Recently I trained the Food and Nutrition team at a hospital in New York State. As we mapped out each staff interaction with the average inpatient, it was amazing to see how many times they had an opportunity to impact the patient experience. Looking at the touchpoint map, a huge epiphany arose - This Food and Nutrition team actually interacts more consistentlywith the average patient than any other one employee in the hospital - perhaps even nurses - so shame on us if we do not form a relationship with them! Realizing this, I asked, “Do the people who deliver food in your hospital know they are a part of the care team?” “Well, doesn’t the food you serve provide a level of comfort for most patients? Does a good meal, served by a warm, friendly employee, have an impact on the patients ability to relax and sleep? Does nutrition and sleep contribute to their overall healing experience? Does great comfort food go a long way in making the patient feel better?” “Definitely!” “Do your employees know they have that level of impact? Is that communicated to them on an ongoing basis?” “... No.” Most of the Food and Nutrition employees who interact with patients are called “Tray Passers;” that is their title, and that is their job task, to pass food trays to the patient. But considering how often they interact with patients, is that their role in the healing experience? When I worked for Disney’s Epcot Center theme park, we worked to change two employee job titles to more accurately reflect their role in the customer experience as opposed to just their job tasks. These positions were Ticket Seller and Ticket Taker. The Ticket Seller was doing just that, selling theme park tickets for exactly what guests asked for (“Four 5-day passes, please.”). But at Disney, it’s much more than that. They needed to help guests plan vacations, not just sell tickets. Staff needed to provide expert advice on how many days to play at the parks, and perhaps even recommend a day off at a water park or by the pool to relax - thus, “Ticket Sellers” became “Disney Vacation Planners”. Their job tasks still included selling theme park tickets, but their role in the guest experience is to help families create magical Disney memories (not just generate maximum revenue). Many times the Disney Ticket Takers at the front gate of each park are the visiting guests’ very first touchpoint - they set the tone for each guest experience. Sure, they take your ticket, but we needed to challenge them to create an “awesome arrivals” for each and every family. They could do this by welcoming you to the park, complimenting your Mickey Mouse shirt, and congratulating your daughter who’s wearing a “happy birthday” pin. At the end of the day, we wanted to create, “Fond Farewells” by asking staff to thank you for visiting Walt Disney World, ask if you had a great day, and remind you to buckle up, drive safely, and return to us soon. This team was also our last line of defense for service recovery. Because of this, we change their job title from “Ticket Takers” to “Official Walt Disney World Greeters”. This is what we’re trying to do with Hospital Tray Passers. They don’t just deliver food trays to a “frequent faller in room 402,” they provide sustenance to Mrs. Smith and her daughter, Judy, in room 402. Their food enables the healing process. They are essential in creating a comfortable and caring environment for patients. They are a part of the care team. At the end of the day they should proudly say, “We provide food that heals,” not “We just pass trays!”“What do you mean?”
Friday, April 18, 2008
Elevating Job Tasks to Include Job Roles:
"We Provide Food That Heals"
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14 comments:
Great article! They are truly “Soul Food Couriers”! In creating the experience we must teach and demonstrate that hospitality is about “how the person receiving the service feels and also about how the person providing the service feels” about the relationship experience!
Robert Harris, FACHE
Assistant Vice Chancellor
Chief Ambulatory Officer
University of Arkansas for Medical Sciences
I think you are on the right track, Jake. As the president of a catering company I struggle with this every day as it is difficult to find a way to show value how each role impacts the overall customer experience. This is a great example of how to raise the morale of a team that may think poorly of themselves and perhaps is underappreciated by the other "more important positions".
Warren Dietel
President
Puff 'n Stuff Catering
Thank you for sharing. This is AWESOME! I think it's great how you truly are applying the Disney-style of business and making such an impact in an area that needs so much improvement. There is such a need to add that important factor to this service industry: compassion plus respect as a human being and just the fact of being listen to -- hospitality at its best.
