Significant Stat: Workday Interruptions

Research shows nurses in acute care complete 100 tasks per shift, with interruptions every three minutes. (source)

Advice from Alexandra Valentin, Corporate Director, Culture Transformation at The Ritz-Carlton Leadership Center:

Interruptions are a normal part of the workday. However, interrupting a nurse or other medical professional can compromise the patient experience—or worse, cause medical errors. Poor teamwork and ineffective communication among team members can contribute toward interruptions. One of the Service Values at The Ritz-Carlton focuses on creating “an environment of team work and lateral service so that needs of our guests and each other are met.” Teamwork is not a “nice to have,” it’s a “must have” that is owned by every Lady and Gentleman. To minimize communication failures, Ladies and Gentlemen at The Ritz-Carlton facilitate a daily meeting known as Line-up. Line-up provides both operational information needed for the day and content that connects the Ladies and Gentlemen back to our culture and purpose. Effective and productive teamwork can only happen when all team members understand the goal and the purpose of the organization. 

Our Enrichment Courses immerse clients in The Ritz-Carlton ambience while offering philosophical and tactical service excellence knowledge. Please visit our Course Calendar to learn more about our upcoming courses and to register. 

5 Ways to Include Family in the Patient Experience

If you accept the term “patient experience” at face value, it can imply that organizations should focus only on bedside manner or what happens in the hospital room. However, it’s important to take a much broader view of the term “patient experience.” Patient experience includes what happens when patients call the hospital and how patients receive their bills. Even the décor and smells in the hallways are part of the patient experience.

The Beryl Institute defines patient experience as “The sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.” A patient’s perceptions can be greatly impacted by their family and loved ones. Hospitals should remember that they’re not just serving their patients, but also their families. The families are sometimes more alert than the patient, and family members are taking in everything around them—including how they and their loved one are being treated.

Here are five ways that healthcare organizations should work on including family in the patient experience:

1) Recognition

At The Ritz-Carlton, we practice the Three Steps of Service, which ensure that we use “a warm and sincere greeting,” and “use the guest’s name.” This shows our guests that they’re not just another transaction—they’re valued as individuals. When healthcare professionals recognize family members, then family members feel reassured that their loved one is receiving personalized care and attention as well. This doesn’t mean healthcare professionals need to memorize a patient’s family tree, but if a spouse visits daily, it’s important to remember who that spouse is—and even better, know the spouse’s name.

2) Cleanliness & Safety

One of the Service Values at The Ritz-Carlton states: “I am responsible for uncompromising levels of cleanliness and creating a safe and accident-free environment.” Cleanliness is especially important in a healthcare facility because of the possibility of spreading infection. One family member walked into a patient’s hospital room and saw a small pile of dirt on the floor. The pile of dirt remained on the floor for several hours, and eventually, the patient—who was having trouble walking—was escorted by hospital personnel directly through the pile of dirt. While the pile of dirt may not have been a threat to the patient’s health, it indicated a lack of attention to details and that does not instill trust.

3) Timeliness

Healthcare professionals are busy and strive to spend as much time with patients as possible. Unfortunately, patients often need to wait for test results, specialists and sometimes even for scheduled appointments. If patients are accompanied by family members, then all parties end up waiting. This can be very challenging for family members who have re-scheduled their day in order to support a loved one at a specific time. Waiting for care becomes even more frustrating when staff does not indicate how long the wait might be. Answers like “soon” and “momentarily” are too vague and not informative. Your staff should work together to manage the expectations of patients and family members by setting and communicating realistic time frames. At The Ritz-Carlton, we strive to “create a work environment of teamwork and lateral service so that the needs of our guests and each other are met.”

4) Comfort

Hospital visits are often accompanied by fear and concern, and anything hospitals can do to lessen anxiety will help everyone. The Credo at The Ritz-Carlton pledges that “the genuine care and comfort of our guests is our highest mission.” If family members are visiting a loved one, they want to see that the staff is responding when the loved one is experiencing discomfort. Family members shouldn’t have to wander down hospital corridors looking for someone to assist their loved one. Family members often feel a sense of responsibility for loved ones, and they want to believe that their loved one is receiving the best care possible. It’s also important that family members feel comfortable. Providing a waiting room for families that is calm and peaceful can help alleviate tension.

5) Communication & Respect

One of the Service Values at The Ritz-Carlton promises that “I am always responsive to the expressed and unexpressed wishes and needs of our guests.” Providing good communication is one way to be responsive. Most of the patients in a hospital are looking for answers. What’s wrong with me? How can it be fixed? Family members typically have the same questions. In addition, family members may want to know possible risks and side effects. Even when loved ones are only facing a routine procedure, it’s not routine for the family. Their questions need to be treated with respect—even when their questions may seem silly. Family members should also be communicated with in a language they understand—free of acronyms and confusing medical terminology. Clear and consistent communication allows family members to feel that the needs of their loved ones are being met. 

