the list, we can’t do anything about it.

The saying of stepping over dollars to pick up pennies also applies.  The reality of these types of breakdowns is that it’s usually the facility’s fault.  What an opportunity to exceed expectations!  Where customer satisfaction is involved, the regulations come no where near a guideline.  Rather, asking the simple question, ‘how would I hope to be treated?’ is all the guideline you need.  Follow it.  Always.  You’ll turn around digruntled, distressed, disapointed customers and build loyalty and promoters.

Just like that one guy who became so loyal to Hotwire, he dedicated a blog post to sing their praises …

Honesty, Humility, & Domino’s Pizza

We’ve all had those moments when a truly unhappy, disappointed, angry customer lets us have it. Many of you run operations that have poor reputations (earned over the years one unsatisfied patient/resident at a time). How do shake the bad rep? How do you deal with the consistently negative feedback? Domino’s Pizza demonstrates some keys to taking the criticism, owning up to it, empowering their people to fix it, and inviting the customer into the solution.

Some key takeaways:

  1. Listen to the criticism
  2. Own up to it
  3. Empower your best people to solve it
  4. Invite the customer in on the solution

Because our daily plates are so full (pardon the Pizza pun), we often see complaints as To Do items.  We see our dealing with them (ie, calling back the complainer) as things we have check off a list.  I assume that’s how Domino’s treated the complaint about cardboard crust for years.  “Someone write this guy back.”  I’m not sure what woke them up to just how bad the problem is, but I assume it was the numbers.  Is it safe to assume that their numbers finally caught up to their poor quality?

The wisdom, of course, is to recognize that for every 1 complaint there are 10+ more people who feel the same way.  Let’s act with more urgency to see the complaints not as isolated incidents but as a choice EXCUSE to own up to our systemic deficiencies, empower our best people to solve it, and to invite our residents and patients in on the solution.

What Domino’s did here makes me want to try their pizza again.  I’m a straight Pepperoni guy myself.