The most important factor that is so necessary is making everyone involved a participant and accountable for the success of a total process -the healing process of a patient --so true it's just not the nurses or doctors that have an impact.
Congrats! This is wonderful work --humanizing the process of healing.
Cris Novoa
Research Specialist
Walt Disney World Research
This is great Jake. But you made we want to know what the new name for the food tray passers would be.
Here at Blue Ridge HealthCare, we call all employees Care Team Members, but even that doesn’t get at the specific contribution the “food tray passers” make, or does it? Should there by another job title for that group? Should we think about that for every role on the care team? Or is “Care Team Member” good enough?
These are the questions your article made me think of. And in that regard, it was a great article…made me question my own performance and process. If your whole book has that effect, I think you’ll have a business best seller!
David Crouch
Director of Organizational Development
Blue Ridge HealthCare
David,
Thank you for the nice comments.
We may just borrow the new title from Robert Harris at the University of Arkansas for Medical Sciences. See his comment above, "They are truly 'Soul Food Couriers!'" I will keep you posted on the actual title if my client approves I can share it with you.
Jake this is very good blog.
The Press Ganey Patient Satisfaction Survey helps us understands that Meals are a critical element of the patient experience. As a result they include Meals in their Inpatient Survey that patients receive approx. 2 weeks after they are discharged from the hospital.
BUT... It's vital for Food Service or Meals Staff to understand the impact they make on patients.
In this article you do a good job of explaining the situation... but you are not explicit what you did..(i.e., what was the intervention used that will help Meals Staff improve their impact the patient experience?
I see you also created a department service theme ("WE SERVE FOOD THAT HEALS") but you are explicit about HOW you did that... also how about an explanation that it's staff job or role to bring this theme to life everyday... and they do this by... and then please explain the intervention.
Also would be helpful if you describe how this team you worked
with will measure their impact... maybe even state up front if they are a Press Ganey user what the raw score or percentile ranking was.
Good stuff... reads nice, I especially like the everyday Disney examples.
Jack Dunleavy
Lehigh Valley Hospital
Organizational Development
Jake, I love the blog and can't wait to read the book. You are right on with the team approach. I'm currently working on a project for transplant and they all have the same "team approach". The MD leader has a great line where he mentions that everyone on the team has the same goal, to take care of the patient. That includes the person that cleans the floors, the person that serves the food, etc.
I also love the part where you mention all of the factors that contribute to the overall healing experience. I truly believe that. And, the roles and titles of the employees need to be emphasized. Great stuff. It reminds me of a great quote from a Physician leader in the middle of our Katrina disaster....he said of the how we survived and thrived, "It's not just the Dr.'s or even the nurses, it's everybody."
Jackson Ellisor
Ochsner Health System
I love it!
Wouldn’t it be nice to change the name of hospital registration to hospital “greeters”? Have you checked the Association of Critical Care Nurses and the synergy model? It’s the team as a whole that contributes to creating a healthy, effective work environment. Everyone is responsible for the “magic moment”.
Thanks for sharing,
Terri Rudin RN, BS, CNOR(r)
Director, Continuing Education Center for Health Professions
Abrazo Health Care
Abrazo Institute
Phoenix, Arizona 85021
Jake – I really think this is awesome. If only we could let people to know just how important they/their job/their task are to our company, it would make a world of difference.
I have a couple positions in the shipping/receiving area that need to feel a part of the process. They are always tardy, out many times – which makes the process slow down or become sluggish – the supervisor doesn’t seem to be able to motivate them to greatness. The supervisor just hired a third person. The idea is to replace one of the two guys in the department, but let’s get this one trained first. I absolutely abhor this kind of ideology – I believe it ultimately destroys confidence in personnel and keeps them in fear of loosing their job, thus no motivation.
We recently had a celebration at the Country Club to celebrate first quarter victories during work hours – they were invited. I inquired of them whether or not they would be there. They let me know they were “hourly” and could not take off to attend the celebration. I encouraged them that everyone in the corporate office was invited, even the hourly employees and that they would be paid for those two hours. I asked them to let me know and I would clock them out so they would be paid. They didn’t show up for the event.
