Compass One Healthcare Trains Support Staff in Patient Experience Best Practices

Added on Jan 24, 2019

​​Compass One Healthcare Educates Support Staff on Patient Experience Best Practices
By Audrey Doyle

Compass One Healthcare knows that highly engaged nonclinical support staff play an important role in the delivery of patient-centered care. So the organization has developed a comprehensive training program to ensure that the staff it outsources to hospitals and health systems nationwide are up to the task.

Based in Wayne, Pennsylvania, Compass One supplies approximately 1,800 hospitals and health systems around the country with staff (“associates,” in Compass One parlance) who specialize in one of eight service lines—among them environmental services (EVS), food and nutrition, and patient transportation.

As health systems increasingly realize that factors such as cleanliness of the environment and food quality—while not drivers of patient experience—can positively or negatively influence their ability to meet patients’ needs, they’re turning their attention to these service lines, and their expectations are high.

For this reason, in 2014 Compass One began an exclusive partnership with Press Ganey to better understand the role that highly engaged nonclinical support staff play in improving the care experience for patients, their families, physicians, nurses and other clinical staff. Today the company trains its associates in patient experience best practices and implements several workforce engagement programs to ensure that they feel connected to their work and passionate about the contributions they make to the patient care experience.

A Positive Patient Experience Begins with Positive Impressions

According to Compass One’s vice president of patient experience, Thomas “Dusty” Deringer, nonclinical support staff are the “unsung heroes” in hospitals’ patient experience efforts. “They’ve historically been overlooked, partly because there tends to be high turnover in these positions, but mainly because they’ve been perceived as having minimal or no impact on patient experience compared to physicians, nurses and other clinical care providers,” he said.

However, the relationship between a hospital’s nonclinical support staff and its patients can influence patients’ perceptions of their overall care experience. As Deringer explained, patients encounter nonclinical support staff—particularly those working in the areas of housekeeping, food service and patient transportation—frequently during their stay and view them not as authority figures or threats, but as people with whom they can have friendly conversations about their families, their favorite sports teams, and other topics that can help them take their minds off the reason they’re in the hospital. 
 
“When these staff interact with patients, it’s never to poke or prod them. Just by the nature of the work they do, they’re there to enhance the patient’s hospital stay in some way. So they are integral members of a hospital’s caregiving team and they do play an important role in patient experience overall,” Deringer said.

To illustrate how integral these staff members are to an organization’s clinical team, Deringer pointed to Cincinnati Children’s Hospital and Yale New Haven Hospital as examples. Both facilities began outsourcing staff from Compass One a few years ago. At Cincinnati Children’s, the contract is for EVS staff. At Yale New Haven, it’s for food services staff. 
 
To illustrate how integral these staff members are to an organization’s clinical team, Deringer pointed to Cincinnati Children’s Hospital and Yale New Haven Hospital as examples. Both facilities began outsourcing staff from Compass One a few years ago. At Cincinnati Children’s, the contract is for EVS staff. At Yale New Haven, it’s for food services staff. 

According to Deringer, the hospitals have since improved their ability to meet patients’ needs and expectations regarding cleanliness and food service, as reflected in their patient experience survey scores. At Cincinnati Children’s, top-box scores for the “Room was kept clean during my stay” item rose from 67.2 in 2015 to 76.1 in 2018—a 13.2% increase. And at Yale New Haven, mean percentile rankings improved from 2013 to 2018 on all three survey items pertaining to meals: “Quality of the food,” which rose from the 35th to the 67th percentile; “Temperature of the food,” which rose from the 9th to the 47th percentile; and “Courtesy of the person serving the food,” which rose from the 10th to the 26th percentile—reflecting a whopping 250% increase overall.

“Although nonclinical support staff can’t limit a patient’s inherent suffering—the pain they’re in, or their diagnosis, for example—they can limit a patient’s avoidable suffering—not getting the meal they ordered, not cleaning their room properly, the equipment being used on them isn’t working properly, or there’s a delay in their transportation,” Deringer said. “So they play a tremendous role in the patient experience.”

To ensure that Compass One associates understand how their interactions influence patients’ perceptions of the care they receive while in the hospital and, through extension, their perceptions of the quality of the hospital as a whole, the company developed Positive Impressions™, a program that trains associates in patient experience best practices.

The best practices are grouped into standards that are applied across all of Compass One’s service lines. For example, as part of the Defining Moments standard, associates in food and nutrition services learn that the way a patient’s first meal is presented to them influences their impression of how good the food will be and of the hospital’s food services department overall, so they’re trained in tray presentation protocols designed to show patients that they care about the food they’re serving. 

As part of this standard, these associates are also taught the importance of timeliness and accuracy of food delivery. Research shows that patients expect their food to be delivered on time and to get the meal they ordered. If this doesn’t happen, it can have a negative impact on their perception of the overall quality of the food at a facility, Deringer said. “So we train these associates to visit each patient within 24 hours of admission to set their expectations around meal service and to understand their expectations of what an exceptional dining experience is. We also do a ‘check-back after 5,’ where we deliver five trays and then revisit each of those patients to see if they need anything.”

