Showing posts with label Managers. Show all posts
Showing posts with label Managers. Show all posts

Friday, 12 August 2011

Six Steps For Nurse Managers to Create and Maintain a Culture of Service Excellence


Imagine the front porch of a country store in small town America with rocking chairs and friendly smiles. Just inside the front door, a large barrel full of crisp, delicious homemade pickles awaits. Aunt Mary's unique pickle recipe provides the special spicy yet sweet taste which permeates each aromatic bite. Departments are just like a pickle barrel when it comes to creating culture change. A good recipe, the right ingredients and patience all combine to create long term change. To play out the metaphor, let's look at the necessary components.

OK, you'll need to use your imagination...The pickle barrel represents the nursing department's future state. The cucumbers/pickles are the nurses and other employees within that department and the pickle juice is the vision for a new future of service excellence. The nursing managers' are the pickle "chefs" who create the unique recipe and create standards for continuity.

The culture change we are seeking here revolves around a ViewpointSHIFT(TM) regarding service excellence. Are patient satisfaction scores where you would like? Are you scoring in the top 10-15% of your peers nationwide? In my many years of working with healthcare organizations, I have found that many healthcare organizations make large investments in healthcare excellence, but they do not always provide the strategy and follow up to sustain long term change. Faced with flavor-of-the-month initiatives and lack of service accountability, raw talent is not enough and healthcare service suffers. Employees become numb to the announcements, new policies, and service programs. It is each nursing manager's responsibility to follow through with the strategies outlined below to avoid this lackadaisical attitude.

When it comes to service excellence, there are six key strategies for transforming the cucumbers in your department into pickles. Remember, in order to create long term change, this requires a good recipe, the right ingredients and patience.

Step 1: Strategize for service

Where does service fit in the strategic initiatives of your department? Defining your unique service culture is akin to having your own secret pickle recipe. What are the formal and informal leaders in your department saying (and more importantly doing) about service excellence. Does everyone in your department know how their job impacts patient satisfaction survey results?

I frequently see nursing managers who talk the talk, but don't walk the walk. If your department is not 100% supportive of a healthcare service excellence culture transformation - don't go any further. You will be wasting your time and money!

Step 2: Organize for service

From the physical layout of department to the use of technology, there are proven strategies for creating a culture of service excellence. Is signage well placed? Are chairs comfortable? Are your visiting hours customer friendly if applicable?

Other elements of organizing for service include policies & procedures, job descriptions, staff scheduling, service standards and scripting. A test to make sure your policies and procedures are written with the patient in mind involves asking this question. Can you replace "It's our policy" with "In the best interest of our patient, we..." Think about it- are the rules really in the best interest of the patient? You might ask your patients to find out, for sure.

Creating and agreeing upon universal service standards provides the unique spices and flavoring for your department. What behaviors can staff perform routinely to demonstrate to your patients the culture of healthcare service in your department?

Step 3: Select & train for service

Rotten cucumbers make rotten pickles. Hiring pickles who complement the staffing mix from the start is much easier than hiring a cucumber or worse yet a bell pepper. Remember back in the day, when folks said, "she's a great nurse, she's just not nice"? This is no longer acceptable.

Using behavior-based interviewing questions and validated pre-hire assessments allows nurse managers to select staff who already embrace the service standards of your department.

Orientation and on-the-job training provide important foundations for staff. Making sure there is congruence once the staff arrives in their department is trickier, but doable with strong management support. On-going training keeps the cucumbers immersed in the recipe long after the initial hoopla has died down and allows for service excellence over time.

Step 4: Deliver excellent service

This step is where the rubber meets the road or the pickle meets the customer. Well defined service behaviors which are competency based provide the foundation for service delivery. The expectation is that these behaviors are demonstrated daily and with ease.

Positive first impressions play a major role in setting the stage for service excellence. When problems do occur, service recovery procedures need to be set up to allow staff to solve service problems at the front line.