The next day I inquired about why they had not attended the event. They have a mentality that they are not important to the team, and yet, they are vital to our seminars and our deal team. Perhaps a title change would help? But then again I believe some of our management team looks down on the importance of the position and the people. They are quick to point out mistakes, but do not reward them for all the things they do without mistakes.
At an awards event in January - one of our employees was not present for his award. It was one of these guys from our shipping/receiving department. He didn’t attend because he “didn’t have a suit to wear to the event.” I’m not sure he was properly notified to be at the event. Afterward when I gave him the award, it didn’t seem to make a difference in his attitude toward the job, or the company.
Congratulations on writing your book. I have every confidence it will be a best seller!! Your message is much needed in the workplace.
M.P.
Major FInancial Institution in Texas
M.P:
Thanks for your heartfelt email. Ugggh! I feel bad for those two guys... I think we have all been there at one time or another. That manager is going to always have a revolving door if he/she doesn’t change the culture in that dept. I don’t think just changing their job title will change their behaviors or impact their pride level... the manager needs to change too!
Especially since they only hear from their manager when they do something WRONG!
Jake, Great stuff.
The silos in healthcare, not to mention the rampant hierarchical mindset (where Nurses are better than Nurse aides, nurse aids are better than food services, cleaning staff…etc), gets us all confused about the end goal – an exemplary experience created by a cast of characters – all of whom play a vital role.
Matt Turner
Leadership & Organizational Development
Carolinas Physicians Network
Carolinas HealthCare System
Nice. Great example of using what you did at Disney and relaying it to the hospital. One thing you might want to add for the tray passers is for them to mention to the patient any special precautions taken by the hospital.
For example, if the patient indicated they have a food allergy, then the person serving the food could indicate that the meal was prepared without that ingredient. That would put the patient at ease and enhance the patient experience.
Keep them coming.
Randy Buchnowski
Care Team Manager
University of Colorado Hospitals
Thanks for your comment, Randy.
The dietician does ask those questions when she/he rounds with patients, which the kitchen does get via the computer and prints out info to go with meal, BUT, BUT, BUT... does everyone on the team CONSISTENTLY verfify the food out loud as they uncover the food for the patient, verify the special request or allergy, and then say, “I hope you enjoy your meal”... HECK NO! But we are getting there!!!
Jack
You overwhelm me with your enthusiasm! Thank you for your O.D. perspective. Great questions….here are my answers:
1-Why did we start there?
This is just the first step with this particular hospital and this department of Food Service. Their Patient Sat. Scores are mediocre to flat. Patient complaints are up, staff morale is very low. The real impetus here is that they are merging with another hospital into one brand new hospital soon and they would like to design the blueprints and start to build the infrastructure for world-class dining experience now. I think you are correct though, HCAHPS and Press Ganey Scores will be some key indicators to success long term.
2—Our Explicit Methodology?
I will need a white paper essay to explain it detail, but here is the outline:
1. We held a leadership strategy session with management the week before staff training. We got alignment of topics to discuss, goals to accomplish and what would be needed from them to live the new culture they build.
2. We sent out formal invitations to all food service employees and ask they sign up for one of five 4-hour training sessions. We even invited special guests influencers: an RN manager, HR manager, Unit Clerk, Union Leader, and a front-line nurse.
3. The workshop outline included: emphasizing their ROLE in the healing experience, work around the cost of bad service and patient defection /costs.
4. We benchmarked Disney, Southwest Airlines, Ritz Carlton, other hospitals.
5. We mapped out the current patient experience and ranked each step as the patient might. We looked for ways to elevate each step of the process through the eyes of the patient.
6. We role-played the actual delivery of food to the patient, where employees acted as a patient in a bed, a tray-passer employee, and a leader-coach.
7. We left with a pretty robust list of favorable and forbidden phrases, a new agreed upon 12-step delivery process and recommendations of new title for the job of the old “Tray passer”
I hope that helps, Jack?
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