SOLUTION BRIEF | EMPOWERED EMPLOYEES · Solution Brief | Empowered Employees ... and/or the goal of...

Solution Brief | Empowered Employees

of 13

Copyright © Vocera, Inc. 2014.

SOLUTION BRIEF | EMPOWERED EMPLOYEES Empowering frontline staff to solve problems



of 13


CONTENT

What is Employee Empowerment? _______________________________________________________________________________ 3

The Case For Employee Empowerment ___________________________________________________________________________ 3

Leadership’s Role in Supporting Staff Empowerment ________________________________________________________________ 4

Understanding Employee Sentiment: the Pulse Survey __________________________________________________ 4

Approaches that Help Build Employee Empowerment: The No Excuses Team ____________________________________________ 5

The Value of The No Excuses Team __________________________________________________________________ 6

Creating a No Excuses Team _______________________________________________________________________ 6

Participants _____________________________________________________________________________________________ 6

Team charter ____________________________________________________________________________________________ 7

Getting started __________________________________________________________________________________ 7

Sample No Excuses Team Solutions __________________________________________________________________ 9

Other Approches to Employee Empowerment ____________________________________________________________________ 10

Leadership Rounds for Staff _______________________________________________________________________ 10

Empowerment for Service Recovery ________________________________________________________________ 11

Physician-Led Technology Planning _________________________________________________________________ 11

Innovation Funnels / Bottom-Up Ideas ______________________________________________________________ 12


of 13


WHAT IS EMPLOYEE EMPOWERMENT?

Employee empowerment is a key driver of cultural strength and resilience. It results when

employees have the competence and confidence to make key decisions about their work,

without constant recourse to leadership. This results both in lower management overhead

for trivial operational decisions, and higher likelihood that employees will make decisions

that align with organizational goals and values because they have embraced them as their

own.

Employee empowerment is not a tactic. Instead it results from an approach to

communication, shared decision making, change management, and recognition that is focused on enabling physicians and staff to

reach their full potential and create and optimal healing environment. There are many different tactics to help build employee

empowerment and engagement, but all share four fundamental actions on the part of leadership:

1. Inspire employees to embrace the mission of the organization

and/or the goal of a change process by appealing to their innate desire to

help patients and create an efficient, effective work environment.

2. Listen to the voice of physicians and staff to understand key

barriers, issues, and opportunities to driving improvement, and allow them

to have a voice in crafting solutoins.

3. Enable frontline workers to execute change by supplying resources

(education, funding, access to other skillsets within the organization, etc.)

and removing obstacles to change.

4. Reward employees for effort and successes, and create

opportunities for successful frontline leaders to expand their influence.

THE CASE FOR EMPLOYEE EMPOWERMENT

Based on extensive research, Gallup estimates that only 30% of U.S. employees are actively engaged in their work. Of the remaining

70%, 50% are not engaged, and 20% are actively disengaged.i This matters because engaged employees provide higher quality work,

produce better results, and have a greater entrepreneurial spirit to support their companies through changes in market conditions.

Actively disengaged employees, on the other hand, sabotage experience and productivity by spreading discontent. Often the

difference between engaged and disengaged employees, is leadership’s ability to inspire and empower. This is as true in healthcare

as in other industries. According to Towers Watson, higher employee engagement leads to:ii

Higher patient satisfaction and loyalty. Comparing HCAHPS overall ratings and nurse communication scores against an

employee culture index (confidence in leaders’ long-term business strategy, trust in senior leaders, and adequacy of

leaders’ communication of company goals and objectives) at a large system of 536 healthcare facilities found that facilities

in the bottom culture quartile scored 7 points lower on overall rating and 5

points lower on nurse communication than those in the top quartile.

Similarly, an analysis of 52 acute care centers found that organizations with

higher employee scores for “I have the equipment and supplies I need to

perform my job,” “I have the opportunity to enhance my skills and abilities,”

and “Communication here is a priority, and I have access to the information

I need” correlated to 7 point, 9 point, and 11 point better average results

respectively for patients’ willingness to recommend than organizations with

lower scores. What’s more, when culture improves, patient experience

score improvements accelerate. Source: Towers Watson study of a 536 facility system


of 13


Higher clinical quality. Examining clinical quality indicators at a system of 536 healthcare facilities, Towers Watson found

that facilities that scored in the top quartile of the organizational culture index had bloodstream infection rates 150% lower

than those in the bottom 25% of culture perceptions. In those same facilities, hospital mortality rates were 26% lower at

the facilities with the top quartile perception of confidence in leaders’ long-term business strategy, trust in senior leaders,

and adequacy of leaders’ communication of company goals and objectives than those in the bottom quartile.

