Attitude Adjustment

How to boost the morale and profitability of your department one person at a time

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Behavior Standards Sample for Radiology Departments

__I will call the patient by his or her full name.
__I will introduce myself by my full name.
__I will mention my years of experience.
__I will check and confirm the patient's ID.
__I will explain the exam including the number of films required.
__I will explain the pain or discomfort that is expected.
__I will take the patient's detailed history.
__I will check the films and explain how long

it will be until they return.

When returning from processing films:
__I will state how long it will be before the results will be available.
__I will ask the patient if he or she has any questions.
__I will give the patient my business card.
__I will mention the survey and use key word(s).
__I will walk the patient to the dressing room.
__I will thank the patient for choosing __________ Medical Center.
__I will ask the patient if he or she knows where to go next.
__I will offer to walk the patient to his or her next destination.

Technologist:
__I will display a positive attitude.
__I will explain each step during the exam.
__I will ask if the patient has any questions during or after the exam.
__I will ask the patient if he or she had a lengthy wait and use key word(s).
__I will, if applicable, initiate service recovery.
__I will talk and listen to the patient by showing concern and/or making conversation.
__I will make eye contact with the patient.
__I will offer the patient a blanket and make sure the patient is comfortable.

My signature below indicates that I have been given a copy of the standards of behavior. I will try to uphold these standards to the best of my ability.

Name: ____________________________

Date: ____________________________

One copy to employee. Second copy signed and filed with HR.

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Employees want to be treated fairly and have a say in shaping their work environment. Patients and physicians want consistency. I think we can all agree with these statements. They are universal truths in the healthcare industry (probably the workplace in general), and they certainly apply to radiology departments and practices. Yet, they're not the norm in most facilities around the country.

It stands to reason that there are "bottom-line" benefits to making all of these statements a reality in your practice or department. But how can you achieve this goal? Let me share three little words: standards of behavior. I frequently suggest to my healthcare clients that they develop a standards of behavior contract and have everyone, from practice or department manager to receptionist, sign it. This document covers any and all aspects of behavior at work: from interaction with patients to phone etiquette and "good manners" when making requests of co-workers to "positive attitude" markers like smiling or saying "thank you." And yes, when taken seriously and adhered to faithfully, it achieves all three of the statements that kick off this article.

You'll see I have included a "sample" standards of behavior document. You may think it looks too simplistic to be effective, but ask yourself if you and your co-workers regularly and consistently follow these guidelines. If you're honest, you'll have to admit that some people in your practice or department – perhaps even you – fall short of these ideals. If everyone's signature were affixed to a similar document, wouldn't everyone be far more likely to at least try to behave in ways consistent with organizational standards and aligned with desired outcomes?

I think they would. Actually, I know they would. I have seen firsthand how standards of behavior contracts work. And they are powerful, indeed.

So how do you go about creating your own contract? It's not rocket science, especially for a small practice or department. First, get someone or a team to spearhead the project. Then, follow these simple steps:

Phase 1. Talk to all employees. Ask what they want in their work environment. When people identify the specific behaviors that make for a desirable workplace, buy-in happens up front and life becomes better for everybody.

Phase 2. Listen to your patients. Fold in the desired behaviors identified in patient satisfaction surveys. How do your patients define good service? What specific behaviors will ensure that they walk out of your practice or department believing they received great care? By putting the answers to these questions into your standards of behavior contract, you are committing to "live your mission" for excellent patient care.

Phase 3. Seek input from radiologists and medical staff. Ask physicians questions like, "What standards do you want to see in order to be satisfied? How should we report back to you? When should we report back to you? What can we do to reduce the number of "no shows"? By getting these questions answered and incorporating the results of your answers into your standards of behavior contract, you create conditions that ensure patients show up well prepared for procedures.

Phase 4. Finalize the document and collect signatures. Because everyone signing the standards of behavior had a hand in creating it, they generally won't balk. (If they do, there are bigger issues involved than signing a contract, and the supervisor can take this opportunity to address them.) Finally, require prospective employees to sign the document before they even get an application.

Soft Core or Solid Strategy?

Some people may consider issues like teamwork and good manners to be "soft" in nature, but this is not true. The workplace environment has everything to do with profitability. Think about it: Problematic employees in a radiology facility can send morale plunging, create a high turnover rate, lead to poor patient care and make no-shows more likely. Any and all of these problems will result in lost revenue.

You see, crafting and implementing your own standards of behavior contract is not a soft issue but a solid financial tactic. It just makes good business sense. That alone is reason enough to do it, and when you end up with an environment that's pleasant, professional and aligned with your mission to provide excellent care, that's just icing on the cake.

Boost Morale Now

Want to create your own standards of behavior contract? Here are some guidelines guaranteed to get your department started on the right path.