The delivery of excellent service is evidenced by positive attitudes, friendly smiles and high quality work output. Service efforts are not just about being "nice" - they involve a ViewpointSHIFT to match up safety and quality with caring and kindness.

Step 5: Manage for service

As steps one through four are being implemented, the nurse manager has a major responsibility for insuring the success of the process. Communicating strategic alignment (or the pickle recipe) is the first step toward culture change. Do staff members in your department really understand the service vision?

I frequently talk with front line service providers after training workshops and presentations and their concern is "will my manager really hold us all accountable?" Performance management, executed daily, will move the department towards the service vision.

In addition, regular contact with patients including surveys, focus groups and rounding provide real-time data for managers to use. On-going coaching lets staff know what is important on a regular basis.

Step 6: Sustain service momentum

Last, but not least, keeping the pickle recipe fresh requires the resources of time and money. Measuring patient satisfaction provides important data for making better decisions. Standardizing operations to decrease variation on the job is another key element.

Staff members who are providing excellent patient care want their managers to manage low performers - to get them to "shape up or ship out". Employee satisfaction is a key indicator of patient satisfaction so this is a good place to start. Keep your eyes open for fresh ideas from other types of service related businesses and see what might work in your organization.

So ponder that barrel of pickles in that country store. Imagine the friendly service and amiable folks who are running the place. These six strategies are a glimpse of what it takes to turn cucumbers into pickles so that your raw talent becomes excellent healthcare service providers.




Vicki Hess, RN, MS, Certified Speaking Professional, is an Escape Artist. She helps people escape from Professional Prison and provides a passport to Professional Paradise. To download free tools go to http://www.ProfessionalParadise.com . Vicki is passionate about working with forward-thinking organizations to develop fully engaged employees and leaders, who in turn deliver remarkable business results and ultimately create Professional Paradise! A highly-regarded speaker, author, facilitator and consultant, Vicki is an expert in employee engagement, team dynamics, and workforce and leadership development for healthcare leaders and employees. Vicki is a Certified Speaking Professional, the speaking profession's international standard for platform skill. She holds a Master's Degree in Human Resource Development from Towson University and was an adjunct professor at The Johns Hopkins University Graduate School of Business for five years. Vicki is the author of SHIFT to Professional Paradise: 5 Steps to Less Stress, More Energy & Remarkable Results at Work (CornerStone 2008). For more information please visit http://www.VickiHess.com .





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Friday, 22 July 2011

The Importance of Business Acumen Training For Managers and Employees


The message to CLOs is becoming clearer and clearer. Company leaders want them to align educational offerings with the organization's strategic objectives.

That's not an easy challenge. They must ensure that education and communication initiatives reinforce the company's goals. They must help employees understand these goals and develop the skills and motivation to contribute to them.

And at the most basic level of alignment, they must make sure that every employee understands how the company makes money. That includes understanding how profitability is driven, how assets are used, how cash is generated and how day-to-day actions and decisions, including their own, impact success.

Developing business acumen is fundamental to business alignment. Consider Southwest Airlines, which was founded in 1971. With 33 straight years of profitability, the airline has become widely recognized for the motivational culture it creates for employees and its extraordinary dedication to customer service.

Much of the industry has suffered during the years of Southwest's growth, including many airlines that have merged or declared bankruptcy. Southwest buys the same planes and the same jet fuel as other airlines, and pays its employees competitive wages and benefits. What's the difference?

Unlike some of its competitors, Southwest's management team involves employees in the company's financial results, explaining what the numbers mean and, more important, helping to link everyone's decisions and actions to the bottom line. The airline has an open culture, one of inclusion at all levels, and employees understand their roles in providing great service and keeping costs in line.

Certainly there are other factors that contribute to the success at Southwest, but it's difficult to ignore the positive impact of an approach that develops the business acumen of all employees and managers so that they can contribute to the airline's success.

An Educational Challenge

Unlike those at Southwest, individual contributors and managers in many organizations today have not been educated about the big picture of their businesses. They have a narrow focus on their own departments and job functions and aren't able to make the link between their actions and the company's success. Multiplied by hundreds or even thousands of employees, this lack of understanding - the lack of true business acumen - means that too many decisions are being made and too many actions are being taken that don't align with business objectives.