Fewer safety incidents and less sick leave. Empowered, engaged employees are more dedicated and attentive to the work

they do. The top percentile facilities at a 536 facility system where employees reported receiving regular performance

feedback and recognition from supervisors for good work reported 48% fewer workplace safety incidents than did the

bottom quartile within the system. In addition, top quartile facilities on this measure had an average 26% fewer sick days

per year than did facilities in the bottom quartile.

LEADERSHIP’S ROLE IN SUPPORTING STAFF EMPOWERMENT

Senior leadership plays a large role in empowering staff to own and drive change. Shifting from disempowered to empowered can

initially be perceived as an increase in workload or blaming staff for problems that exist. To support empowerment efforts,

leadership must:

Tie improvement efforts to the broader mission and strategy of the organization to reinforce its importance.

Stand steadfastly behind the message that identifying and resolving issues is an expectation for all staff.

Visibly champion these efforts and provide the needed “air cover” and resources to resolve lingering issues.

Provide timely feedback and transparency into decision-making and budgeting considerations.

Dedicate resources to the change management process and to support local spending discretion.

UNDERSTANDING EMPLOYEE SENTIMENT: THE PULSE SURVEY

Empowerment initiatives that are foisted onto staff from management are likely to meet with resistance. A critical component of

engaging staff to participate in improvement as empowered team members is soliciting their perspective on what works well and

what barriers they perceive to creating an optimal workplace and healing environment. A low-cost, effective, and rapid way to

gather this feedback is to administer a Pulse Survey – a short survey that combines quantitative and qualitative feedback to assess

employee perceptions and preferences. The Pulse Survey consists of 2 quantitative and 2-4 open-ended qualitative questions:

Baseline Questions

• How likely are you to recommend this hospital/clinic as a place to work to a friend or relative?

– What would it take for you to rate us a “10” or to maintain your rating?

• How likely are you to recommend this hospital/clinic as a place to come for care to a friend or relative?

– What would it take for you to rate us a “10” or to maintain your rating of “10”?

Optional Questions

• What would you do to improve the patient and family experience?

• What would you do to improve the physician and staff experience?


of 13


Analyzing and discussing the information gleaned from the Pulse Survey with physicians and staff helps gain buy in, uncover barriers

to staff engagement, identify improvement opportunities, and promote dialog between leaders and staff. And because the pulse

survey is short and easy to administer, leaders can use it to benchmark and measure progress over time. One key result calculated

from a Pulse survey is Bain and Company’s Net Promoter Score (NPS)®. This is calculated off the gap between end users who would

provide ratings of 9 or 10 and of 1 through 6.

[More information, tools, and resources for the Pulse Survey are available in the Experience Mapping and Design Toolkit.]

POWER OF THE PULSE EXAMPLE - LAKE COUNTY TRIBAL HEALTH

Situation:

Lake County Tribal Health was initially established to serve the needs of the six Native American tribes that are located in and

around Lakeport, CA, but because these tribes are integrated into their surrounding communities, the center now serves all comers.

Through a Pulse Survey, LTCH knew that there was no way to move forward with initiatives to improve care along the continuum

unless they addressed low employee morale. The baseline NPS score was only 14.

Solutions:

The group immediately instituted monthly all-staff team building exercises designed to bring the staff together and build a sense of

shared purpose. “We knew we had to make changes and get to where employees were receptive to change,” says Iyesha Miller,

Quality Improvement Coordinator. “We had to do small processes and see the quick wins in order to then move on to the bigger

projects.” The team conducted communication exercises and discussed

opportunities to make LCTH a better place to work. And they engaged all

departments in discussions about the PEAC project plan so that all parties

would be invested in the improvements. Based on these meetings, the

LCTH team went on to tackle communication around the care continuum

directly, for example, by improving the check out process.

Results:

LTCH has experienced a substantial improvement in its Pulse Survey scores

– particularly in the staff members’ willingness to recommend the center

as a place to get care, which saw a 360% improvement. In addition, the

center has experienced a 5% decrease in the volume of patient complaints

each month from May 2012 to January 2013. And word of the improved

care experience has spread, leading to a 45% increase in new patients.

