Every hospital we’ve ever worked with has a series of expectations for their staff members related to the customer experience—things like:

• Addressing patients by their preferred name
• Offering hospitality to waiting visitors
• Making eye contact and greeting patients and visitors in hallways and elevators
• Picking up and disposing of any litter or spills, or notifying housekeeping
• Not eating food in patient care areas or when visible to patients

And the list goes on. Your hospital probably also has a list of “service standards” contained in some policy manual or online and used in training employees at orientation and, maybe, during annual in-service.

But, despite the fact that these standards are commonplace, what is also commonplace is the failure to hold employees—including senior level executives—accountable to these standards.

As we evaluate and work with hospital staff to improve the patient experience it’s not uncommon for us to observe such things as:

• Hospital staff talking about other staff, patients, and hospital issues in areas where patients and visitors can hear these conversations
• Staff members failing to ask if they can help a patient find their appointment when the patient looks notably “lost”
• Staff members chatting among themselves while patients are waiting to be served, or while the phone is ringing
• Employees walking by garbage that could and should have been picked up and deposited in the trash
• Staff smoking on a smoke-free campus

All of these things happen while leaders walk by without comment.

This list, unfortunately, also goes on. And that’s a major problem. Because, you see, creating an exceptional patient experience isn’t about writing standards. It’s about living those standards. And it starts at the very top of the organization.

If your senior leaders, and we’d include medical staff here, aren’t walking the talk, your standards lack credibility and become virtually worthless. What you permit, you promote! If employees see their leaders ignoring the standards, why should they follow them? Further, if they observe leaders allowing others to ignore the standards, that also sends a powerful message. A message that you really don’t care.

That’s not the message you should be sending in this era of heightened scrutiny and shared public data on hospitals and health systems. Competition is on the upswing and word of mouth rules. With increasing choice, consumers will more than ever seek care elsewhere if you’re not meeting their needs.

Action Steps that Promote Accountability

How can you remedy the situation? Senior leaders can drive a shift when they do two things consistently: 1. Make their expectations clear that leaders at all levels are expected to uphold the standards themselves AND hold everyone accountable. Borrow from the TSA by abiding by the statement, “If you see something; say something.” 2. Make regular rounds to model the way, reinforce the positive and identify issues in need of correction. While you don’t want to become known as the “white glove” patrol, it’s important that you are both visible and observant. Rounding gives you the opportunity to see how middle managers interact and provide feedback. It helps drive greater accountability when everyone knows that you not only expect, but inspect people, processes, and the environment (place) that effect the patient experience.

Look around your facility. Are your leaders walking the talk? Remember: What you permit, you promote.