Enroll in “Excellence in the Patient Experience” to benchmark the business practices of The Ritz-Carlton and discover how a service excellence culture results in engaged employees and legendary service.

DOs & DON’Ts of Setting Customer Expectations

Although every organization is striving to deliver perfect customer service, not all of your customer interactions will be home runs. Physician Brian Goldman points out in a TEDx Talk that a good batting average is .300—and that means a baseball player has only hit the ball three out of 10 times. A player who hits the ball four out of 10 times is considered legendary.

In customer service, when we swing and miss, it’s important to know how to quickly rectify the situation. One of the most important steps we can take is to set appropriate customer expectations, and this can begin before we even meet our customer. Every interaction with a customer—on a website, over the phone or in person—is an opportunity to set realistic expectations and prevent future disappointments. The following DO’s and DON’Ts share specific ways organizations can better manage customer expectations.

DO Value Your Customer’s Trust

When your customers are upset, their frustrations extend beyond a specific incident. They’re also upset because you have violated their trust. They may be saying to you, “I’m upset because you promised me a free toaster and instead you gave me a flashlight.” However, what they are really thinking is, “You’ve let me down, and I’m worried I won’t be able to continue trusting you.” Everyone in your organization must contribute to earning customer loyalty by endeavoring to establish and restore a customer’s faith in your services.

One of the Service Values at The Ritz-Carlton states “I build strong relationships and create Ritz-Carlton guests for life.” Lifelong relationships tend to include an occasional disappointment. However, when relationships are built on a foundation of trust, you have more understanding and goodwill as you work through any difficulties. You want to do everything possible to earn and maintain your customers’ confidence, and managing customer expectations will help preserve trust.

DON’T Oversell Your Products or Services

Everyone wants to be the best. If you’re a diner, you may want to claim you serve the best waffles in the country—or even on the planet! The problem with claiming to be the best is that you immediately set yourself up for comparisons and disappointments. Your customers may try your waffles, and they may really like them. However, liking them is no longer enough. Your waffles have to be the best waffles in the world! Your customers will be dissatisfied if your waffles aren’t far and above any other waffles they’ve ever eaten. Are you losing customers by setting the bar too high? When you inflate customers’ expectations, you’re making it more difficult for your organization to achieve success.

DO Pay Special Attention to Time Frames

Organizations often make promises related to time. “Someone will be with you in a moment,” “You’ll have the shipment by Thursday,” or the ever-so-vague “This won’t take long at all.” When time is part of the expectation, you’re in greater danger of losing trust if you get it wrong. If that shipment does not arrive on Thursday, your customer will be understandably upset. Depending on how you handle the situation, you may lose the customer’s trust altogether. If your organization is proactive in their communication, quick to look for solutions and rectify any difficulties and is apologetic, then you have the opportunity to restore faith. However, if your organization fails to communicate with the customer and maintains an indifferent, “win some, lose some” attitude, you will most likely lose future business.

The healthcare industry has one of the toughest challenges in regard to setting time frames. Doctors and nurses are in a difficult position because patients—and their families—want to know when they can expect to be well. It’s important to give patients hope; however, because doctors and nurses are also dealing with people when they are the most vulnerable, it’s important not to set expectations too high. If patients think they can expect to be up and waltzing next week, it will be hugely disappointing if they’re still confined to a sickbed. Healthcare professionals risk not only losing the trust of their patients, but also diminishing the spirits of their patients and their families.

DON’T Make Impossible Promises

Sometimes organizations make promises that seem possible when they’re being concocted in a boardroom with a group of passionate and committed executives. However, your staff—the people who will be fulfilling the promises—must buy-in and agree on the feasibility of the promises as well. At The Ritz-Carlton, one of our Service Values ensures that our employees—known as our Ladies and Gentlemen—are “involved in the planning of the work that affects [them.]”

Your organization can make promises to your customer—as long as the promises are truly executable.  Back in the 1960s, Avis rental car launched the tagline and brand promise, “We try Harder.” They maintained that promise for five decades, and according to AdAge, the “campaign reversed the company’s fortunes, helping it to go from losing $3.2 million to turning a profit of $1.2 million for the first time in 13 years.”

DO Practice Seamless Communication

Customers may contact your organization through email, text, social media, phone or in person, and it is your organization’s responsibility to record and transmit any communications appropriately. Your customer does not realize the complexities of your organization. Your customers want to believe that they can send one communication, and they will be heard. That is their expectation.

