Is Your Management Style Killing the Service Spirit?

It can take months, even years, to establish a solid culture of service excellence yet only one unfortunate misstep to destroy the results of all that hard work. Unfortunately, too often healthcare leaders are inadvertently hampering their own efforts to create a strong service-oriented environment. We see examples of this far too frequently. For instance:

  • Scenario One: A woman I know who works in a long-term care facility with rehab patients had a patient who came in for rehab related to his ambulation needs. Unfortunately, his progress was being hindered by the length of his pants—they were too long and were making it difficult for him to benefit from the rehab services she was attempting to provide. So, she offered to hem his pants for him. A wonderful gesture, but she told me, when her manager got wind of what she had done, she was told that her efforts were “unprofessional.” Really? She spotted a need, identified that he had no other feasible resources, and took action to help provide a safer rehab experience.
  • Scenario Two: In another organization, a policy requiring employees to physically escort patients, family members, or visitors to their destinations was getting in the way of one manager’s strict requirements about being at meetings on time. One attendee who showed up a few minutes late because he had stopped to take a family to their destination was publicly chastised for his tardiness and told to not let it happen again, “or else.” This type of mixed message will squelch any employee’s best efforts.
  • Scenario Three: A maintenance worker passing through a nursing unit responded to a request from a nurse manager to get a bed in working order. The nurse manager wanted to admit a patient who had been waiting for hours to be transferred from the ER to be comfortably settled in a room. Unfortunately, the bed was not working. When the maintenance worker stopped to assess and quickly repair the problem, he was disciplined for failing to process a work order before doing the work.

These are just a few examples of times when managers behave in ways that squelch employee enthusiasm for doing the right thing. Do these sorts of things happen in your hospital? Are you sending negative signals to employees who are trying to provide exceptional patient experiences?

Yes, we must have protocol and policy in healthcare organizations for being on time and for processing necessary paperwork. However, when we let protocol and policy hinder rather than help to provide a great patient experience, everyone loses. Our patients lose. Our employees lose. And, our organization loses.

Somehow, though, we must create a culture that nurtures employees’ desires to do what needs to be done to ensure a positive patient experience. Help staff feel empowered to take steps to do the right thing for patients. The examples cited above provided an opportunity for the leader to celebrate—rather than berate—an employee’s initiative to do what was right for the patient at that moment in time.

Importantly, there are many studies that show us the positive correlation between engaged employees and satisfied patients. Here are just a few:

  • Gallup postulates that psychologically committed, or engaged, employees are the key to improving patient satisfaction and loyalty.
  • A University of Wisconsin study explored the relationship between employee satisfaction and hospital patient experiences and found a positive correlation between the two.

But we don’t really need formal studies to tell us what is intuitively apparent. When our employees are happy and engaged, they innately provide better experiences, creating a more positive and supportive environment for our patients. It’s not rocket science, yet too often in ways that range from the subtle to the outrageous we send signals that hinder the employee spirit.

Let’s revisit the examples above and turn them into mission moments:

  • Scenario One: Instead of scolding the well-meaning seamstress, what if the manager said, “Jane, that was an incredibly kind thing for you to do. I’m impressed that you spotted the need and took action, especially on your own time. That shows compassion as well as initiative, and I’m proud to have you on my team. You’re an example of our mission in action.” I’ll bet Jane will feel pretty good. And chances are she’ll be keeping her eyes open for other opportunities to please the customers in the future.
  • Scenario Two: When the staff person arrived late for the meeting and explained his reason was due to helping a customer, the manager could have said, “James, although I’m a stickler about punctuality, you clearly have your priorities straight. Thank you for upholding our standards even when I know you were pressured to get here on time.” This sends a message that still stresses accountability for the staff meeting but recognizes the employee for doing the right thing.
  • Scenario Three: This is actually a situation that happened with me when I was a staff nurse, and I was mortified that what “Jerry” had done to help a patient became grounds for discipline. Here’s how I’d have liked it to play out: When Jerry’s boss learns that he took action to help me prepare a bed for a patient in need, he’d say, “Thanks for taking action, Jerry. I’m glad you see how important it is that we are serving the people who are serving the patient. At the same time, we need to document our time and activity. I’d like you to put in a work order and just mark it as completed. And in the future, if the nurses need this type of thing, go ahead and do exactly what you did but ask them to submit an order so we don’t lose track of what is being done. You did the right thing.”

In each of these scenarios, the leader had the opportunity to nourish the employee spirit or kill it on the spot.


What does the culture look like at your organization? Are you inadvertently killing a strong service culture? Commit to filtering your responses in order to nurture a culture of excellence.

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