Dianne Davidson, CEO,
Union General Hospital

Service Excellence Standards and Expectations

OUR SERVICE GOAL
To provide consistently excellent patient-and family-centered care and service to patients, families, caregivers, support persons, guests, physicians and others.

Standard 1: CARING AND COMPASSION
To provide healthcare services to patients and families with care and compassion, in a manner that is sensitive to their cultural and ethnic health beliefs and their preferred language.

Guiding Philosophy
We are committed to providing the highest quality, patient- and family-centered healthcare services with sensitivity and compassion. We actively seek new ways of exceeding the expectations of patients, families, caregivers, guests, co-workers, physicians and others.

Expectations
Consistently shows caring by making eye contact, listening, offering assistance,  speaking in a warm, friendly tone of voice and giving information and explanations.
• Identifies an individual’s needs and responds to requests by acting quickly, communicating status, using all available resources and following through until the request is completed.
• Displays friendliness and approachability when communicating (for example, body language, verbal and written communication.)
• Notices a person’s special needs and takes steps to meet them (for example, age-specific needs, disabilities, etc.).
• Ensures that patients and families receive effective and respectful care that is provided in a manner compatible with their cultural and ethnic health beliefs, practices, preferred language, and spiritual needs.
• Respects patient-only areas (e.g. parking, drop-off, waiting rooms.) Demonstrates respect for environment and community health through healthcare practices.

Standard 2: TEAMWORK
To work as a diverse, organization team that provides quality, compassionate care and services to patients while promoting a sense of inclusiveness for all team members.

Guiding Philosophy
We recognize that each team member is skilled in his or her field. Only by combining our talents can we best serve our patients, families, caregivers, support persons, guests, co-workers, physicians and others. We respect individuality, celebrate diversity, and encourage collaboration and teamwork.

Expectations
• Arrives to work prepared and when expected. Avoids unplanned absences from work, providing as much notice as possible when absence is unavoidable.
• Takes responsibility for the “common work” of the department (for example, answering phones, maintaining department supplies, and responding to
requests).
• Is flexible in work schedule, assists other co-workers and willingly volunteers for additional assignments.
• Works with other departments to ensure efficient, timely delivery of care and services.
• Works with co-workers to solve problems.
• Displays a positive attitude, is receptive to change.
• Adheres to dress code, maintaining a professional appearance in clothing and personal grooming.
• Recognizes the importance of a multi-cultural workforce to best meet the needs of a multi-cultural patient population.
• Supports a work environment where co-workers are treated with dignity and respect.
• Supports diversity within the team and promotes a sense of belonging and inclusiveness for all team members. Avoids stereotyping of individuals (for
example, culture, ethnicity, race, religion, age, etc.)
• Works toward positive conflict resolution by listening and being open to different points of view.
• Listens to and accepts different points of view.

Standard 3: PRIVACY AND CONFIDENTIALITY
To maintain and protect privacy in every aspect of care and service. 

Guiding Philosophy
We establish and maintain a secure, respectful and trusting environment for patients, families, caregivers, support persons, guests, co-workers, physicians and others. Information regarding individuals and the organization is safeguarded, kept confidential, and treated as privileged. 

Expectations
• Follows HIPAA privacy regulations and applicable laws to protect health information while ensuring quality patient care and effective organizational operations.
• Respects the physical privacy and personal dignity of the patient while providing care and services (for example, closing doors and curtains, and providing additional gowns and blankets.)
• Requests permission to enter patient areas or offices and waits for acknowledgement.
• Secures all documentation containing privileged information (for example, filing in locked cabinets or shredding when appropriate.)
• Avoids inadvertent disclosures by discussing patient, employee and organizational confidential information in private (for example, avoids talking in cafeteria, hallways and other public areas.)
• Secures all computer information (for example, uses screen savers or logs off applications when computer is unattended, and keeps passwords confidential.)
• Verifies identity of person before releasing information via telephone, fax, or e-mail (for example, requests medical record number, employee number, birth date, or other identifying information.) 
• Maintains confidentiality when giving out privileged information on the telephone (for example, never leaves private information on answering machines or discusses on speaker phone.)
• Shares private information (for example, schedules, procedures and policies) only in private areas.
• Maintains confidentiality on all social media sites; never posts, discusses or references any information or photographs of patients, their families, visitors, health information or descriptions of interactions with patients. 
• Respects each patient’s definition of family or loved one.
• Listens to patients from their cultural perspectives, and explains reasons for asking for personal information. Acknowledges patient’s concerns, recommends a course of action, and negotiates a plan that takes into consideration patient’s cultural norms and personal lifestyles.

Standard 4: EFFECTIVE COMMUNICATION
To communicate effectively by using appropriate methods.

Guiding Philosophy
Effective communication is essential to our success in delivering safe, quality care. We communicate professionally in all interactions. We provide timely, accurate and consistent information that satisfies the needs of patients, families, caregivers, support persons, guests, co-workers, physicians and others.