How can training help bridge this knowledge gap? For many companies like Southwest, implementing learning programs designed to develop a strong foundation of financial literacy and business acumen has made the communication of financial results to employees easier and more effective.

Business Acumen: A Definition

Very simply, business acumen is the understanding of what it takes for a business to make money. It involves financial literacy, which is an understanding of the numbers on financial statements, as well as an understanding of the strategies, decisions and actions that impact these numbers.

Someone with financial literacy, for example, would be able to "read" the company's income statement. This employee or manager would understand the terminology (revenue, cost of goods sold, gross margin, profit, etc.) and what the numbers represent (i.e., gross margin equals total sales/revenue less the cost of goods sold).

With business acumen, the individual would be able to "interpret" this same income statement, taking into consideration how company strategies and initiatives have impacted the numbers during specific periods of time.

Consider a simple comparison: In football, it's necessary for players to know how the game is scored as well as how to play the game to change the score. In business, financial literacy is understanding the "score" (financial statements) and business acumen is understanding how to impact it (strategic actions and decisions).

Asking the Right Questions

When business acumen spreads through an organization, employees and managers begin to ask questions. These questions are directed not only at the organization, but also at themselves and their departments - questions about processes, products, systems, staffing and more that can lead to necessary and innovative decisions and actions.

Business acumen helps everyone understand that it's not enough to ask, "How do we cut costs?" or to say, "We need to increase sales." Digging deeper, employees with higher levels of business acumen will ask questions that take into consideration the far-reaching impact of potential decisions and demonstrate a greater ability to make the connections between performance and results.

Questions that could get to the root of disappointing operating ratios:

• Have production costs gone up? If so, why?

• Have we changed prices? If so, how has that affected our margins?

• Are there any competitive issues impacting our performance?

• Have there been any customer requirement changes?

• If our costs per unit produced have gone up, can we better control the efficiency of our production or service delivery?

• Is there a way to produce a greater product volume at the same cost?

• Can we raise prices, still provide value to the customer and remain competitive?

When questions become more specific, the right decisions can be made.

Business Acumen for Managers

Managers at all levels need a high level of business acumen to do their jobs. Every day, they make decisions about employees, projects, processes, expenditures, customers and much more - decisions that ultimately roll up into larger organizational results. Managers who make these decisions while looking through a departmental lens only, with a limited understanding of how these decisions affect financial results or how they are tied to the organization's goals and objectives, are working in silos that can ultimately damage the company.

Managers are often promoted to their positions of responsibility because of their "technical" expertise. They've been successful customer service representatives, great salespeople, innovative researchers or well-respected IT professionals. They are now entrusted with decision making, budgets, projects and people. They often do not have financial literacy, nor have they developed a higher-level perspective about the business. Over time, especially if they move up the managerial ladder, they may develop these. Or they may not.

Organizations need managers who operate as part of the management team, taking accountability for their own results as well as the results of the entire company. Therefore, more and more organizations have built financial literacy and business acumen into managerial competency requirements and have integrated business acumen training into management curriculums.

Business Acumen for Employees

Although there is little debate about the need for managers to develop business acumen, organizations sometimes question the need for this understanding at employee levels. But frontline contributors, those who are most directly involved with production or customer service, for example, take actions every day that impact business results.

Consider the salesperson who discounts products, or the service representative who deals with an unhappy customer, or the maintenance person who notices a problem. The actions each of them takes might erode profit margin, lose a good customer or allow safety issues to escalate. Without an understanding of how their actions impact the company's results, they might not have the context to consider alternatives.

Many organizations have determined that financial literacy and business acumen aren't just for managers anymore. They have decided to develop a company of people who understand the business; who know what return on assets and return on investment mean; who know how inventory turnover rates affect results and the importance of positive cash flow; who see the connection between the company's financial success and their own health benefits, 401(k) plans and more. In other words, they need people who understand the "business" of the business.