When there are communication breakdowns, customers often become frustrated. Think about the customer who calls your establishment to make a special request and is told everything is set, but finds out later that the request was never passed along. Or the customer who finds a coupon for your store on the Web, but when the customer arrives at the store, he or she finds out that none of your employees know how to process the coupon. Worst of all is when a customer is handed-off from one employee to another and each employee tells the customer a different story.

When customers are forced to sort through confusion and have to fight to be heard, they will lose confidence and faith in your organization. If your customers must be handed-off to another employee or if customers will need to reiterate their needs to another department, be sure to communicate the process to your customers. Good communications can deflate frustration and is a cornerstone of trust.

Don’t Forget to Value Your Customers

Your customers have more power than ever. They can shop anywhere. Even if you’re the only retail store on an island, you’re still competing with E-tail. If your customers are unhappy with your product or service, they don’t just tell their neighbor or friends. They tell the Internet and share their opinion around the world. Your customers expect to be valued. They expect to be cared for. When they don’t feel appreciated, they can easily carry through on the threat, “I will take my business elsewhere!” If your organization isn’t willing to make extra efforts and show customers that they’re valued, your customers will probably find a competitor who is willing to earn their business. Again, small gestures can make a small impact. Saying “thank you” and “we appreciate your business” are easy, cost-free and express your gratitude.

Focusing on Expectations

It’s important to meet the expressed and unexpressed needs of your customers, but at the same time, make sure you set realistic expectations. If you’re resolving an issue, be sure you direct your customers through any process and communicate regularly, thanking them for their patience along the way. Building relationships with your customers and managing their expectations takes extra time and effort, but it is rewarded by positive word-of-mouth and customer loyalty.

The Ritz-Carlton Leadership Center offers advisory services, courses and presentations to organizations that wish to benchmark the award-winning business practices of The Ritz-Carlton. Your organization can learn about The Ritz-Carlton methodology for customer service, employee engagement and leadership development. We also guide organizations through a multi-step process in order to achieve sustainable culture transformation.

Significant Stat: Medical Errors

In the United States, medical errors cost $17 billion to $29 billion per year. (source)

Advice from Alexandra Valentin, Corporate Director, Culture Transformation at The Ritz-Carlton Leadership Center:

If there is one thing we all have in common, it is the fact that we are all patients at some point. As patients, we rely on the competency as well as the genuine care from healthcare providers. However, as physician Brian Goldman points out in his TedTalk, doctors make mistakes—just like everyone else in the world. We can now search the Internet and find out which healthcare professionals and organizations have the least amount of errors, and the accessibility of this information has created greater awareness of patient experience and safety. Dr. A. E. Joiner, a celebrated orthopaedic surgeon from Alabama, credits his success to having a second opinion from another doctor, limiting his case load, treating people really well and getting to know them before and after surgery. At The Ritz-Carlton, we believe that a strong culture of service excellence can lead to a reduction of errors, as well as a reduction of complications. One of our Service Values stresses our commitment to “creating a safe and accident-free environment,” and like Dr. Joiner, we feel that genuine engagement with the people you are serving can greatly impact your outcomes. 

Join us for a one-day symposium on November 12th. Take advantage of the early-bird rate and sign-up by September 1st. The day includes a Ritz-Carlton executive panel with Herve Humler, president & chief operations officer of The Ritz-Carlton Hotel Company, L.L.C.

Patient Experience Impacts Safety

Medical errors are now the third leading cause of death in the United States. According to Hospital Safety Score, new research estimates up to 440,000 Americans are dying annually from preventable hospital errors. In addition, medical errors are very costly. The Institute of Medicine has estimated that medical errors cost $17 billion to $29 billion per year.

One method of reducing errors and increasing safety is to improve the patient experience. To many, the patient experience means expressing kindness and making patients happy. However, patient experience is more than just niceties. The Ritz-Carlton has built a brand based on service, and we know it is the systems we have in place—the systems behind the smiles—that ensure our service is effective and the guest experience is a positive one.

Healthcare leaders must focus on better service and adopt systems that will support an improved patient experience. This is especially true for hospitals in the United States that are participating in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS measures the patient perspective on care, and it focuses on key aspects of the patient experience such as communication with doctors and nurses, responsiveness of hospital staff, cleanliness and quietness of the hospital environment.

The research below shows how communication, responsiveness and cleanliness lead to improved safety.


Miscommunication can occur during patient handoffs. Three studies provide evidence that poor communication impacts safety.