Expectations
• Writes legible, understandable and specific communications.
• Answers the telephone in a timely manner, greets the caller, identifies him or  herself and offers assistance.
• Asks and waits for permission before putting the caller on hold. If an extended hold period is unavoidable, revisits the caller to communicate the status of the hold.
• Provides the caller with the correct extension before transferring a call. Offers the caller the opportunity to be transferred to voice mail or another person if the intended party is not available.
• Listens by giving undivided attention and checks to make sure that the information conveyed is fully understood.
• Selects the best way to communicate and deliver information to the right people at the right time (for example phone, mail, fax and in person).
• Keeps conversations positive and professional by using positive words and a pleasant tone of voice and volume.
• Ensures that online conversations on social media are positive and professional, never disparaging Union General Hospital or its staff.
• Provides translating services and communications equipment when needed.
• Except for emergencies, conducts personal phone calls and private business on personal time (for example, break and lunch time.)
• Respects others by placing communication devices on silent/vibrate and explaining their use (for example, using cell phones in private settings, limiting personal calls on Union General Hospital-provided communication equipment).
• Ensures that cultural and language needs are met.

Standard 5: Safety
To consistently promote and provide safe care and services.

Guiding Philosophy
Patient safety is everyone’s responsibility. We all create a safe and clean environment for patients, families, caregivers, support persons, guests, coworkers, physicians and ourselves. Union General Hospital relies upon reporting of errors, near misses and safety hazards in order to improve our care and services.

Expectations
• Patient Safety
• Intervenes to prevent harm to patients and self. Speaks up for patient safety.
• Follows National Patient Safety Goals (for example, using patient identifiers, reading back telephone orders, not using abbreviations, washing hands, falls prevention, etc.).
• Immediately reports errors, near misses and safety hazards to direct supervisor.
• Recognizes and facilitates the patient’s, their family’s, caregivers’ and support persons’ role in patient safety.
• Wears identification badge in an easily visible place at all times (for example, above the waist and with face and name visible.)

Environment of Care
• Is alert to and addresses unauthorized people in their area (for example, those without an ID badge.) Reports suspicious people, unsafe activities, or hazards in areas surrounding the facility (for example, speeding or accidents, lights out in stairwells, and vandalism.)
• Uses correct body mechanics when lifting or using equipment.
• Uses equipment appropriately. Follows usage and maintenance guidelines, and reports failures, broken equipment and hazards.
• Secures patient and employee belongings.
• Adheres to the non-smoking policy and enforces it with others.
• Keeps all areas clear and safe by removing hazards, trash and clutter in common work areas. Reports, marks and quickly follows up on all spills (for example, hallways, patient rooms and walkways). Promptly calls Environmental Services for a large cleanup.

Standard 6: QUALITY AND SERVICE RECOVERY
To provide consistently high-quality care and services, make efforts to ensure service recovery and be sensitive to the ways cultural influences can shape clinical encounters.

Guiding Philosophy
Problem solving is an important part of everyone’s job. We identify, correct and address problems quickly and efficiently in order to exceed the expectations of  patients, families, caregivers, support persons, guests, coworkers, physicians and others.

Expectations
• Anticipates potential quality and service issues and takes steps to avoid them.
• Follows the service recovery policy by acknowledging and apologizing when problems occur, listening attentively, and correcting the problem by taking action or informing the appropriate person to correct the problem. 
• Immediately reports potential and existing quality and service problems to the appropriate person (for example, direct supervisor, compliance officer, or risk manager.)
• Provides suggestions and new ideas to improve the quality of care and services.
• Participates in process-improvement activities and takes part in creating solutions.
• Appreciates the ways culture may shape a clinical encounter; demonstrates an inquiring approach that is alert and sensitive to cultural influences. 
• Ensures that conflict and grievance resolution processes are culturally and
linguistically sensitive and capable of identifying, preventing, and resolving
cross-cultural conflicts or complaints by patients/consumers.

Standard 7: COST EFFECTIVENESS
To perform work in a cost-effective manner while consistently providing high-quality care and services.

Guiding Philosophy
Providing consistently high-quality care and services to patients, families, caregivers, support persons, guests, co-workers, physicians and others is our highest priority.  Each of us also has the opportunity to help the organization succeed by performing our everyday duties in cost-effective ways.

Expectations
• Accurately accounts for and records time; ensure that all overtime is authorized in advance.
• Minimizes waste by using supplies efficiently. Recycles materials where appropriate.
• Takes proper care of and maintains equipment in order to avoid extra repair and replacement costs.
• Protects organizational property by safeguarding against abuse and theft (for example, secures equipment and locks office/desk.)
• Provides cost-saving suggestions and ideas.
• Helps the organization meet its philanthropic goals by participating in community or Union General Hospital events.

"Union General Hospital is for everyone, and our goal is to allow
each individual we touch to be his or her best."

A not-for-profit organization committed to our mission of service
excellence.