Caring for Patients
WHEN THE H1N1 virus became a serious health concern in the spring of last year, administrators at the Alta Bates Summit Medical Center decided that all visitors to the emergency department should wear masks to keep from spreading the illness. When it came time to enforce the policy, Dave Lawson, the center’s director of operations, noticed something interesting. If a uniformed security officer asked visitors to wear the masks, many people became offended and refused. However, if Lawson, dressed in a suit, approached people about the policy, he encountered no resistance from anyone.
The experience led Lawson to implement a new ambassador program in which some security officers wear less traditional uniforms and are trained in customer service. These officers are told to serve as compassionate representatives of the hospital first and as security guards second.
The Alta Bates Summit Medical Center operates a private nonprofit hospital system spanning three campuses in Berkeley and Oakland, California. Specializing in clinical and community outreach, Alta Bates offers advanced medical care through 30 different programs ranging from behavioral health to orthopedics. The facilities have more than 1,000 beds and employ more than 6,000 people.
AlliedBarton Security Services has provided contract security officers for Alta Bates since 2003. Officers conduct interior and exterior patrols and staff posts in the hospital’s lobby and emergency department entrances.
About a year ago, with the help of AlliedBarton, Lawson retrained four of its 125 officers so that they could serve as ambassadors. A specific job description, enhanced customer service training, specialized recruiting, and designated attire are critical to the program.
The hospital security officers are charged with maintaining order and ensuring that employees, patients, and visitors comply with security rules. The ambassadors supplement the security officers by bringing a more personal level of customer service. Ambassadors are stationed at points where these customer service skills are most needed—at the main entrance to the hospital and in the emergency department.
The ambassador located at the main entrance replaced the security officer who was previously posted at the reception desk. This ambassador serves as the first contact a visitor makes at the hospital. Some of the ambassador’s duties include making sure that people walking in the door are greeted, taken care of, given accurate directions, and, if necessary, escorted to their destinations. The ambassador also assists with wheelchairs and is given discretion to hand out food vouchers and parking vouchers if the situation warrants.
This post is critical, according to Lawson. “Many people coming to the front entrance of the hospital have had very bad news,” he notes. “They can be disoriented and panicked. The ambassador, who is trained to be calm, who is physically strong and capable of helping people… this person can be a great comfort.”
The ambassador assigned to the hectic emergency department works with three security officers. The ambassador’s job in the emergency department is to talk to patrons, bring them water or blankets, keep them comfortable, and provide updates on wait times. These small gestures keep anxious patients from acting out.
In the emergency department, the ambassador steps in at the first sign of disturbance, before the security officer. Lawson has found that having the ambassador intercede first helps defuse the situation more quickly. “The security officers are visible and are there to serve as a deterrent,” he says. “But having an officer step into an altercation can sometimes cause the escalation.”
Instead, the ambassador attempts to listen to the problem and find a solution, even if that means moving the distressed person into a separate room.
Ambassadors are not medically trained, but they have the authority to advance someone who has a serious medical emergency to the front of the line. The employee who staffs the emergency department desk is a trained medical professional, usually a registered nurse. If an ambassador moves someone to the front of the line, the nurse can see the patient and assess whether the ambassador is right to seek immediate care for the person.
Far from feeling usurped, the doctors and nurses in the emergency department have expressed thanks for this part of the ambassador’s job description. When the emergency department gets busy, medical personnel can inadvertently overlook a patient in serious distress. Having the ambassador on hand to keep an eye on patients has helped ensure that critical cases are not overlooked.
Another important part of the ambassador’s position is participating in hospital groups to keep abreast of activities and help improve rapport with visitors. For example, the hospital has orientations for women and infants, wellness programs, and planning sessions for surgery patients. Ambassadors participate in these programs so that they can stay up-to-date on initiatives the hospital offers and share that information with visitors.
After being hired, new security officers must obtain basic certification in Management of Aggressive Behavior (MOAB) and complete an orientation session. They also receive 40 hours of on-the-job training once they start working.
Further training from the healthcare curriculum includes courses on privacy regulations, blood-borne pathogens, and customer service, as well as instruction on the hospital’s manuals.
The communications and customer service training are the most critical, according to Lawson. These skills are more important in the ambassador program than for security officers because the ambassadors rely less on their authority and more on their empathy.
“The ambassador program is presented as a stepping stone for a management position,” says Lawson. “It takes a special person to provide enhanced customer service. They need advanced skills and must be cool under pressure,” he notes.
Therefore, the hospital offers a significant pay increase for those in the ambassador program. Ambassadors wear tailored blue suits instead of standard uniforms to distinguish them from security officers. The ambassadors also wear badges embossed with the program logo.
The program has improved morale among officers by providing an opportunity for advancement.
The hospital’s administration has been inundated with praise for the ambassador program and frequently receives thank you notes pointing out how helpful the ambassadors have been.
Lawson says that he has not collected official statistics in the first year in order to allow the program to go through a sort of beta-testing phase but he has noted a drop in the number of complaints and in “code gray” calls, which indicate an incident or altercation.
Lawson is in the process of adding more ambassadors to the program, for a total of 10. The goal is to have more ambassadors on more shifts, especially late in the evening, to assign them to more departments, and to allow them to be more visible.
Though the ambassador program has reduced the total number of staff working as uniformed security officers, Lawson stresses that the program was designed to improve customer service, not save money by reducing staff. He notes that the program is more expensive because of training and salary costs. However, it has also proved a valuable addition to both the security and customer service functions of the hospital.