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Keep it personal to engage employees, improve care

December 9th, 2013

by Tom Salerno

A hospital is the ultimate service sector business, where it's all about people taking care of people. The primary role of a hospital president is to engage employees in the mutual goal of providing excellent patient-centered care. My job, in 10 words or fewer: engage and encourage the people who take care of people.

Engagement is a state of mind where people have a collective understanding. Nurses, radiology technicians, environmental services technicians, admissions representatives, social workers and others are interconnected in service to our patients. We look to one another every day to renew our common purpose and essentially recommit to our passion.

Studies show a positive correlation between employee engagement and behaviors that keep hospital employees and their patients safe from harm. One of the ways we recommit, reconnect and reinforce safety is through rounding. Doctors round on their patients, checking their progress and updating their courses of treatment. Nurses round on their patients, asking how they feel, checking vital signs, and providing kind, compassionate care.


Rounding helps everyone stay focused on what is important: attending to the individual patient's needs and ensuring each patient is safe and receiving proper care. Rounding is rooted in best clinical practices and has expanded into the nonclinical realm.

Our department directors round on their staffs. Senior leaders also round throughout the hospital, listening to employees. In a milieu of trust and openness, leaders acquire firsthand knowledge of what's going on in the hospital.

At St. Mary Medical Center, many of my mornings begin by meeting with staff in the emergency department, where we review patient flow, discuss concerns, and share ideas for improving hospital quality and operations.

Interactions with physicians, clinical leaders and other staff take place throughout the day. Sometimes these take place in a meeting room, sometimes in passing in the hallway. There are nights where we have so-called "pizza rounds," a good way to personally engage with staff in all departments.

Beyond rounding, things get more interesting when I don scrubs and work regular shifts with clinical support staff. In the past year, I've worked shifts in the operating room, the cardiac catheterization lab and the ER, performing terminal cleans, scrubbing patient gurneys, and preparing and restocking rooms when needed. I've helped with patient transfers--moving a patient from a bed to a gurney--and transported patients where they need to go.

Interacting elbow-to-elbow with caregivers and support staff helps to reinforce a culture of kindness that values the work done closest to the bedside. Wearing scrubs and working shifts allows me to have contact with front-line employees. They tell me what they like and don't like, what works well in their unit, and what changes they would suggest to improve quality of care and patient safety. Working with staff improves two-way communication and encourages employee engagement.

Upon return to my office, I'm eager to pursue new ideas and follow up on questions and concerns that our employees have expressed. Interacting with front-line employees allows for more informed decision-making that often helps the hospital's bottom line.

In the end, this is all about kindness and compassion. If we demonstrate our values by working alongside our employees, then it will be reflected consistently in the care we deliver to our patients every day and night.

Tom Salerno is chief executive officer of St. Mary Medical Center in Long Beach, Calif.


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