How to talk to clinicians: Part I

I had just arrived in a Home Health agency that was struggling in many areas (fiscal, census, productivity, etc.), but staff satisfaction and retention was particularly problematic. The Director of Clinical Services (DCS) gave me quick tour of the central office. On the bulletin board in the break room I saw a posting that stopped me in my tracks. It had the current average HHRG score (in dollars!) and the goal for the dollar amount the DCS was shooting for.  “If they meet the target they get a shaved ice machine for the office,” the DCS excitedly explained, while I silently screamed inside.

Setting aside the obvious ethical and regulatory nightmare here, this DCS was also demonstrating a perfect example of how NOT to talk to clinicians and support teams. In part one of a three-part series we’re going to briefly introduce two effective strategies for training and motivating staff in any health care setting: 1. Always remember why your staff are working where they are. 2. Train to develop elite teams.

These strategies are informed by lessons learned from what over 50 years of research has taught us about what really motivates employees.

Why are they here? College Nursing and Allied Health programs have become incredibly competitive. The GPA requirements are as high, or even higher in some cases, than what’s required to apply for some Med Schools! Our clinicians have lots of other career options – many of which would have been much more lucrative and less stressful. They chose this path because they want to help people. If we tie our messaging in with this altruistic motivation it increases confidence in the organization and leadership, improves engagement and, most importantly, it works!

One study showed changing signs in a hospital from “Hand hygiene prevents you from catching diseases” to “Hand hygiene prevents patients from catching diseases” increased hand washing compliance 33%! Our clinicians and support teams care deeply about our clients and want to help them. In fact, that’s why got into health care and why they stay, despite the ever-increasing demands piled on them.

It is an inescapable fact that health care in the United States is a (big) business. There is no denying that. If we don’t watch the bottom line, our organization will not be around to serve our clients, and our staff should understand that reality. However, improving the quality of care is the only real way to gain a competitive advantage in the marketplace, improve reimbursement, achieve compliance… all the factors that effect the bottom line!

Train to create elite teams. Humans are social creatures and we need a sense of belonging. Simply put, we want to be part of a team. And we really are motivated when we feel we are a part of a highly successful team. I’ve been in health care a long time and have seen many examples of individual and team success. I don’t think I’ve ever seen as much enthusiasm in the workplace as I have the few times I’ve been in the room as a team received the news they had earned a deficiency-free Survey. This is a rare accomplishment that really makes teams feel they are in the top tier.

I’ve worked with hospital systems all over the country and the “Life Flight” (or watever they are called in your area) teams often take on almost mythical status. They usually have a very competitive selection process, rigorous training and are regarded as the “best of the best.” They have the cool uniforms, gear, logos and branding. I was at a hospital event once and they were giving out baseball-style trading cards with each of the team members on them – some kids even asked them to sign the cards! These flight crews work long and undesirable hours, routinely see horrific tragedies and have very stressful working conditions, but they usually report a very high level of satisfaction with their jobs.

We can’t all ride in the helicopter, but we all need to constantly build team identity and cohesiveness – and it helps to be unique and special. I’ve had great success, for example, having teams pick colors and mascots like athletic teams. Collective goals are often more effective than individual goals.

Our organizational culture should aim to be the best in the industry and we should reinforce this goal with our messaging and daily interactions. In fact, we should start in the hiring process. The hiring process should be rigorous and thorough, and we should clearly state our high expectations from the encounter on. Staff are motivated as much by what we expect of them as what we will do for them.

Trust the research. Despite over five decades of research, most of us are all still stuck on now disproven methods of motivation (definitely confessing my guilt, here). Rewards, bonuses, “if/then” incentives, carrots and sticks… all of these myths of motivation have been proven not only ineffective, but they often actually decrease employee performance and engagement. So, what does the research – and the example of the most successful companies – tell us really works? Author Daniel Pink in his brilliant book “Drive” summarizes the findings into three main factors: autonomy, mastery and purpose. Autonomy in healthcare is a massive challenge and opportunity too complicated for the space available here (stay tuned).

The two strategies mentioned above are strong tools in helping our people feed their need for mastery and purpose. There is much more to consider regarding staff communications and training, but these two approaches can be transformative and epic in and of themselves. As if that’s not enough, reconnecting with our passions and developing elite teams also makes for a really, really fun work environments.

References

Patients’ Health Motivates Workers To Wash Their Hands

https://www.psychologicalscience.org/news/releases/patients-health-motivates-workers-to-wash-their-hands.html

Doctor Mike Evans’ “Med School for The Public” YouTube channel

https://www.youtube.com/user/DocMikeEvans

Improving The Patients’ Experience

http://www.stmichaelshospital.com/pdf/quality/QIP-2017-18.pdf

Drive. The Surprising truth about What Motivates Us

By Daniel H. Pink

http://www.powells.com/book/-9781594484803

TED Talk: The puzzle of motivation.

https://www.ted.com/talks/dan_pink_on_motivation/transcript

A Motivation Expert Explains Why Businesses Go About Motivating People All Wrong – And How To Do It Better

https://www.businessinsider.com/dan-pink-businesses-motivate-people-all-wrong-2017-1#according-to-pink-the-way-businesses-motivate-people-to-solve-those-problems-is-completely-misguided-they-rely-on-incentives-like-bonuses-perks-and-free-stuff-while-all-the-science-suggests-those-dont-work-4

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