I know I’ve said it before, but what you permit – you promote. And one of the things that will kill your dreams for a great culture and a superior patient experience, is tolerating bad behavior from select people in the organization.
Having standards for excellence is one tactic that can help level the playing field for all members of the organization. Typically, these service standards are behaviors that are expected of everyone. It should be pretty cut and dried. Unless, of course, you make exceptions.
Now, most of you will say that you don’t tolerate less-than-desirable behavior from anyone. Look more closely. Ask yourself if someone’s rank or position has ever prevented you from speaking up when you see undesirable behavior. If you’re like most leaders, and if you’re honest with yourself, you’ll have to admit that you’ve slipped at least once or twice.
I can recall many times in the past few years that I’ve had to point out that bad behaviors were being tolerated for any number of reasons. In one case it was a COO who had longevity in the organization, but was a gruff bully. He would scream during leadership meetings, and embarrass his subordinates in front of their peers and staff. The CEO hired us to help change the culture, yet he could not bring himself to reel that COO in.
Then there was the orthopedic service line in a large academic medical center that hired us to help improve their patient satisfaction scores. Two of the surgeons were allowed to keep patients waiting for hours and triple book their schedules. They were also allowed to cancel full days of appointments at the last minute to go golfing. When I pointed out that these practices were not patient-focused, I faced more than just a tad of resistance.
I will never forget the day that I was sitting in the division leader’s office discussing culture, and the current practices that were killing their patient satisfaction scores. It was a Thursday afternoon when one of the orthopedic surgeons poked his head in the door, and announced that since the local high school basketball team was going to regionals, he would be taking Friday off. The division leader said, “Great. Have a good time,” and returned to our conversation. I asked the leader to pull up the surgeon’s clinic schedule for the next day. He was scheduled with more than 30 appointments that were about to be cancelled. Patient-centered? I think not. And, by the way, during focus groups with their patients, I had learned that some of them had had appointments cancelled and rescheduled up to three times. They were angry and said they would not return for future care. The staff confided in me that when the doctors are allowed to make last minute changes, they are the ones that have to call patients and deal with their wrath.
It’s hard to say no to requests, and to curb bad behavior. But leaders who are committed to excellence must learn to make tough decisions in the name of culture. The return on investment is well worth a few difficult conversations.