APPROACHES THAT HELP BUILD EMPLOYEE EMPOWERMENT: THE NO EXCUSES TEAM

There are countless ways to drive employee empowerment. Below, we detail one effective approach to driving change at the clinic,

unit or department level through the formation of a ‘No Excuses Team’.

The No Excuses Team is a multi-disciplinary team of frontline employees who are motivated and empowered to solve

the small challenges that pile up into significant disruptions in workflow, efficiency, and patient and staff experience.

Pioneered by a med-surg team at Twin Rivers Regional Medical Center (TRRMC) in Kennett, Missouri, the No Excuses

Team is designed to collect patient and staff challenges, and devise and implement immediate solutions – no excuses.


of 13


THE VALUE OF THE NO EXCUSES TEAM

The No Excuses Team enables staff to have an immediate impact on their environment, and empowers them to solve

problems without bureaucracy or delay. At TRRMC, the creation of the No Excuses Team resulted in:

A greater sense of self-efficacy among staff

Improved teamwork

16 Quick Wins in 2 days (including decluttering the nurses’ station, adding clocks to patient rooms, creating employee-of-the-month parking, creation of pediatric admission kits, etc.)

Contributed to a 117% increase in patient satisfaction

No Excuses Teams are a great way to capitalize on desire for change, build

momentum, and prove that the organization is serious in its commitment to driving experience improvement, working with staff to

co-create solutions, encouraging trial and error, and rewarding success.

CREATING A NO EXCUSES TEAM

PARTICIPANTS

The top criterion for joining the No Excuses Team is a willingness to listen and creatively solve problems, and an enthusiasm for the

work. Team members should consist of multidisciplinary stakeholders, including frontline staff members who work on and/or

support the clinic, unit or department. Participants may include representatives from:

Inpatient Outpatient

Physicians

Nursing

Case management

Radiology

Lab

Respiratory and physical therapy

Chart auditing, billing, etc.

Education coordination

Marketing

Social Work

IT

Physicians

Nursing

Physician Assistant

Medical Assistant

Site Manager

Front Desk / Registration

Call Center

Eligibility

Billing/Financial Services

At least some of the participants should have management authority. Central administration should be called in as needed. The

team MUST have an administrative/executive champion with access to budget.


of 13


TEAM CHARTER

Mission: The No Excuses Team’s mission is to identify and creatively solve the small problems that tend to get

overlooked, but which collectively erode patient and staff engagement and experience.

Primary responsibilities:

• Identify improvement opportunities in collaboration with all unit or department staff. Conduct experience

huddles weekly or monthly to solicit staff ideas.

• Brainstorm and design new solutions

• Conduct rapid prototyping and proof-of-concept

• Collect feedback regarding the success or failure of changes and tweak accordingly

• Celebrate success and recognize staff for their contributions to creating a more humanized healthcare

experience

Budget: Not every No Excuses Team has a budget, but it can be helpful to set aside a small amount of funds (~$2,000

per unit) to fund small purchases, and support team celebrations of success.

Scope: The No Excuses Team is ideally positioned to solve problems that are relatively contained. This does not mean

the solutions are always obvious, but they should not involve hospital-wide processes.

Good Fit for NET

Relatively small capital investment.

Improves staff and/or patient experience.

Solves a meaningful problem in a simple way.

Involves resources directly available/utilized on the unit

Not Right for NET

Requires a major process redesign or significant capital or training investment.

Crosses multiple units

Requires executive approval

Is a “pet project” that the unit does not see as an issue

GETTING STARTED

No Excuses Teams need the authority and backing of senior leadership to accomplish change. Below is a simple

approach to getting started and creating an operational rhythm to start a No Excuses Team.

1. Select a pilot unit / department –This focus area should have strong leadership and a willingness to embrace change.

2. Identify champions – No Excuses Teams should be led and managed on the unit/department, to ensure staff ownership of improvements. Unit champions should have leadership authority (implicit and explicit), respect of their peers, and enthusiasm for change.

3. Create an implementation plan – Determine the appropriate dates for communicating the implementation to unit members, conducting a kick-off event, communicating successes, and moving to an ongoing operating rhythm.


of 13


4. Collect baseline metrics – Determine which existing unit metrics will capture the value of change (e.g. patient experience, employee Pulse Survey, safety, etc.). Collect baseline data, and plan for collecting ongoing data (may need more frequent data collection at first).

