Written By: Kristin Baird, RN, BSN, MHA

 Imagine a workplace where employees, supervisors, managers, senior leaders, physicians and other clinicians all felt comfortable giving and receiving feedback from each other. Think of the opportunities for improvement that could emerge. Think of the impact on patient experience as well as quality and safety outcomes.

Unfortunately, it’s rare that I come across this type of culture. Instead. What I’m most likely to hear are questions such as “How do I deal with people who are not following our service standards?” or “What can I do about staff members who are rude to each other?”

The goal for leaders in these types of environments is to nurture a culture where employees at all levels become  comfortable both giving and receiving feedback—where the employees become the keepers of the culture, both praising each other for positive behaviors and offering corrective feedback when there are opportunities for improvement.

For that to happen employees must become not only comfortable with, but adept at, giving feedback. One way to approach staff hesitancy in sharing feedback is to appeal to their sense of selflessness. This is actually a concept used as one of the leadership principles followed by the United States Marines, according to this Entrepreneur article. “Managers who shy away from sharing feedback because they fear confrontation are doing themselves and their team a serious disservice,” writes John Boitnott. It is, he asserts, selfish!

Individuals who take ownership seem more likely to give feedback to others. But even some of the most engaged owners may hesitate because they fear backlash or retribution.

With that in mind, here are my Top 10 Tips for Giving and Receiving Feedback:

Giving:

1. Identify the feedback that your staff members need most to help them support your mission, vision and values—and support an exceptional patient experience.
2. Don’t qualify the word “feedback” by saying “positive feedback” or “constructive feedback.” When we use the word “feedback” we use it as a neutral term—it’s just feedback.
3. Always assume the best. Too often, we tend to assume negative intent. Instead, flip that around and approach every situation from the standpoint that the employee wanted to do the right thing. “Pat, I know you care about our patients.”
4. Be specific. Focus on specific, observable behaviors rather than making broad judgments. “Chris, you’re too insensitive” is a vague comment that carries little value. Compare that general statement to: “Chris, I’m not sure if you realize this, but I just observed you walk right past a patient who appeared lost.” A specific example like this may help a co-worker re-examine some of his habits.
5. Do it now! Feedback should be offered in the moment. Don’t want to address an issue later. The closer to the actual situation, the more pertinent and relevant your feedback will be. Take the example in #4. Giving real time feedback, makes the example real and may even offer the opportunity for immediate service recovery.
6. Ensure that your message was understood as intended. This doesn’t have to sound like: “Repeat back to me what I just said.” That can come across as condescending. But, following up a discussion with a statement like: “Just so I know we’re on the same stage, could you tell me what you understand our next steps to be?,” sends the message that “we’re in this together” and indicates your support for a positive outcome.

While some of us may have received training in school on how to give feedback, few of us have ever been schooled in how to graciously receive feedback. Here are some tips to help you receive feedback effectively:

1. Avoid becoming defensive. Our natural inclination when receiving feedback is to fall into a “fight or flight” response. Work against that tendency. Take a deep breath and keep your emotions in check.
2. View feedback as a gift—information that you can use to improve. Keep in mind that we’re not labeling feedback as either positive or negative; it’s simply information.
3. Ask for specifics. Just as you should provide specific feedback to others, you should ensure that you’re receiving specific feedback that can help you improve. “Could you give me a specific example about what you observed? That would be really helpful to me.”
4. Share your understanding of what you heard and what your next steps will be. “What I hear you saying is…Is that correct?” To further convey your gratitude for receiving feedback, thank for the person for sharing their input with you.

Of course, there will likely always be some tension around being either on the giving or receiving end of feedback and, in some cases, the tendency for these interactions to escalate. To help minimize this tendency, we recommend using empathetic assertion. Empathetic assertion involves making a statement (assertion) that expresses your understanding (empathy) for the other person’s point of view.

For example:

• You spot a housekeeping employee who stops in the hallway to comfort an obviously upset visitor. “I couldn’t help but observe your interaction with that visitor just now and wanted to let you know how impressed I am with your compassion. Thank you for taking the time to express concern and offer assistance to that family. That was a shining example of our mission is action.”
• You observe a fellow nurse enter a patient room to check an IV and never addresses the patient during the encounter.  You could say, “Marilyn, I know you have a lot on your plate, yet I noticed you didn’t say anything to Mr. Jones or his wife when you were in his room. Just remember to use our G.R.E.A.T. communication every time you enter a room.”  In a perfect world, Marilyn would respond with something like, “Thank you for pointing that out to me. I get so caught up in the task that I forget to interact.”

Another important best practice when giving feedback: avoid the use of the word “but.” When you say “but” after a compliment or positive remark, it negates the positivity of the statement and can increase defensiveness. Replace “but” with “yet” to help soften the impact of what you’re saying.

Whether you’re on the giving or receiving end of feedback, the tips above will help ensure that you engage, rather than alienate, your team members. Baird Group’s Coaching for Engagement and Improved Performance Training addresses how to give and recieve feedback.