Six Steps to Getting Employee Buy-In

Every organization has established policies and work rules, and healthcare providers are no exception. In order for Quality and Process Improvement initiatives in the healthcare industry to succeed, we need a level of compliance. Yet, most managers are uncomfortable gaining the level of compliance and the commitment required to live within the rules.

True performance issues center on quality or quantity of work and should not be confused with someone not following work rules. While guidelines can sometimes be stretched, policies and rules, such as starting times, safety, dosing instructions, etc. must be followed.

[eventPDF]Adhering to and accepting hospital policies and procedures can sometimes be a problem for employees. Often, your best performer is the one who wants to bend the rules. Additionally, some employees might be able to stretch the rules without it affecting their performances, but others in your work group can create huge problems when they bend a rule. Allowing one employee to stretch rules can lead to the perception of favoritism and cause problems with other employees.

Hospital policies and procedures must be enforced. After all, rules and policies are an important part of an organization’s success. The difficult, but necessary, job of the supervisor or manager is gaining acceptance of acknowledged work rules. While it may not be enjoyable, it is necessary. How often have you wanted to say: "Just do it!" That’s the quick and dirty response but not exactly the most effective way to gain acceptance of company rules.

You can keep your employees committed to work rules by following specific Action Steps designed to generate buy-in.

Take this example for instance:

Your hospital has specific work hours for good reasons. One of your top performers recently started to show up 40 minutes late for her assigned shift. Her being late doesn’t affect her productivity, but if others adopt this work habit, you could have a problem with overall productivity and customer service. What do you do about this? If anything?

A situation like this doesn’t need to be difficult if you keep a few key points in mind. First, be committed to the rules and policies of the company. If you not committed, no one else is likely to reach commitment.

Next, define what you consider is an acceptable outcome before you ever have a conversation with the employee who is not following hospital rules. Ask yourself what optimally you would like to achieve and what your minimal acceptable outcome would be.

When you do talk to the employee, don’t make the discussion personal. If you do, the likelihood is that the employee will become defensive. Remember: It is about the rule and policy, not the person. Despite the potentially touchy nature of the situation, it will help if you focus on the behavior and not the person.

Also, recognize that occasionally, a temporary situation might be causing the problem, so you need to understand why your employee is not following the hospital’s rules or policy. Temporary situations can be worked around. However, for long term scenarios, you may need to find other ways to deal with the employee’s situation. But keep in mind, sometimes there is no work around, especially when not following the rules (such as safety regulations) could put the employee and/or others at risk.

Another step is to acknowledge and attempt to see the situation from the employee’s perspective. This allows you to focus the conversation on finding solutions to meet the work rule. Often it is the employees themselves who find a solution that is acceptable.

Finally, and most importantly, maintain confidence that together you and your employee will find a way for the rule or policy to be met.

Action Steps at Work

Let’s look at the specific Action Steps and examples demonstrating how the conversation might go.

1. Describe the exact behavior that would be in accord with work rules.
"Each shift has a specific start time and it is important that everyone is on time."

2. Explain why.
"Our patients depend on someone being available around the clock."

3. Ask for reasons the issue exists now.
"This has not been a problem until recently. Is there something that is causing the frequent tardiness?"

If there are reasons that cause the behavior that you can live with temporarily, then adjust. Sometimes personal situations dictate temporary measures, but they must be temporary with a timeframe that everyone involved can live with. Certain rules and policies, such as safety, sexual harassment, etc., have no such latitudes.

4. Restate the work rule and ask what can be done to change the behavior.
"The hospital policy is that the shift start time is 8:00 a.m. What can be done in order to meet the policy?"

5. Discuss suggestions and select the best solution.
"Let’s discuss the different options that will meet the company policy and then choose which one ensures that the policy is met."

6. Seek commitment not agreement.
"My expectation is starting Monday all hands on deck at 8 AM ready to work."

"I will try. I will do my best…" are not commitments. They are only good intentions. In those situations, keep the conversations going until you are able to obtain the employee’s commitment. While this may take a little longer, doing so is worth the effort and time.

Living within the rules is essential for any organization and the Action Steps we outlined here should help you gain the buy-in essential to following the policies set forth by your hospital.

First published in HR Pulse, Fall 2009.