Tuesday, December 06, 2011

Lessons for hospitals from the Gaylord Palms

#IHI Transforming health care will require, among other things, the enthusiastic engagement of staff throughout the nation's hospitals in process improvement.  The means for doing this have been demonstrated by corporations in other sectors.  Led by Eric Dickson, Senior Associate Dean of U. Mass. Memorial Hospital, and Christina Gunther-Murphy, IHI's Director of Hospital Portfolio Operations (seen here), a group of us at the IHI Annual National Forum had a chance to witness one such approach during an excursion at the Gaylor Palms hotel and resort.

In this all-day session, entitled "Joy in Work and Staff Best Practices," we  were treated to a dynamic and informative presentation by Richard Caines, training manager at the Gaylord Palms.  You see him here in the caricature portrait hanging outside the door of the human resources department.  I choose this way to introduce Richard because it exemplifies an underlying premise of the GP approach, to create opportunities whenever possible to have fun in the workplace, with an example set by leaders throughout the company.

Richard, seen here in his real body, had a lot of serious things to say, too.  The first related to the criteria used by the Gaylord Palms in hiring staff.  Those "non-negotiable" attributes are laid out explicitly:  Ability to Smile, engage in Team work, bringing the right Attitude to work, Reliability, and Serving with a passion.  Staff, hereafter called STARS, are considered for employment in joint interviews, where HR professionals and line managers look to see which people in the session rise to the top compared to other applicants.  For some jobs, 500 people might apply for a single positions.  Here's Richard in a short video describing the attributes more fully.  (If you cannot see the video click here.)

A thoughtful orientation has to follow a good hiring process.  All STARS receive a full two-day orientation by Richard, focusing on corporate culture, goals, and the like.  Each person then receives a personalized two-week orientation, after which he or she is fully capable of independently carrying out all the responsibilities of the assigned job.  Ninety days later, an orientation reunion is held, at which each STAR has a chance to provide feedback to the company on the quality of the work experience and the environment, and on the orientation process itself.

But good hiring and even a good orientation do not make a good organization.  It takes a corporate culture of trust, empowerment, assistance, and abetting personal and professional growth to deliver fine excellent service all the time to one another and to guests.  Richard explained the panoply of programs offered by the Gaylord Palms to make life better for its STARS.  This includes amenities like an on-site car repair shop, laundry service, convenience store, physical trainers and athletic facilities, and amazingly inexpensive ($1.50 per lunch) cafeteria.

There are more substantive human resource approaches at work, too.  A bonus system provides, based on meeting guest satisfaction goals, offer all hourly STARS the chance for a monthly cash payout.  Even when a staff member has poor performance, the first step in the progressive discipline process is counseling, to see what might be done to help a person regain his or her footing and begin to excel again.  There are also clear moral and ethical standards, the "Red Rules," that make it clear that things like serving alcohol to a minor or hiring an illegal immigrant, will result in termination.  (Even there, the first step by the supervisor is suspension:  The actual termination process can only be carried out by the trained and designated HR professional.)

As part of the commitment to staff to provide the support and resources necessary to provide flawless service, there are also regular STARS satisfaction surveys.  The last one had only one question.  Staff were asked to give an answer from 1 to 5 on the following statement: "I am completely satisfied with my job."  Later, in section meetings, staff are queried, "What makes this a great place?" and "What would make it a better place?"  Is there any doubt why this is the only hotel consistently listed in the top 25 companies for working families by the local newspaper?

But a really fine organization depends on strong leaders who understand that their role is not to micromanage, but to coach.  As noted above, at the Gaylord Palms, leaders also look for opportunities to create fun.  They are expected to model the mutual respect that is a corporate standard.  I close this post with another video of Richard explaining some of these aspects of the corporate culture -- and with the question for my colleagues in the hospital world, "What aspects of what we learned from Richard might be applied in our environment, one dedicated to high service to patients and families, and one dependent on the human capital in the organization to deliver that service?"

If you cannot see the video, click here.


Anonymous said...

I agree entirely with your points about using these techniques to engage staff in process improvement. However, I see a fundamental dichotomy here between the relatively superficial interactions with "normal" customers in service organizations, and giving care to people who are naked, sick and/or dying in our hospitals. And paradoxically, as we saw in your post in memoriam to Monique Doyle Spencer, it is often the workers at the level of housekeepers and transporters who seem to understand the best how to bridge this gap.

Although I think your post makes important points, I always found vaguely insulting the exhortations of our hospital administrators to view patients as 'customers' or 'guests'. They are that, but they are so much more than that, also.

Perhaps the important commonality here is teaching bedrock respect for the customer or patient as an individual and a person - a point often lost in both industries.

nonlocal MD

Unknown said...

Those of us in healthcare can learn much from the hotel industry. As a participant in this excursion, I spent time listening to Richard's talk. While I was very impressed with the amazing amount of focus and dollars this organization invests in their staff, the most amazing observation I made happened while we were walking through the hotel. The training strategies were not simply lofty goals or idle chatter. The stars really were behaving in ways consistant with the core values presented in the lecture. In fact, the stars working for the hotel were far more friendly, welcoming, and engaging than most of the medical team members in attendance. The stars smiled freely, made eye contact, spoke easily, offered assistance, and were so happy to share anything we wanted with us. There is much we can learn from this industry and from the stellar example of positive spirit and common human decency shown by this amazing team if stars. Please consider being open to the ideas and successes of others. We in healthcare have much to learn about demonstrating care, empathy, understanding, and compassion. It all starts with a smile and a welcoming attitude. Please choose to be open, kind, and smile. You will feel so much better!