5. Recruit a “starter” team –Champions should recruit a multi-disciplinary team that includes colleagues from clinical, facilities, and IT staff. Starter team members should have the experience to understand unit operations, and the authority to create small changes and make purchase requests.

6. Communicate, Communicate, Communicate (!) – Communicate the initiation of the No Excuses Team to the staff – through an all-hands meeting, daily huddles, flyers, email, small group discussion, etc. Identify starter team members, request input and opportunities, and provide a mechanism for sharing opportunities. Let staff know that there will be room to expand the team after it is launched.

7. Collect opportunities – Collect opportunities for the initial kick-off event. Solicit frustrations, challenges, and “we can do better” opportunities from staff on the unit. Be sure to include input from s team members. Document the sources of frustrations and ideas so the team can close the loop.

8. Conduct a kick-off event – plan a kick-off event to create momentum and make a dent in the backlog of problems. The agenda for a two-day event is roughly as follows (your kick-off can be anywhere from 1-hr to 2-days):

Day 1 Duration (Hours)

Welcome, introductions, purpose, defining the ideal experience for patients and staff

1

Pool, organize, and prioritize ideas (super quick fixes (2 hours or less), quick fixes requiring brainstorming, longer-term fixes). Assign owners.

1

Complete first set of super quick fixes. 2

Brainstorm solutions for top 2-3 “quick fixes requiring brainstorming.” Assign homework (checking in with stakeholders, sourcing supplies, etc.)

2

Day 2

Recap Day 1 successes, check in on homework, reassess priorities 1

Make progress on “quick fixes requiring brainstorming.” 1

Create communication materials for the broader unit (document successes, show impact – use photos!)

1

Plan ongoing operating rhythm – what additional team members are needed? 1

Celebrate .5

9. Communicate successes – Communicate successes to the unit/department/clinic – how many fixes got completed during the kick-off event? Recognize team members, contributions from unit, and define next steps.

10. Create an ongoing operating rhythm – Plan to meet weekly at first, then taper to an appropriate frequency as the backlog of opportunities diminishes. Assign key roles – communication, measurement, etc. Plan for how the team will collect opportunities that arise in other meetings/situations. Plan ongoing huddles to collect staff input.

11. Maintain visibility and priority – No Excuses Team rely on others surfacing opportunities and helping to design solutions. Find ways to highlight who is on the team, collect feedback, and celebrate and share successes within the unit and across the organization.


of 13


SOLUTION PRIORITIZATION FRAMEWORK

Members of the No Excuses Team can use the framework below to prioritize opportunities:

COMMUNICATION PLANNING TEMPLATE

Who What When Messenger

Unit or Clinic Champions

Program Overview Champion Responsibilities NET Team Format and Best Practices Goals and Measures

NET Trial Team Members

Program Overview NET Team Format and Best Practices Project Rollout Plan

All Clinic Staff Program Overview Format and Purpose of Huddles or other Info Gathering Goals and Measures Weekly/Monthly Experience Huddles Status Updates

MEASUREMENT AND MONITORING

To measure the effectiveness of these programs and validate the need for them, below are outcomes measures to assess:

Measure Baseline After

Pulse Survey

Staff/MD willingness to recommend - place to work

Staff/MD willingness to recommend - come for care

Patient feedback

Patient willingness to recommend clinic

Program Feedback

Staff rating of whether programs meet expectations

Staff rating of willingness to recommend program

Program Progress

Criteria Measure Points Criteria Measure Points

Urgency Issue will grow if not addressed 3 Time to fix Can be fixed immediately 1

Widespread problem 2 Days to weeks 2

Isolated issue 1 Months 3

Severity Quality & safety issue 3 Cost No monetary investment required 1

Known systemic patient dissatisfier 2 Nominal monetary investment required 2

Suspected opportunity to delight 1 Significant monetary investment required 3

Patient Impact Will affect 70-100% of patients annually 3 Process breadth Requires no process change 1

30-70% of patients annually 2 Process change limited to single work group/unit 2

< 30% patient annually 1 Systemic process change required 3

Staff Impact Will affect 70-100% of patients annually 3

30-70% of patients annually 2 TOTAL:

< 30% patient annually 1

TOTAL:

Importance Investment

Instructions: For each potential issue to be tackled by the No Excuses Team,

calculate the importance and investment. Prioritize high importance, low investment

opportunities


of 13


Number/frequency of experience huddles completed to collect staff input

Number of NET projects completed (high v. low importance)

Number of NET projects in process

Staff communication re progress frequency

OTHER APPROACHES TO EMPLOYEE EMPOWERMENT

There are many ways to build employee empowerment. Below is a selection of effective approaches.