In his book Good to Great, Jim Collins says, "We found no evidence that the 'good-to-great' companies had more or better information than the comparison companies. None. Both sets of companies had virtually identical access to good information. The key, then, lies not in better information, but in turning information into information that cannot be ignored."

With an increased level of business acumen, managers and employees can better interpret information, making the connection between their actions and the company's results.

Another Reality of Today's Business World

A public company's operating results are well known at the end of each quarter. Analysts, investors, the media, employees-everyone has access to a company's financial results. With a significantly increased focus on accounting improprieties over the past few years, senior management has become highly conscious of the need to provide accurate and timely financial information. And employees have become much more likely to wonder about these numbers. "Is my company being honest? Are the numbers telling the whole story?"

Without a fundamental understanding of financial results and an ability to interpret them, employees may become suspicious and, ultimately, disengaged. Disengaged workers, in turn, negatively impact productivity and profits.

CEOs of public companies, then, must ensure that managers and employees are able to understand the numbers and have confidence in them. That means effective business acumen education as well as ongoing and open communication from the top.

Former GE chairman Jack Welch said in his book Straight from the Gut, "Getting every employee's mind into the game is a huge part of what the CEO job is all about...There's nothing more important."

The Big Picture

As we have become a nation of specialists, armed with new information technology and enterprise-wide operating systems, it has become easier for managers and employees to become myopically immersed in their own jobs. This immersion can have the effect of obscuring their view of the big picture. They may not consider the cumulative effect of wasted assets. They may have little regard for the objectives and responsibilities of other team members, departments or divisions. They may lack the motivation to invest personal energy in critical project work.

Organizations that engage in developing business acumen provide a clearer vision and an overall context within which employees can work, while creating an environment that is more likely to break down internal barriers. There is less waste and less ambivalence. There is increased innovation. Employees are more engaged, they understand their role and its impact on business results, and they are more likely to believe that their efforts really matter. They are more likely to think like a business owner.

Think Like an Owner

To be successful, business owners must be able to helicopter above day-to-day issues and see the big picture. They must understand how the pieces of the business fit together to impact profitability and cash flow, and they must be able to assess the risks and rewards of potential decisions. The best business owners study the numbers, ask themselves tough questions, analyze their mistakes and take decisive action.

To truly understand the business, owners have to understand how that business makes money - in other words, how it produces sales, profit and cash. Organizationally, they know that it's about people, processes and productivity. On the customer front, it's about satisfaction, loyalty and market share. Ultimately, every action taken and every decision made in any of these areas will impact sales, profit or cash.

When managers and employees begin thinking like owners, they, too, look at the big picture, understand how all the pieces fit together, and assess risks and rewards. They understand, like an owner, how the company makes money, how it stays in business and how they contribute to its success.

The benefits to an organization of engaging managers and employees in this kind of ownership thinking are obvious. So how can a company develop the business acumen of its people?

Developing Business Acumen: Two Stories

Entrepreneurs are generally forced to develop business acumen on their own. They are hands-on with their businesses and have to make all the decisions as they go along, whether good or bad. They either learn from their mistakes or fail.

It's very different for managers and employees in an organization.

They aren't involved in all aspects of the business, and they make decisions primarily within their own areas of responsibility. Since seeing the connections isn't easy, they need to learn in some other way.

Books and lectures can help. But business acumen is best developed experientially. Learners must be able to analyze situations, ask questions, discuss issues with other learners, consider options, make mistakes and see results.

Although there are a variety of ways to accomplish this kind of experiential learning, many companies have found that simulations, which mirror reality and allow learners to experiment in a safe environment, are one of the best ways. Here are the stories of two companies who chose to educate their learners with business simulations.

Comcast Cable Communications

The NorthCentral Division of Comcast - one of the country's largest entertainment, information and communications companies, specializing in cable television, high-speed Internet and telephone service - set out to ensure that managers and employees throughout the organization had the financial acumen required to make good decisions. A companywide survey had clearly demonstrated this need - especially for managers of employees who had direct contact with customers.

