So this is just a very brief thought I had over dinner tonight. OT is by definition a service profession, we are paid to provide a service to others. Waitstaff who provide good service receive (in theory) increased compensation from their customers, and those who provide subpar service are not as well compensated. However, OT is basically "flat-rate" pay, with some increased compensation for experience, but no financial recognition of competence or above average performance. (at least in my experience- is anyone being compensated for specialty certification or other signs of advanced practice??) The only fiscally-related judgment of competence is whether you continue to be employed. We've had a lot of cuts at our hospital lately, particularly in the employee recognition department, and I think it's fair to say that morale is down. We have ways for patients to recognize excellent staff, but one of those methods is tied to the Press-Ganey survey, which doesn't go out to the patient until they have already been discharged for several weeks. By that time, I feel that our impression on the pt. and family may have faded a bit. Anyway, my idea is that during the discharge session with the RN, the pt. and family were handed a paper asking them which services they had received that had a checklist of various ancillary hospital services, and then gave them an imaginary$10-$20 to spend on "tips" for the staff members/departments they felt offered good service. Accumulating "tip money" could either result in an incentive reward or an actual dollar reward, which I think would be cool. I've never worked in another service profession that gets tips, but I have to imagine that it is somewhat motivating to see a reward immediately after your service was provided. Good feedback and all. Any thoughts?


harrisontraining said...

Interesting idea but problematic.

The imaginary tip thing creates a limited resource (a pretend $10-20) and then requires the family and service user to distribute that resource between service providers.

You risk setting up a competitive performance culture. This has implied ramifications.

Would there be a perception within a department that fewer tips means more likelihood of redundancies in the next round of cuts, for example?

If so then it would not take long for collaboration between departments to break down.

Each department would be looking out for their own, to some extent, out of a natural sense of self-preservation.

This dynamic is unlikely to be explicit, or even consciously entered into, but may well be the inevitable outcome in any event.

The risk of sub-conscious, unwilful sabotage between teams would be far too great.

I don't think the redundancies in your team and the lack of an effective feedback system should be linked at all. I hope that has not been the case to date.

For all of that, enabling and obtaining feedback should be given more emphasis.

Great post and great blog!

Cheryl said...

Thanks so much for the thought out comment! I didn't really think about the potential to pit departments against one another, and unfortunately (especially in big bureaucracy of some hospitals) anything that appears positive in one light will definitely have a negative consequence too.

Caitlin said...

Your post reminds me of a fieldwork I recently completed. It was at an acute rehab site affiliated with a large hospital. This hospital has high regards for client satisfaction and in turn employee recognition.

The hospital works on a star system and how it works is for anything good an employee does and is recognized for they earn a star. For instance, if an employee goes out of their way to help a patient get comfortable in bed with positioning and extra blankets and someone else observes them and makes note of the good deed the individual will be given a star.The employees also receive up to five stars depending on their annual reviews, all of their stars are stored in a bank that the employee can access at any time. The hospitals website includes a tab for employees in which they may redeem their stars for different products. The more stars you have the better the prize. I observed one employee redeeming their points for a Wii! I know that incentives such as this may be a bit expensive especially if your hospital is making cuts BUT I do feel that this program could be beneficial!

I also agree that your reviews may be more effective and honest if the individual is given the survey upon discharge and not through the mail.

Morgan said...

This post immediately reminds me of an OT manager clinical reality assignment I had to do. In my imaginary clinic I had to come up with a creative solution to increase morale, communication and use of occupation based treatment. One solution I had was to create a program where the therapist who receives the most points on a 0-5 scale over a 3 month period, based on client satisfaction, would receive an incentive such as a free dinner at a restaurant, a spa day or golf day.

I feel using an incentive is a simple way to promote higher quality services however there is the risk of running into destructive competition among staff. However, I am an optimist and I hope all health care professionals in any particular setting would put aside an overzealous competitive streak to provide optimal services to all clients.