LEADERSHIP ROUNDS FOR STAFF iii

Show top-down support for frontline employee engagement, ideas, and feedback.

The Challenge

At Baptist Easley Hospital, a 109-bed general acute care facility in South Carolina, an organizational survey showed widespread

dissatisfaction among staff and physicians.

The Solution

Leadership led a multi-pronged effort to improve relationships with employees by seeking their direct input on hospital services and

operations. For example, the hospital CEO attended new employee orientation as well as a 90-day follow up and annual meetings

aimed at discussing staff experiences. Other hospital leadership “rounded” on staff in order to solicit ideas. Key questions

leadership asked during rounds were:

What is working well?

Do you want to recognize anyone that has done an exceptional job?

Do you have the tools and equipment you need to do your job?

Are there any systems issues or questions that need to be addressed?

The questions asked during leadership rounds prompted employees to think constructively. They also identified areas for

improvement. Overall, the conversation is credited with creating an environment in which employee concerns could be expressed

and acted upon. Rounding also brought useful information to light, and provided space for deeper engagement with and

empowerment of staff. On the flip side, leadership had the opportunity to see the impact of their decisions on the frontlines.

The Results

Baptist Easley achieved and maintained results in the 95th

percentile on employee partnership surveys and won Press Ganey’s 2012

Distinctive Workplace Award. In addition, the hospital has benefitted directly from employee ideas. For example, these bottom-up

ideas led to nurse efficiency and staffing improvements that allowed the hospital to stop using external nurse staffing agencies. This

translated to cost savings that were over $1 million.

●Inspire ●Listen ●Enable ●Reward


of 13


EMPOWERMENT FOR SERVICE RECOVERY iv

Recognize staff of all levels as the face of the organization through system-wide

promotion of service standards and recovery.

The Challenge

UCLA Health wanted to tie their broad goal of providing “the best patient experience with every patient, every encounter, every

time” to their organizational approach to performance management and improvement.

The Solution

The CICARE service program was developed to engage staff and physicians in delivering exceptional experience. CICARE stands for

Connect, Introduce, Communicate, Ask, Respond, Exit, and guides multiple stakeholders in embodying best practices for patient

interactions. Within CICARE, all staff and physicians are trained to complete service recovery as needed. They are taught to listen,

apologize, and solve the problem by “taking control to do whatever you can to make the situation right.” Finally, they are asked to

thank patients and families for bringing the issue forward. These guidelines apply hospital-wide to any employee who is confronted

with a situation. In addition, each hospital department has access to a service recovery toolkit, including parking validation and

meal tickets, which is maintained by a toolkit manager who logs issues and delivers these assets to patients and families as needed.

Prior to being hired, new employees will sign a document codifying CICARE practices. Leadership also engages in CICARE rounds to

make sure practices are being put into place. “Wins” and opportunities are celebrated and shared at weekly CICARE leadership

meetings, and patient stories are used to emotionally cement the utility of the program.

The Results

CICARE has effectively decentralized service recovery and made it into a hospital-wide responsibility. Now, when patients look lost,

staff will stop in the hallway to help and often escort patients to their destination. CICARE contributed to an improvement in

HCAHPS "Would you recommend?” scores which more than doubled from the 37th percentile to the 75th a year after program

adoption. In March of 2010, this ranking was in the 95th

percentile.

Supporting Solutions from Outside Industries:v

Service Funds: Disney asks – and funds - employees to take five minutes from daily tasks to do something special for guests,

such as bringing chicken soup to the room of a sick guest.

Storytelling: Staff at the Ritz-Carlton Hotel Chain has a daily ritual in which they share a “wow” story – an account of

wonderful things done for guests during a 15-minute staff meeting.

PHYSICIAN-LED TECHNOLOGY PLANNING

Bring staff into decisions pertaining to strategy or resource use.

The Challenge

At UCSF Medical Center, physicians frequently requested that high-capital technologies be adopted by the hospital. The physicians

did not have visibility of the strategy and resource investment behind technology adoption. This led to frustration among both

physicians and staff.