For example, if a customer calls with a service problem, frontline employees and their supervisors can issue credits to the customer's account in an effort to resolve the issue. Although this may be exactly what is needed for the situation, Comcast realized that employees making these decisions didn't necessarily understand that a $10 credit could ultimately require more than $100 in revenue for the company to break even. Similarly, a service technician's visit to a customer's home might cost $50 directly, but the company might have to sell an additional $500 in services to cover the cost.

"The lack of financial acumen among supervisors and employees was largely understandable," says Mark Fortin, senior vice president of finance for Comcast's NorthCentral Division. "Almost 75 percent of the company's employees are on the front lines in roles such as call center personnel or field technicians. They are trained to be good at what they do, but their backgrounds typically don't include emphasis on financial literacy."

Comcast human resource executives determined that a fundamental approach to the development of business acumen was needed. However, this approach also would need to be fast, engaging and job-relevant. Expanding upon its already robust Comcast University management curriculum, the executives chose to integrate a high-energy, tailored learning experience that would provide the "basics" and, at the same time, deal specifically with Comcast terminology, concepts and strategic imperatives.

As they participated, learners made decisions about products, processes, pricing and more, and they saw how those decisions impacted financial success. In the end, it became easier for them to make sharper day-to-day choices.

"The thing that sticks out for the frontline leaders, the field technicians, and the call center supervisors and managers who attend, is the high cost of sales in our business," says Sophia Alexander, senior manager of curriculum and metrics for the division. "It's like a bell goes off in their heads when they realize what it costs for us to earn what we need to earn to run the organization."

Attending the learning session is not mandatory for supervisors and managers. However, there is an unwritten expectation that they will participate in business acumen training as well as other Comcast University core programs, according to Jan Underhill, senior manager of leadership development for the NorthCentral Division. That expectation, coupled with the fact that manager compensation has recently become tied to meeting specific financial goals, has kept attendance high.

Senior executive support also has been an important factor in creating interest and awareness around financial literacy. "Getting people to sign up is much easier when senior executives like Mark Fortin are strong advocates for the program," says Underhill.

Feedback has been resoundingly positive. On average, for example, Level 1 feedback about the discovery learning based business acumen sessions has been 4.5 on a 5-point scale. That means that the program has exceeded expectations. Better than that, says Sophia Alexander, senior manager of curriculum and metrics for the NorthCentral Division, is the empirical evidence that the new insights and knowledge have made a difference. For example:

• Participant self-evaluations indicate that financial literacy has increased by at least 25 percent as a result of the business acumen training.

• After the training, there was a 20 percent increase in the participants' ability to use basic financial terms and concepts on the job.

• Almost 45 percent of supervisory participants report that they are using their business acumen knowledge in daily communications with staff and peers.

"Some people, particularly in big companies, feel like there is an open checkbook. They think... I don't own the company. It's not my problem. Somebody will pay the bills. But in today's environment, with some very large companies in trouble, everyone needs to be part of the solution. Business acumen education for managers and employees helps the company as a whole, but it also helps employees. It's about self-preservation to some extent." comments Fortin.

Southwest Airlines

Southwest Airlines is one of the consistently profitable companies that makes "business literacy" a core component of its employee training programs. Every employee has a solid understanding of what a new customer, and new revenue, means to the company. Employees also know how the loss of a customer can impact the business.

According to Elizabeth Bryant, director of leadership training at Southwest Airlines, "Our training covers how the financial ratios such as return on assets and various margins are determined. Knowing that team managers, supervisors and all employees have this knowledge enables the company's leadership to present detailed financial reports and explain to the teams where the margins need to be. Management can speak more in depth to all the employees, and the employees understand what the objectives are."

Bryant added, "Because we don't waste the little things, because we track every penny and every activity, we've all come to know the importance of each cent. With the pennies in hand, we spotlight the idea of compound interest- for example, how the small savings help us by year's end and how small amounts of waste can conversely add up to hurt us."

