Is that "million dollar smile" really worth a million bucks? Now it may be.

 “Just The Facts” research insight series

From time to time we will use the "daily pulse” blog space to share insights about healthcare working and workplaces with our community.  Today’s post is dedicated to healthcare workers and how this impacts the quality of your care.  If you happen to land in the hospital or urgent care, these are workers upon whom you depend for treatment, care and handling and well-being.  Sometimes your very life depends on their care and their “engagement” with their work.

"When that “million-dollar smile” from your nurse or healthcare worker can really mean a million dollars"

Hospitals and healthcare delivery organizations have long since been “local” one-off affairs, with long-term workers and friendly, familiar workers (many of whom may have been your neighbors).  Sadly, these organizations have consolidated, the healthcare system has expanded, and these are now outposts of extremely large and complicated corporations. 

This is not to say that the great folks who dedicate their time to treatment and care of others are not wonderful.  This is simply to suggest that life “inside” of a huge healthcare organization is no longer simple, nor is it free from many conflicting priorities, complex paperwork procedures and legal mandates…. Which all contributes to a sometimes frustrating working environment, to say the least.   And this is what you walk-into when you are ill or injured.

Is “attitude” and “engagement” and workplace happiness relevant to healthcare delivery quality?

Yes it is.  That grumpy front desk receptionist, or that grouchy advice nurse can really do damage.  Similarly, that angelic nurse practitioner or on-duty physician’s assistant can turn disaster into “problem solved” for patients.  It’s that important.  Traditionally that has been the concern of marketing and "brand" chiefs at hospitals and healthcare organization.  It is still very important in the new hyper-competitive era.  Just listen to drive-time radio and you can hear at least two or three healthcare systems in your region battling it out for the loyalty and hearts and minds of consumers.  The "brand" war (for patient loyalty) has been raging for some time. 

But something else has happened in the last 18 months.  It's all about the impact of quality on the “bottom line” in terms of finances.

Research clearly shows that workplace happiness can affect the bottom line of most enterprises.   As we said, hospitals and healthcare delivery facilities are now large enterprises.

Until now, it has always been more anecdotal to say that engagement also affects the business top line or bottom line. Whether you agree or disagree with what is known as “healthcare reform” (The Affordable Care Act), there are new rules inside that act that have changed this equation forever for healthcare organizations.  

This is completely separate from what kind of policy an individual may purchase. It's all about the focus on the hospital, clinic, skilled nursing facility, long-term care or other "delivery" point in healthcare that touches patients.  And the rules are already being enforced.

For the first time ever, patient care, and the level of quality they report (patients) will directly impact the reimbursement (payment) received by healthcare delivery organizations.  This is such a dramatic change we’ll say it again:  The healthcare organizations with above-average patient satisfaction and other quality scores will stand to earn more money, and those with below-average patient satisfaction scores will earn less.  Much less.

A whole lot of healthcare industry administrators just got a new metric, and they now share it with their CEO, CFO and Board of Directors.

Let’s now connect the dots.  Happy workers result in happier “customers” and a higher level of satisfaction.  Happy workers = happy customers (patients) = more revenue / earnings to healthcare organizations.  Unhappy workers = unhappy customers (patients) = less revenue/ earnings to healthcare organizations.  And this is more than pride.  This is a matter of millions of dollars per institution.

How this new “carrot and stick” concept works:

Through the Affordable Care Act that is now in force, Medicare’s reimbursements to hospitals will be partially dependent on patient satisfaction scores, including bonuses that will be paid to the hospitals that show the highest rates of patient satisfaction.  The “winning” hospitals will be determined based on patient satisfaction surveys.  Patients will rate how well their doctors and nurses communicated with them, how responsive hospital personnel were to the patients’ needs, how clean and quiet the hospital was, how well their pain was managed, even how accurate and easy-to understand the accounting and billing was.  

Again, this component of healthcare reform is not subject to "repeal" or the area of controversy in the political arena.  "Both sides" of the aisle have agreed to these terms.  So it can't be "wished away" or "ignored." 

All of a sudden this “happy workers = happy patients” is of central focus.  While we suggest that most great healthcare organizations have always put “happy patients” and superior patient care at the top of their priority list, this gives the entire topic a new and super-charged level of importance.

Worker satisfaction and happiness is a leading indicator for patient satisfaction and thus a leading indicator for financial performance and reimbursement trends at these organizations.  It won't stop at Medicare reimbursements.  The industry's payer community (the organizations including HMOs, Insurance companies, et al) will shortly follow in lock-step, once the Medicare standards and metrics are in existence for a sufficient period that they can be referenced as defensible "government standards."  This may be only a matter of several years.  