  • A study on quality and safety of hospital discharge concludes that “Lack of knowledge, understanding and interest between hospital and community care providers are important causes for ineffective and unsafe discharge.”
  • The Agency for Healthcare Research and Quality shared a study that found that “nearly 20% of patients experience adverse events within 3 weeks of discharge, nearly three-quarters of which could have been prevented or ameliorated.”
  • A study in The Journal of the American Medical Association notes that when hospitals adopt standardized communication systems for patient transitions, they can significantly reduce medical errors. The statistical evidence showed that “medical errors decreased from 33.8 per 100 admissions to 18.3 per 100 admissions.”


  • Peter J. Pronovost, M.D., Ph.D., director of Johns Hopkins University’s Quality and Safety Research Group, has devoted much of his career to improving hospital safety. In his life-saving book, Safe Patients, Smart Hospitals: How One Doctor’s Checklist Can Help Us Change Health Care from the Inside Out, Dr. Pronovost shows how a lack of teamwork can impede responsiveness. By studying liability claims and substantially harmful errors at various hospitals, he found that in nearly 90% of instances a team member knew something was wrong, and either kept silent, or spoke up and was ignored.
  • When Memorial Regional Medical Center in Richmond, VA—part of the Bon Secours Richmond health system—began working with The Ritz-Carlton Leadership Center, the medical center had all of their staff—including the environmental services team—go through training to become more aware of patients’ needs. Not long after this training, one of the maintenance workers was in a patient’s room and noticed the patient’s face was turning blue. The maintenance employee quickly found medical staff and they were able to save the patient’s life. Before the training this employee rarely noticed the patients, but once he understood that patient experience was part of his role he was empowered to take action, which consequently, saved a life. Adopting a more patient-centric approach resulted in a decreased mortality rate at Memorial Regional Medical Center. In two years, the mortality rated dropped from 2.84% to 2.62%.


  • An article in Consumer Reports titled, “How Safe is Your Hospital?” asserts that “about one in 20 hospitalized patients will develop an infection. They can be devastating, deadly even, and many can be prevented. Dirty instruments, improperly sterilized catheters or needles, and the contaminated hands of doctors, nurses, or other healthcare workers are common causes.”
  • A blog post about medical errors by Bob Ruche, president of a healthcare consulting company, notes that “Hospital infections kill as many as AIDS, breast cancer and auto accidents combined in a given year. The most prevalent hospital induced infection, known as MRSA—accounting for 60% of all hospital induced infections—is generally spread through direct contact with the hands of a healthcare worker or a patient who is infected or carrying the organism.”

Patient Experience Impacts Safety

The patient experience goes beyond courtesy. When healthcare organizations become more patient-centric—when they empower employees and increase employee engagement—they have the foundation for improving communication, becoming more responsive to requests, and maintaining an efficient and clean facility. These improved standards not only affect the overall patient experience, they impact safety and save lives. 

Enroll in “Excellence in the Patient Experience” to benchmark the business practices of The Ritz-Carlton and discover how a service excellence culture results in engaged employees and legendary service.

Dear Ritz-Carlton: Hospitals and The Ritz-Carlton?

Dear Ritz-Carlton: What can hospitals learn from The Ritz-Carlton?

Answer from Alexandra Valentin, Corporate Director, Culture Transformation at The Ritz-Carlton Leadership Center:

Head Shot Alexandra Valentin

The U.S. Department of Health & Human Services asserts that “good medical care depends upon effective communication between patients and providers. Ineffective communication can lead to improper diagnosis and delayed or improper medical treatment.” Safety is at risk when communication is poor. At The Ritz-Carlton, communication is the essence of our legendary customer service. The systems behind our smiles—such as employee empowerment and daily line-ups—lay the framework for effective communication. We also practice being attuned to the expressed and unexpressed wishes and needs of our guests. Healthcare professionals must learn what is important to patients. Are you welcoming patients with a concierge mindset? Are you making them feel at home? Are you anticipating their needs — like an extra blanket, a cup of water, or maybe a “do not disturb” sign to minimize noise? Are you following up at discharge? Have you exceeded expectations? Even though guests typically come to The Ritz-Carlton for either business or pleasure, at hospitals or at the doctor’s office, patients deserve to be treated as humans. After all, one of the definitions of healthcare is “the preservation of mental and physical well-being through the services offered.” Effective communication can allow us to tap into the whole person. It allows for a give and take of thoughts and feelings. And most importantly, it allows us to make sure everyone is safe. 

Join us for a one-day symposium, “Your Journey to Service Excellence.” The day includes a keynote speaker, a Q&A session with The Ritz-Carlton executive panel, an optional networking reception and presentations about legendary service, employee engagement and a customer-centric culture.