Customer Experience

If you work in long term care long enough, a bit of a bunker mentality can start to take hold.  You feel beset on all sides by enemies: bureaucrats adding to a regulatory burden that already exceeds that of the nuclear power industry, legislators making draconian cuts to reimbursement rates, state surveyors looking to tag you for so much as an improperly folded sheet, media outlets sensationalizing every adverse event, family members wracked with guilt, stress, and frustration, and of course trial attorneys looking to profit from any mistake you make.

A friend recently told me that nursing home administrators and DoN’s are the only professionals in America who can literally lose their licenses AND potentially face criminal charges for acts or omissions by their employees–even when they aren’t in the building!  It is truly a 24/7 profession.

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Recenty, Signature asked our Administrators and Directors of Nursing to complete a brief survey on how they dealt with struggling employees.  We called it the “Work Styles Questionnaire.”  With a little gentle encouragement, nearly everyone responded–over 90% of Administrators and over 75% of DoNs.

The Questionnaire was a series of vignettes–short scenarios in which employees were underperforming for various reasons.  After each vignette, we asked the Administrators and DoN’s a series of questions about what managerial strategies they thought would be most appropriate, given the context. 

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[MAJOR CAVEAT:  When I blog about corporate hypocrisy, I don't want anyone to think that I am pointing fingers or getting on a soapbox.  The entire purpose of posts about this issue is to raise awareness and stimulate discussion about an intriguing problem that is by no means unique to Signature.  Virtually every organization (not to mention every person) is capable of behaving in ways that are inconsistent with core values...]

If you’ve been following this blog at all over the last several months, you already know that the one of the biggest threats to our culture and engagement is the perception among stakeholders that we don’t always live up to our own values.  This challenge is by no means unique to Signature.  In fact, based on conversations with other HR and Customer Experience professionals, I suspect that it is rampant in much of corporate America today.  Why?  Is it because corporations are inherently evil entities that seek to suck the life and spirit of their people?   No, of course not!  Corporations are like all institutions–they are made up of people, mostly regular people who want to do the right thing.

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I’ve spent the last few months researching the various benchmarking and Voice of the Customer platforms that are available to the Long Term Care industry.  My conclusion: what the industry really needs doesn’t exist, at least not yet.

Most skilled nursing facilities today use a traditional survey approach.  The surveys are conducted either by phone or mail, and the data is compiled and correlated in a single annual report.  Facilities are benchmarked against their competition in key categories, such as employee engagement, customer loyalty, food quality, cleanliness, etc.  Some states actually mandate that nursing homes use specific vendors in order to qualify for a “quality” bonus of up to 1% in their reimbursement rates.  Nobody has yet been able to explain to me how a once-per-year paper survey that captures only the most superficial information concerning loyalty drives “quality.”  I am convinced that the only reason that many facilities are purchasing this kind of stale, aggregated data is because they have no other choice.  Regulations dictate that they must “check a box” for benchmarking and “quality.”

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“Power corrupts.  Absolute power corrupts absolutely.”

“Win with honor.”  For decades, that was the motto of the storied Penn State football program, and its legendary coach Joe Paterno.

And for all appearances, the program lived up to its own high standards.  Its players attended class and graduated.  They went on to successful careers both on and off the football field.  They generally avoided the kind of hi-jinks that have gotten other high-profile student athletes into trouble.  They represented the university, the team, and themselves honorably.

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It’s nearly 11pm on a Saturday night, and psychology nerd that I am, I just finished watching the one of the most fascinating 20 minute presentations I have ever seen.  I might as well have just chugged a flight of large espresso drinks; I won’t be able to fall asleep for hours!

It was a TED talk, by Daniel Kahneman, a Nobel prize-winning psychologist and the father of behavioral economics.

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Awhile back, I posted about Self Determination Theory (SDT).  SDT is one of the most promising and well-validated fields of psychological inquiry to have emerged in the last 25 years.  Briefly, it offers a theory of human motivation, from the intrinsic (i.e., an activity that is done for the sake of the activity itself) to the externally regulated (i.e., an activity that is done for fear of the consequences of NOT doing it).  It also offers a kind of psychological parallel to Maslow’s Hierarchy of Needs.

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I’ve been thinking a lot recently about Corporate Hypocrisy, or more specifically about how to combat it.

One of the most surprising aspects of our recent surveys on customer experience was the extent to which our frontline caregivers perceive management as failing to “walk the walk.”  Along with lack of teamwork and poor communication, Corporate Hypocrisy was the top driver of disengagement.  Of the three, Corporate Hypocrisy is by far the most toxic and dangerous to the culture of the organization, because it erodes the foundation of trust and affection and destroys the individual’s sense of purpose.

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