Written By: Kristin Baird, RN, BSN, MHAHaving constructive conversations with employees is a common occurrence in the lives of managers. Unfortunately, even the most experienced and skilled manager is likely to, on occasion, be faced with an employee who is in a deep state of denial about their own behaviors – or about the impact of their behaviors.
Employees who are particularly steeped in denial may also deny that they’re in denial! Sound like a challenging situation? It is! There are though, some ways that managers can help to cut through the denial to get to positive change. Here are four conversations you can initiate with employees to break down the barriers that can get in the way of providing exceptional patient experiences. 

1. Hold up the mirror. Since employees who are prone to denial are unaware of their behaviors, one important step is to hold up the mirror to help them see—through their own eyes—exactly what’s going on. How to do this? Ask leading questions and then listen to move employees closer toward reality. Make them part of the solution instead of part of the problem. For instance: “Our scores show that patients are concerned about noise levels. Why do you think we’re receiving this feedback? If you were a patient on this floor, what would you expect us to do to improve the environment?”
2. Be specific—and explicit! In a culture of service excellence, customer satisfaction is everyone’s job. But staff may sometimes forget this, or maybe they’re just not getting the message often enough. That’s where you come in. One of the most important things you can do as a leader is to clearly make the connection between employee behaviors and desired outcomes. The “XYZ formula” can help you frame this conversation: “When you do X, Y happens. I’d like you to do Z.” For example: “Mary, when you continually discount the patient satisfaction scores, it keeps us from finding real solutions. I’d like you to focus on potential solutions to the noise issue we keep hearing about from our patients. These scores reflect our patients’ realities and we need to do something to improve the care environment for them.”
3. Stick to the facts and expect accountability. Create a “no excuses here” environment. Put your focus on desired outcomes and hold all employees accountable for achieving those outcomes. But, go beyond holding them accountable—become a model of accountability yourself. Employees accept responsibility when they observe their leaders accepting, and modeling, responsibility. Move beyond excuses to focus on action through consistent responses that focus on the facts. For instance: “As you know, our service goal is to reach the 90th percentile. Our patients are rating us in the 30th percentile for noise. I’d like your suggestions on what we can do to improve the patient environment.”

Easy? No. Important? Yes! As you work to diminish denial among your staff members, watch out for the following characters. These common excuses will help you quickly identify those who are most steeped in denial:  

• The hand-washer. Washes his hands of any responsibility by saying, “That’s not my job.” Or, “There’s nothing we can do.”
• The victim. “It’s not my fault; no one ever told me! If the other departments (shifts, etc.) would do their part, we’d be so much better!” 
• The procrastinator. “I’ll get to it when I can. I’m working on it.” 
• The minimizer. “What’s the big deal? It isn’t that bad. A few patients complain and we jump.”

Patient experience is a big deal. But the patient experience won’t improve in an environment of denial. Use the conversation starters provided here to help your staff ensure a solid, and consistent, focus on improving the patient experience. To learn more about the Baird Model for Service Excellence, employee engagement or leadership development workshops, or to sign up for her FREE newsletter, write to info@baird-group.com.

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Nurse, author, and consultant Kristin Baird, “Healthcare’s Customer Service Guru,” is  the author of Raising the Bar on Service Excellence: The Health Care Leader’s Guide to Putting Passion into Practice (Golden Lamp Press, 2008), Reclaiming the Passion: Stories that Celebrate the Essence of Nursing (Golden Lamp Press, 2004), and Customer Service In Healthcare: A Grassroots Approach to Creating a Culture of Service Excellence (Jossey Bass, 2000). The Baird Group provides consulting, mystery shopping, and training services for improving the patient experience. To learn more, please visit https://baird-group.com or call 920-563-4684.