Consider the importance of a key operating metric for the airline industry - operating cost-per-seat mile. This is how much it costs an airline to fly one seat one mile. All the operating costs are divided by the total number of seat miles (the total number of miles of all the seats that were flown for a given period, whether a passenger was in the seat or not). Much of the industry has had cost-per-seat mile results at or over 10 cents. Southwest Airlines' cost-per-seat mile is about 6.5 cents. The lowest cost-per-seat mile in the industry almost 25 years ago was just over 5 cents.

How do they do it? Certainly there are a number of factors that lead to success. However, one of the key influences is Southwest's ongoing training in business acumen. This training ensures that employees know:

• How challenging it is to ensure ongoing profitability; making a profit can never be taken for granted

• The importance of utilizing the benefits of the good years to prepare for the tough years

• The impact of individual actions and decisions to the bottom line

In other words, Southwest invests in training to help employees think like business owners. This, in turn, produces real results, like its consistently low cost-per-seat mile. When Southwest's learning team decided to implement a business acumen simulation several years ago, there was some initial concern about how well it would be received.

Bryant explained, "Some people, especially those without financial training, were nervous about the topic. We are such a people-oriented company that we didn't want people to think that now we're just a financially oriented company and everyone will be judged purely on financial performance. But we positioned the need for the business literacy training as another way to prove that we actually care tremendously for each employee. We explained that if you understand what the numbers mean then you can better understand how your work provides an integral contribution to the business."

Southwest Airlines, according to Bryant, has never had a layoff - a rarity in the airline business. The more their employees understand the challenges of the business, the better they appreciate the importance of making smart decisions every day.

Bryant concluded that the discovery learning techniques in a robust business simulation work well in the Southwest culture because of the team orientation. "All the participants learn that they can't individually make it all happen," said Bryant. "They learn that they have to look beyond themselves, act and think like an owner, and realize that our efforts and financial results here are not just for a career, but for a cause. It's this cause-oriented philosophy toward delivering a low-cost, high-quality service that allows people the opportunity to travel. Our success at achieving positive results translates to individual opportunities to work, to grow and to continually think of innovative ways to improve our business and serve our customers."

The Classroom Advantage

These two companies chose to develop the business acumen of managers and employees by using a classroom-based simulation, facilitated by instructors at company sites. Although online options were available and were used in some cases to supplement the instructor-led training sessions, they decided that there were significant advantages to tackling this subject in a "live" session where they could leverage the power of:

• SHARED KNOWLEDGE AND EXPERIENCE: Learners bring their own perspectives and issues to the session.

• TEAMWORK: Learners work together, make decisions together and rely on each other as they learn.

• COMPETITIVE FUN: Small teams "play" against each other and enjoy a competitive environment.

• COMPANY-SPECIFIC DISCUSSIONS: The learners' common interest in their own company's financial and strategic issues allows for greater analysis and depth of discussions and a true "connection" between the learning simulation and the organization's reality.

• LEARNING MOTIVATION AND COMFORT: Learners who may not be comfortable with the subject of finance find themselves playing a game in the comfort of a team environment.

Although there are a number of educational approaches available to organizations in the area of business acumen, classroom-based training that brings together teams of learners can help ensure that learning occurs and that connections to the business are made in ways that prompt action back on the job.

The Bottom Line

More than ever, successful companies will need to focus on developing the business acumen of managers and employees. These companies will realize that when their people understand the numbers, when they understand how their departments contribute to the company's objectives and when they see how their own decisions and actions make a difference, they will begin to operate as part of a team rather than in a departmental or personal silo. And a critical piece of the alignment puzzle will be solved.

With widespread business acumen, companies can have a powerful asset - educated, knowledgeable and motivated employees. And with this asset, those will be the companies best positioned to succeed.




Raymond (Ray) Green is cofounder and CEO of Paradigm Learning. Paradigm Learning is a corporate training and communications company specializing in the design of business games, business simulations and Discovery Maps®.





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