We have a small staff of Patient Service Representative and a couple of staff in her department to proactively (we try! but not always) speak to patients and deal with complaints we have complaint process that now includes leaders in doing investigations and resolutions. Templates for letters have been developed to assist managers in writing responses and all investigations are on a shared plateform (MIDAS) so managed by Patient Relations but entry can be from staff etc. We have hard wired this function into our leaders and some staff's role accountabilities. It is no longer viewed as a separate function - much like quality. But we have an expert or two that oversees the program.

We have a variety of different programs for staff satisfaction and have significantly cut back on the gifts and programs that are expensive with the difficult financial times in our community.

We have tried to maintain the less espesnsive recogonition programs. For the most part staff is supportive. We are now trying to improve communication with the staff to avoid the rumor mill from corrupting the progress we have made.

Service Excellence outside contracts can run as much as $300,000 per year for a full time in house consultant. not being able to afford that, we have tried an internal SE committee to define expectations and to beat that drum. We have also reassigned one leader who gets it to a half time role to work with key areas of influence. The key, beyond all else is CEO commitment and role modeling - better than any long term consultant! But he/she must be as attentive to it as he/sh eis to th efinancials - or everyone else will let it slide. when your senior leaders ask you to lead service excellence - ask them if they will lead by example and do everytthing you ask of them.

We have homegrown service excellence programs that have not been cut. These programs require nothing but the time of employees who volunteer to attend them. We have attempted not to cut programs, but to cut the frills surrounding each program - i.e. catering, multiple color copies for each participant, additional educational materials like books, CDs, etc. While we have successfully cut back on costs regarding these programs, we have been able to maintain a full catalogue/curriculum of service excellence academy courses for employees.

We have a customer service program which came from the Disney way of doing things. We call it "Here to Serve." Our employees can be recognized doing things for others, a ticket gets filled out and goes into a box for someone to be picked for the Customer Service Representative of the month. This gets awarded in front of as many of their peers as possible. Then every year we have one week, which happens to be this week where we celebrate our service standards, there are little benefits for the staff this year we are giving them beach towels, we will also have an ice cream party for the staff. Out of the 12 employees who were selected for the Rep of the month we give a Beacon of Service award.

Every new employee must go through the Here to Serve orientation class and most seem to enjoy it. Our yearly performance evaluations have the customer service initiatives weaved throughout.

We have a service excellence program in place modeled after the Studer Group's program without any formal contract/coaching. We have reduced our Leadership Development Institutes from 2 to 1 day per quarter, but have continued to fund and focus on the work. It's probably a 0.3 FTE of a Director in my department to lead the initiative. They are on the senior leadership team and I completely agree with Michael that CEO/senior team support and modeling is the most critical component of any program.

Though our budgets have been challenging this year as well, our senior management does not reduce expectations for top notch customer care. Great customer care should not have to cost a lot of money to implement. Our organization constantly reminds employees of our culture and high standards and we are encouraging all managers to accurately reflect employee performance in these areas on their performance appraisals. There is a consistent tracking of scorecards and managers in each area are held accountable. Though there is some standardization to the overall approach, managers are all encouraged to come up with creative initiatives that lead to the desired results. Each clinic in our ambulatory care division has a "service rep" that was nominated by their practice manager based on their excellent customer service skills. These reps meet at least on a monthly basis and share best practices and come up with new ideas to share. We are also rolling out a new standardized approach in our ambulatory division that will require managers to follow several service excellence initiatives. A few examples include the practice patient satisfaction goals on every employee performance appraisal (encouraging teamwork), every practice going through a monthly service excellence tracer survey with recorded scores, required commitment letters signed by every employee, etc. We also recently introduced multi-disciplinary shared governance in our ambulatory division and each practice has their own council (that will also eventually link up into the hospital councils). Since service excellence is always a priority in our hospital system, the councils will be addressing process improvements related to patient and employee satisfaction.