Once the initial candidates were hired
they attended a general hospital orientation. All training was done at the hospital
for about 6–7 weeks prior to the opening of the pavilion. In addition, a two day
team orientation specific for the facility
was conducted, which took place about
two weeks prior to opening. For much
of the team, this was the first time they
met so orientation was done as one large
group. This orientation not only reviewed
items such as life safety, facility layout, and
parking, but a number of team building
exercises were also held. Team members
were divided out by shifts, not specialties.
This was very purposeful, as it was a key
step in ensuring leaders were not enabling
the silo effect.
Emphasis was placed on Studer’s
AIDET concept, which stands for
acknowledge, introduce, duration,
explanation and thank. 1 Team members
were taught how to develop their own
AIDET and how to utilize “key words
at key times.” The expectation was set
that AIDET would be used for “every
patient every time.” Additionally, there
was a four hour class focused solely on
the patient experience and on how to
communicate with the patient, actions
that could be taken to provide a higher
level of care, and how to perform service
recovery if the patient’s expectations are
not being met.
Team members were taught about the
expectations for being a part of the team.
The expectations are similar to what Studer
calls “standards of behavior” or Michael
Cohen calls “conditions of employment.” 2
They include items such as:
• Refrain from negative/disruptive
behavior (eg, complaining, gossiping,
communicating in an inappropriate
Accountability and Sustaining
Merely selecting and educating a team
was not enough to create a culture of
excellence. After all the selection and
training came the hardest part for the
leaders. Leaders had to ensure that what
was taught in orientation was implemented. For many teams, this is where
failure occurs. With opening a new center
there was a lot of excitement and energy,
but eventually people got comfortable
and lost some focus and energy. The
leaders had to keep that focus and make
sure the mission and vision of the team
were at the forefront.
To help ensure team members stay
focused, leaders rounded on patients
daily. Outpatient imaging patients and
ED patients were rounded on by lead-
ers. During patient rounding leaders
talked with patients about their services.
The following questions are asked during
• Have you been receiving excellent care?
After rounding with the patient, the
leader provides feedback to the team
member caring for the patient. If an
issue is identified the leader will perform
service recovery immediately. The nurse
manager of the ED rounds on outpatient
imaging exams, as well as ED patients.
The imaging lead does the same. The
expectation is that all leaders are respon-
sible for all patients.
The facility has been open for a little over
a year and over 350 interviews have been
conducted. There are still some vacancies
to fill, but the team is okay with that. The
team is phenomenal and willing to fill in
the gaps until the right people are found.
So far, there have been well over 16,000 ED