Align desired behaviors with corporate goals and desired outcomes. Before you start writing, take a look at your organization's long-term goals and areas that need improvement. Make sure the content of your standards of behavior supports and promotes these outcomes. This is especially relevant in healthcare settings, where staff performance is constantly measured and rated by patients. If your department wants to improve its ratings in a certain area – say, patient perception of care – it will include carefully crafted "key words at key times" as a part of its standards of behavior. When everyone begins to use these words consistently, ratings will improve. In radiology there are several key words and actions that have been effective in demonstrating concern for patients:

• Explain whether or not the procedure will hurt – reassure and put the patient at ease.
• Share with the patient your years of experience and professional licensing.
• Always ask if the patient has any questions before starting the procedure.
• Provide the patient with time expectation for the procedure. Include how long it will take, when the procedure will begin and how the physician will receive the results.
• Continue to explain each step during the procedure.
  

Review other organizations' standards of behavior. If you're having trouble getting started, find copies of such documents used by other organizations. Even if you decide that some of the standards aren't relevant to your practice or department, it will give you a good "jumping off" point.

Be crystal clear and very specific in your wording. Don't write "Display a positive attitude." Do write "Smile, make eye contact and greet patients by name." Don't worry about insulting people's intelligence. Sometimes people really, truly don't know what is appropriate behavior and what is not. For instance, if you don't want common "slang" phrases used with customers, you need to identify them up front. One standards of behavior document created by a client of mine contains the phone etiquette directive: Avoid phrases like "OK," "yeah," "hold on," "honey" and "see ya."

Hold a ceremonial standards of behavior "roll out." Once you have finalized your document, it's time to implement the plan. Hold a meeting to introduce the standards and distribute pledges for everyone to sign. You may even hold activities designed to educate employees about some of the points. Make it fun, but make sure everyone signs a pledge. It's amazing how much more seriously people take rules when they've signed on the dotted line.

Hold people accountable when they violate a standard. Make sure all employees know they'll be held accountable for the behaviors outlined in the standards of behavior document. Then, just do it. How you hold them accountable is up to you. Sometimes a simple meeting in which you show an employee the signed pledge and point out his error is sufficient. Other times, you might need to write him up or take more drastic disciplinary measures. But one thing is clear: the standards of behavior pledge gives you something to hold people accountable to. That's important.

Create a designated "Standard of the Month." Every month, highlight a specific standard. This will boost awareness of the standards in general and will get people thinking about how that specific one applies to their daily lives. Let's say, for example, that you decide to focus on your policy for dealing with disgruntled patients. At the beginning of the month you might send out a "reminder" e-mail detailing the policy. Next, you might ask employees to write up real-life or hypothetical scenarios in which they must deal with angry or dissatisfied patients. Finally, you might hold a companywide forum in which you recruit people to "act out" both sides of a conflict: the disgruntled patient and the employee trying to soothe her. Not only is this fun and often hilarious, it can be a valuable learning tool, as it forces people to see both sides of an issue.

Update the standards of behavior. The standards shouldn't be carved in stone or preserved behind glass, never to be touched again. As time goes by, you may see that one or two directives are not working and need to be changed. You may also discover new standards that need to be added as your organization grows and evolves in new directions. Make changes as necessary. Your standards of behavior should be a "living document" that serves your practice or department, not the other way around.

Have new applicants sign it up front. Before you even interview prospective new employees, have them read and sign your standards of behavior. You will be able to eliminate people from the race up front if they visibly balk at conforming to your corporate culture. But more importantly, when you do hire someone, there will be no doubt in his mind what you expect of him. If he is going to have trouble meeting your standards, you will probably know during the initial "probationary" period.

Expect to see positive changes in employee performance. Just knowing that a standards of behavior document exists – and knowing that their signature is affixed to a pledge to uphold it – is enough to keep average employees on their toes. It creates an extra boost of awareness that really does affect day-to-day behavior. Best of all, it functions as a tidal pull on lower-performing employees. The document forces people to do their best, to be their best. If low performers don't move up, the division between them and the high performers becomes a chasm. Then, it's easier to deal with them.

Bring the standards to life. It is important for employees to see the standards in practice and to connect employees' behavior to them. One way to facilitate this process is to have the department leaders begin each department meeting by sharing a moment when an employee did a good job in living the standards. Some leaders even start department meetings by having each employee share how another employee lived the standards of performance.

Another effective way to facilitate the process is to review patient survey comments from the survey tool. Highlight top performance when the standards were adhered to and review low patient ratings when the standards were not met. When leaders are rounding for outcomes in their departments, they need to be looking for employees who live the standards and provide on-the-spot reward and recognition.

— Quint Studer is a former hospital president, 20-year healthcare veteran and founder/CEO of Studer Group (www.studergroup.com), headquartered in Gulf Breeze, Fla. An executive coaching firm and national learning lab, Studer Group is devoted to teaching tools and processes that organizations use to achieve sustained focus on service and operational excellence. Questions and comments can be directed to editorial@rt-image.com.