Another best practice in the Defining Moments standard is to engage in Compass Conversations—essentially, key actions and key words associates should use when interacting with patients. For example, when cleaning a patient’s room, EVS associates are taught to briefly explain what they’re doing and why they’re doing it. 

“A housekeeper will say to the patient something like, ‘I’m cleaning your bedrail to prevent you from getting a hospital-acquired infection,’ or ‘I’m using a new rag so that I’m not cleaning your table with the same rag I used to clean your bathroom,’” Deringer said. “The idea is to explain what we’re doing at each step of the process so the patient is confident that we’re providing a 100% clean environment.

“In health care, we used to want our housekeeping staff to be like Ninjas—run in, clean the room, be quiet, don’t be seen, and run out. Since the advent of HCAHPS, we can’t do that anymore,” he continued. “We want people to enter the room, introduce themselves, be courteous, engage in friendly conversation, and not only clean the room thoroughly, but leave patients with the perception that we cleaned the room thoroughly.”

Patient transporters receive similar conversation training. “We call it the 15 Golden Minutes—those 15, typically uninterrupted minutes they have with the patient when they’re transporting them from one area to another,” said Deringer. During transport, associates are taught, for instance, to form a human connection with the patient and their family by engaging them in friendly conversation, and to talk about the hospital or the patient’s medical condition only if asked a specific question that they can answer.

At handoff, meanwhile, they’re taught to “manage up” so that the caregiver they’re handing the patient to can begin their interaction with the patient on a positive note. “For example, a transporter might say, ‘Jim will take great care of you, he really knows his stuff,’” said Deringer. “It’s a great opportunity to let the patient know they’re being seamlessly cared for and to lessen any anxiety they might be feeling.”

Because no two hospitals are exactly alike, Compass One also works with its clients through the Positive Impressions program to develop action plans that are tailored to the facility or unit being served. The action plans act as a tool for assigning accountability and completion dates to individuals. An action plan developed for EVS staff might include strategies for developing a way to better understand and exceed patients’ expectations of cleanliness, and might include such tactics as ensuring that the department leader meets with all new patients within 24 hours of admission and that expectations are recorded on whiteboards for all new patients on target units. 

Nurturing Employee Development and Engagement

According to Deringer, when employees are happy and engaged in their jobs, they’re more likely to have a positive influence on patients’ perceptions of the facility and their overall care experience there. This makes patients more likely to recommend the hospital to family and friends, which protects and promotes the hospital’s brand, Deringer said.

To this end, Compass One developed several programs designed to retain, grow and engage its associates. For instance, to ensure that associates not only maintain but improve their skills, the company holds monthly training seminars and provides optional skills development classes. These efforts have reduced turnover and enabled Compass One to grow its most talented managers from within. 

Rewards and recognition are also key components of Compass One’s engagement formula. For instance, a monthly recognition initiative known as the GEM2 Program recognizes and rewards hourly associates based on the key performance indicators of customer service, safety, company values, quality and attendance (GEM2 stands for Great Employees Make Magic).

Through another program, known as Make a Difference, Compass One recognizes associates for their dedication to improving the lives of those they touch while on the job by accentuating the company’s core values, demonstrating initiative and innovation, performing tasks that fall outside their normal responsibilities, and making a difference in the life of a patient and client.

As an example, Deringer recounted a difference that Compass One food services associates made for a patient at Yale New Haven Hospital. The patient was going through chemotherapy treatment and was too ill to attend his son’s wedding, so Compass One associates worked with the hospital staff to enable the patient to “attend” the wedding from his hospital bed. 

“They got the patient a tuxedo, our chef cooked the same dinner they were serving at the reception and baked a replica of the wedding cake, and they live-streamed the ceremony and reception so the patient could feel like he was with his family during the celebration,” Deringer said. “Actions like these are very motivational and make our associates feel like they’re caregivers and that what they do really matters.”

Support from hospital leadership is essential for creating an environment in which nonclinical support staff are recognized for their contribution to patient care. So Compass One also has a team of more than 100 patient experience managers who work with client hospitals to develop and foster a culture in which associates are elevated to the level of caregiver.

For example, at client hospitals, Compass One’s EVS associates are included in nursing staff huddles and patient rounds, and nursing staff are included in EVS celebrations for a job well done, such as when a housekeeper reaches their monthly HCAHPS goal for room cleanliness. This imparts the message that housekeepers and nurses are partners in achieving their HCAHPS goals, and further emphasizes the housekeeper’s role as a caregiver, according to Deringer.

And that’s really what Compass One’s mission is all about, Deringer said: ensuring that patients at client hospitals feel good about the care they receive from associates, and that associates feel good about the care they provide to patients and are viewed by clients as caregivers.

“Our associates don’t start IVs or perform surgery, but they do help enhance the patient experience,” Deringer concluded. “As I tell our associates, you have more than a billion patient touches in the United States annually. That’s a billion opportunities for you to really knock it out of the ballpark and brighten someone’s day.”