Ask Chuck: This CEO's health system merged 2 years ago — but he still hears 'us v. them' comments from staff


What's the route to systemness? Hit a home run on customer service.

Editor's note: This is a regular feature in which Charles Lauer, the former publisher of Modern Healthcare magazine and now a consultant and public speaker, takes readers' questions/challenges and answers them with a column. To submit a question or topic, email Unless you specifically give permission, your name and any identifying information will be kept confidential.


Dear Chuck: Nearly three years ago, my health system merged with another system in our market. Both organizations had a track record of strong performances and a long history of serving our patients and community. Both legacy organizations' cultures and missions were similar. We developed and communicated a common vision, strategic plan, balanced scorecard, board, executive team and brand. However, we still occasionally hear "we/they" comments, particularly among the longer-tenured staff. What suggestions can you provide in addition to what we have implemented so that we can accelerate our common culture?

Of course, there is so much you can do. Staff retreats, executive rounding and public relations campaigns are just a few strategies. Given the nature of your situation, however, one answer springs to mind: customer service (also known as: patient satisfaction!).

A shared service project with a defined objective across the enterprise is a great way to enhance the feeling of "systemness." The goal could be ambitious, such as reaching the 99th percentile on HCAHPS or Press Ganey scores nationwide, or it could be to lead your local or regional markets in patient satisfaction. Make the goal something worthy, and alert your hospitals that they are on the hook for raising their scores. You may even want to create a kind of friendly competition, with a significant prize or recognition for the hospital with the highest scores or the biggest improvement.

After all, patient satisfaction is a significant component of CMS' Hospital Compare rankings. HCAHPS scores pop up when you search for a hospital on Google or Yahoo. The scores also are a major component of CMS' Value-Based Purchasing Program, so they are tied to reimbursement. And it has been proven that patient perceptions of quality of care closely mirror the actual quality delivered.

So how do you achieve your goals?

  • It all starts with you! As the top executive, how you frame this initiative will let your staff know the priority this should be given and how much effort to put forth. Have an all-staff meeting, including video for those unable to attend in person, to announce the program. However, if all you do is make a big initial splash and then go back to the C-suite, I guarantee it will fail. You have to persuade the staff that a really first-rate customer service program requires total commitment to succeed. You have to follow through by seeking updates at every executive meeting and going out to meet with staff at every opportunity.
  • Raise awareness through posters and looped video of the importance of the patient experience. Bring patients into the mix by making the awareness campaign public. Create hospital customer services committees made up of doctors, nurses, nurses' assistants, front desk staff, billing, security, environmental services and, yes, patients to oversee the campaigns at each facility.
  • You have to be willing to train your staff on the nuances of good customer service practices and why they are so important to every patient in the hospital. This can be as simple as guidance on how to make good eye contact or as complex as how to show (and feel) empathy by listening to the patient describe their desires and needs. Patient care is the ultimate purpose for the hospital, so act like it! Too often many staffers feel that the needs of the patients are an interruption of their workday and not the purpose of it. The difference is critical!
  • Smiles are important. People are in hospitals as patients because they are in need. No one really wants to be there and therefore a patient feels resentment from the very beginning of the stay. Having someone smile at them can have a very positive effect on a patient's attitude.
  • Valet parking is a marvelous idea for improving customer service. Looking for a parking spot when you are nervous or worried or not feeling well is disconcerting to say the least. Here is a radical notion: Valet parking should be free for anyone coming to the hospital! Parking shouldn't be a way to enhance revenue; it should be a way to welcome people and put them at ease. I guarantee you this expense will pay off hugely in terms of public perception of your institution.

So there it is, my friend, a low-hanging fruit for improving a sense of shared mission, a way to improve your revenue and public perception and a way to enhance patient care. I think it's called a home run!

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