Recognizing and Rewarding Success in Delivering Better Patient Experiences
The pursuit of better performance benefits greatly from positive incentives, whether at the organizational level or the individual level. Rewards can be financial or non-financial, but what matters is that they are directly linked to either the effort to improve or, ideally, the actual improvement. External rewards for healthcare organizations can motivate the leadership and the staff of an organization to focus on quality. Internal reward systems pay close attention to the front-line staff, managers, and clinicians who do what is necessary to achieve the external rewards.
External rewards for high-quality care
Over the past decade or so, the idea of rewarding healthcare organizations that exhibit good quality or a commitment to improving their performance has taken off, accelerated by various provisions under the Affordable Care Act. Initially, these rewards came in the form of public recognition. Some purchaser organizations share comparative information on health plan quality—including patient experience scores—to draw attention to high-performing plans, while some health plans and systems do the same with medical groups, physician practices, hospitals, and even individual physicians.
More recently, purchasers and payers have explored ways of offering higher financial payments for good quality. The most prominent example has been the Centers for Medicare & Medicaid Services (CMS), which has implemented several programs to reward health plans, accountable care organizations, hospitals, and physicians both for providing high quality care—including patient experience—and improving that care over time.
Internal Rewards
Internal reward and recognition programs usually include formal programs, day-to-day feedback, and informal recognition programs.
Formal Programs. Examples of internal formal programs include:
- Staff recognition awards that focus on different behaviors and actions, such as implementing quality initiatives, service excellence, clinical competence, teaching, and mentoring.
- Years of service awards: 5, 10, and 25 years.
Day-to-Day Feedback. Effective managers provide consistent and timely feedback to employees about their performance. Experts confirm that providing praise in a timely manner does have a positive effect on employee motivation and sense of belonging. Some organizations develop formal coaching programs to assist managers in coaching and providing feedback to their employees and peers. Many organizations share patient comments with staff who are mentioned and post general comments in public areas for all staff and patients to see.
Related topic brief: Using Patient Comments and Narratives to Identify Improvement Opportunities and Solutions
Informal Recognition Programs. Many employees go above and beyond their assigned duties to assist patients, other staff, clinicians, and the community. It is important to encourage the recognition of these individuals for their service excellence, teamwork, integrity, or overall positive attitude. Research indicates that informal recognition by managers, such as personal thank you notes and opportunities for colleagues to express appreciation for each other, is a key motivating factor for effective job performance.1
“Creating loyalty means giving employees more for their labor than just a paycheck. Both research and personal experience tell us that people work for a sense of accomplishment and the recognition of others.”
Gelinas L, Bohlen C. Tomorrow’s Workforce: A Strategic Approach. VHA Research Series; 2002.
Orientation
Orientation of new employees is the best place to begin the education about the culture of your organization. It is also an excellent way to highlight how the internal reward and recognition system is linked to the philosophy of care and organizational standards.
Key objectives of orientation:
- Instill a feeling of self-worth.
- Create a sense of belonging.
- Develop an attitude of pride and confidence in oneself and the organization.
- Spark a desire to succeed.
- Enhance the relationship between the employee and the organization.
- Highlight the importance of everyone’s role in delivering patient- and family-centered care (sometimes through presentations by patients and families).
“Most people can’t sleep the night before their first day of a new job. They probably decided two weeks in advance what they’d wear. They can’t wait to get started, meet new people, see everything, do great things. After all of the anticipation, their first day is usually a big yawn. They find themselves hidden away in a room somewhere filling out forms. What a mistake! First impressions are lasting.”
Rosenbluth H. The Customer Comes Second. New York, NY: Harper Business; 2002.
Compensation and Benefits
Compensation and benefits can be designed to reinforce the desired behaviors and performance standards of the organization. Compensation levels can be linked to meeting service-oriented performance standards, coaching and mentoring goals for managers, and other indirect reward activities, such as completing performance reviews on time.
Check out some ideas for incentives and benefits.
Rewards That Go Beyond the Individual
Rewards can also be actions and changes that support the entire organization and help transform the culture. Examples include the following:
- Improve your systems to “make it easy to do the right thing” and improve the quality of life for frontline staff.
- Make sure people have the aptitude, training, and resources they need to perform their job well.
- Give star performers the opportunity to attend conferences of their choice and/or receive tuition reimbursement for courses that advance their expertise.
- Tell stories, create legends, and celebrate “heroes” in organizational communications
- Help people get recognition internally and externally through presentations at meetings and conferences, newsletters, and local media.
- Encourage patients to compliment staff when appropriate (e.g., with thank you notes or voice messages), and publicly post thank you letters from grateful patients and families.
- Be aggressive about the management of poor performers (i.e., staff who do not uphold the values and culture of excellence).
- Show respect for people; start everything on time.
- Invite frontline staff to meet routinely with senior management and the board to improve communication and trust in management.
1. McElroy J. Managing workplace commitment by putting people first. Human Resource Management Review 2001;11(3): 327-335.