The Solution

○ Inspire ●Listen ●Enable ●Reward



of 13


The UCSF Healthcare Technology Assessment Program (HTAP) was formed in 2005. This physician-directed program is tasked with

evaluation of technologies. Physicians present technology requests to a panel comprised mainly of their peers, and must be

prepared to discuss the corresponding “safety, efficacy, financial impact, and fit with the programmatic needs and mission” of the

medical center. Purchasing decisions can be made for those costing below $100,000. For more expensive investments, HTAP will

make a recommendation to the Capital Budget Committee.

The Results

About 38% of technologies submitted to the committee have been approved and 48% provisionally approved with additional review

pending. The committee is credited with reducing the contention around making investments in costly technology platforms, and

with honing physicians to take leadership roles within the medical center.

INNOVATION FUNNELS / BOTTOM-UP IDEASvi

Solicit, test, and implement ideas from the front lines through formal channels.

The Challenge

Nursing work environments are frequently not conducive to patient-centered care and contribute to poor outcomes, inefficiency,

high dissatisfaction and staff turnover. Hospitals in the State of New Jersey anticipated a critical need for a stable nurse workforce.

The Solution

The New Jersey Hospital Association ran a three-year program called, “Transforming Care at the Bedside – New Jersey” that took a

bottom-up approach to hospital improvement. In each of 48 hospitals and 2 non-acute facilities, two staff nurses were designated

champions and initiated improvement efforts in collaboration with individual unit managers and their facility’s chief nursing officer.

Frontline staff brainstormed new ideas, piloted them, measured outcomes, and then spread, modified, or ended projects, as

appropriate.

The Results

Solutions were developed that pertained to a variety of issues, for example, supply chain, medication delivery, and patient care

hand-offs. One unit developed an improvement in shift change handoffs by creating a standardized report sheet to be filled out at

bedside. Overall, pilot units showed significant improvements in pressure ulcers (decline from 3.39 to 1.65 per quarter) and patient

satisfaction as it related to being treated with courtesy and respect by nurses, and how often nurses listened carefully. Staff also

reported that the nursing work environment was greatly improved, in particular, teamwork scores increased across multiple

dimensions, including leadership.

ABOUT THE EXPERIENCE INNOVATION NETWORK

The Experience Innovation Network supported by Vocera Communications and the Stanford Clinical Excellence Research Center

fosters partnerships across organizations to revolutionize healthcare experience and outcomes. Founded by Dr. Bridget Duffy, the

first Chief Experience Officer in the nation, this network of healthcare pioneers is accelerating the discovery and adoption of

innovations that restore the human connection in healthcare that ultimately improves clinical outcomes, increases patient and staff

satisfaction, drives physician loyalty, and creates market differentiation in an uncertain healthcare environment.

©2014 Vocera Communications. Inc.

i Source: Gallup, Inc. “State of the American Workforce: Employee Engagement Insights for U.S. Business Leaders,” 2013.



of 13


ii Source: Towers-Watson, “When We’re Feeling Better, They’re Feeling Better: How Hospitals Can Impact Employee Behavior to

Drive Better Care Outcomes,” March 2012. iiiBaptist Easley Receives Summit and Distinctive Workplace Awards. Hospital Press Release, 11/28/12; Empowered Employees,

Satisfied Patients at Baptist Easley Hospital. 2010 Press Ganey Associates. Mike Riordan, President and Chief Executive Officer, Greenville Health System. Rounding with and for a Purpose. September 01, 2010. iv Mark Goulston, M.D., Putting the 'Care' Back in Health Care -- the UCLA Transformation, Huffington Post, November 4, 2010 09:00

AM; Healing Humankind One Patient at a Time: UCLA Health System - Los Angeles, CA February 2011, Jason A. Wolf, Beryl Institute; UCLA Health System: The Patient Experience, CICARE. http://hr.healthcare.ucla.edu/training/CICARE/index.htm v Hagen, Paul. How to Build a Customer-Centric Culture. Forrester Research, November 24, 2010.

vi Driving Hospital Improvements by Empowering Front-line Nursing Staff. Robert Wood Johnson Foundation. November 18, 2013.

SOLUTION BRIEF | EMPOWERED EMPLOYEES · Solution Brief | Empowered Employees ... and/or the goal of...

Documents

Transcript of SOLUTION BRIEF | EMPOWERED EMPLOYEES · Solution Brief | Empowered Employees ... and/or the goal of...