Hello, my name is Stephen Hurst. I am a Clinical Director of two Acute Medical Units at DePaul Health Center is St. Louis Missouri. My story is one of personal change.

Like most managers, I want my units to achieve high scores on quality and customer service. In working to achieve those results, I have tried many different things. I have had trusted colleges help me look at how my departments run trying to find that one thing that will make the difference.

Then after a conversation with my new Chief Nurse Kathy Bonser where she reviewed my continuing struggles with customer service scores, I decided to try one more person for help.

I spoke to Frances Thomas, an Employee Social Worker with whom I had had some good success stories from employee referrals she handled. While speaking to Frances, I reviewed the struggles I had and my frustration with my perception that my Care Team Coordinators just were not holding staff accountable. Frances asked me several questions relating to how I interacted with staff. I did not understand why she would ask such questions since the problem was with the Care Team Coordinators, but I answered anyway. Much to my surprise Frances then told me some of my problems were with how I interacted with staff.

How could this be? I suddenly had a lot to think about. Frances went on to explain that my style was one of encouraging staff to challenge me and the Care Team Coordinators did not know how to work with staff who challenged them. Frances also suspected that staff did not always know to turn off the challenging when interacting with patients, and so would cause customer service problems.

My past management experience had been in industry where the ability to, "hold your own" with co-workers was a valued trait. Then when I went into nursing, I first worked in the ER and then in the ICU, where customer service was not much more than making sure the doctor had what he or she needed. So again the ability to "hold your own" was a good trait.

After talking to Frances, I realized I needed to change and fast. I read the books "Crucial Conversations" and "Crucial Confrontations" and then held an all-day retreat with my Care Team Coordinators to make sure we were all on the same page with how to handle difficult situations. Our Press Ganey score went from the 2nd percentile to the 97th percentile in 3 months.

We have had some new challenges as we deal with staff shortages and as we work to refill newly opened positions. I recently received the best endorsement for the changes when I recently ask a nurse on 5 South if there was anything I should be doing differently. She responded that 5 months ago she would have said yes. But, she said to me, "You have dealt with and removed the staff members who were causing problems."