So what this means is that every reimbursement from every patient interaction or treatment will be subject to an "adjustment" factor.  This is an annual multi-billion dollar impact.  Measurements (and adjustments) will be made annually.

Can you “track” and “manage” worker happiness with an annual or Quarterly survey?  It’s possible, but as sailors know, making frequent, small adjustments to direction is much better than discovering you are hundreds of miles off-course after a few days or weeks between measurements.  The same applies to worker satisfaction and happiness measures.  Daily polling, using simple, short (and even fun) reporting experiences, will give everyone a much better read of (pardon the medical pun) the “pulse” of the organization’s happiness.  With such an early warning (or affirmation), it’s much simpler and easier to alter course, or do more of what’s working.  It’s just common sense.

WorkersCount's services called "NursesCount" and "PatientCount" (and others) are examples of such a daily service—and they provides the daily “pulse” of the organization’s worker satisfaction and happiness, as well as patient satisfaction.  Using a fun, simple mobile experience, the NursesCount service enables caregiver teams to “check-in” multiple times in a day (or just once if they wish), and make their voices heard.  If they’re excited about work, it shows.  If they’re frustrated, that also shows.  All anonymously and safely.  Games that reward users for prompt regular check-ins and other fun interactive features keep it light and engaging.  Users are in-and-out in under 30 seconds…. So they can get back to their work providing amazing care to patients!

Here is an example of a NursesCount check-in screen.  Just 2 radio buttons and no typing.  A simple “how do you feel about your life at work today?” and a single “question of the day.”  That’s it.

For patients, its just as simple.  During "rounding" (visits from caregiver teams), the patients are handed a tablet and provide feedback in a similar, 30-second experience with four simple questions.  A constant question ("how is your hospital stay going so far?") and three rotating questions below it (one about the caregiver team, the other about the environment, the other about their care plan).  Like NursesCount, it is private, anonymous and fun.  Patients love giving feedback this way.  For outpatient and ambulatory services (like urgent care and walk-in procedures) the patients use a tablet-based check-out podium that provides them the same level of feedback, anonymously and privately in 30 seconds on their way out the door.

This provides the first single view of service quality and engagement across the entire healthcare organization.  Most importantly it is the only real-time service of its kind.  This provides a unique daily view for leadership, that can be used as a real management system.

How can we help healthcare delivery organizations manage this on a wide-scale basis?  Simple again.  We provide dashboards, alerts and reports that display just this type of “early warning” or “confirmation” of great results.  It’s kind of like a blend between an “early warning system” and a “magic mirror into the future.” 

Here is one look at a dashboard:

All of this from two radio-button questions per day per caregiver, and four from patients.  

In summary, there is no better way to measure worker happiness and satisfaction than walking around and watching and listening and engaging with workers.  But this is difficult to do on a daily basis in today’s reality.  One tool to keep an eye on the “pulse” of the workforce is the NursesCount service.  And there's no better way to discover patient sentiment and satisfaction than while they're right in the hospital or clinic, and the experience is real-time.  This is what PatientCount is doing.

In the context of the new healthcare reform Act and the “carrot and stick” consequences, this kind of inexpensive, fun (did we mention games and rewards for participation etc?) and simple engagement measurement is a no-brainer, in terms of “diagnostics” and “prognosis” for a healthcare organization’s financial performance and worker happiness level.

The next time a healthcare worker gives you a million-dollar smile, a pat on the shoulder and a kind word, remember that, in fact, it could very well be a million-dollar smile if that’s what you walk away wearing as well.

What is your view on this topic?

Let us know what you think below:

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3 responses
Very interesting perspective. While I know, work, study, and teach all about healthcare providers well-being and how it impacts patient care- I loved the writing in this post and the fact that the article is sharing this information with the consumer. So fascinating. I definitely agree with healthy healthcare providers equals better care and more satisfied patients. Just last night I was on a call with a client who spoke about how she tried in the last week to smile at every single co-worker. Whether it was leaving after an exhausting night shift or entering (and not really wanting to be there) work at 7 pm, she walked by and greeted everyone with a smile. What she found was that she not only received smiles back from everyone she passed, but she felt better before, during, and after each shift. Some of the stress didn't phase her as much. Happier workers equal smoother, safer, and more caring shifts! Thanks for sharing this piece.
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