Crucial to the success of a long-term care facility is its recognition of the value of seeing residents and their family members as customers and serving them well.

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magine one of your staff members or coworkers gets into an elevator with his or her name badge on. Another passenger takes note of the name badge and, in an effort to engage in elevator conversation, asks, “What do you do?” or, better yet, “Tell me a little about where you work.” How would he or she respond? When those elevator doors opened, would the other passenger walk away thinking, “Make sure I never take my parents there,” or would he or she run after your staff member yelling, “Tell me more”?
       Have you or your staff ever stopped to really think about the business you are in? If you had to tell someone what made your facility special in 21 words or less, would it make a lasting impression? Could they even put into words why someone would want to bring a loved one to your facility?
       Try it at your next staff meeting. Tell staff to write down in 21 words or less just what makes your facility stand out. Why bother, you ask? Why would you want your staff to be prepared to make a great impression if your facility services are already good enough to protect their jobs and paychecks?
       Here is a one-question test that will answer itself: if all of your customers—yes, we do have customers—went away for good, would you still have a facility and would you still have a job? Of course not. That is your clue to a most important aspect of what you do: you are in the customer service business. And that means you not only need to know the right way to provide nursing care, activities, and dietary services and keep the facility clean or whatever, but you also need to know the right way to serve customers. You. Your staff. Every staff member needs to know it and, more importantly, practice it.
       There are 3 major reasons to deliver great customer service:
• It is the right thing to do
• It promotes repeat business
• It fosters happiness.
       Customer service turns new customers into repeat customers, and it makes customers happy. Happy customers are easier to deal with than irate customers are.
       When you consider what most facilities say nowadays, it is obvious that they do recognize the importance of good customer service. It seems that in every mission statement you will find facilities touting slogans, such as “Customers come first,” “We are here to provide high-quality care and good customer service,” and, “We go the extra mile.” The funny thing is while this all sounds noble and good, well-intended talk is rising and the quality of service, or customer service, declining.
       Think back on your own experiences as a customer. Has not great customer service really become the exception rather than the rule? Do you not find yourself pleasantly surprised when someone goes above and beyond the call of duty? Have you not at some point taken your business somewhere else because of poor service?
       On any given day in our long-term care facilities, on any shift, if you walk the halls you will undoubtedly hear examples of both great customer service and the bad, why-did-they-say-that customer service, such as:
• “I can’t get you any more coffee right now. We’re working short and I don’t have time to run to the kitchen just for that!”
• “If you put your light on one more time, I’m going to take it away.”
• “If you don’t want to take your bath now, I’m not going to do it at all. I have other people to take care of tonight.”
• “It was my pleasure helping you. If there’s anything else you need, don’t hesitate to put your light on.”
       Bottom line: facilities are losing customers every day because staff members are not walking the customer service talk. They are not treating customers the way the pretty words say they will. Is it because they do not realize each and every staff member in the facility is in the customer service business, or is it because they do not care? Either way, there is a problem.
       We have a duty to provide educational training to all staff members so they can provide not just good but exceptional customer service. Give staff the knowledge and tools they need to be successful in putting the pieces of the customer service puzzle together.
       One of the first things they need to understand is that there are 2 types of customers. The first are the internal customers. This includes someone who works for the facility, a current resident, family members of current residents, and current visitors. The second type of customer is the external customer. This includes individuals, businesspersons, groups in the community, organizations, and anyone else staff may encounter outside of the facility—even the person in the elevator making conversation.
       Staff members must understand and appreciate that internal customer service is just as important as external customer service, and this boils down to attitude. Attitude is a choice and a formula for success. Staff members who are respected, rewarded, and recognized for all they do at work will be your best customer service representatives. They shine not only inside the facility but also when they come into contact with the external customers. But in order to be successful at the customer service puzzle, one must master the basics.

The Customer Service Puzzle Pieces

Puzzle Piece #1
       Everyone must remember that great customer service starts with the first few seconds of the first contact. You only get one chance to make a first impression. Everyone should be greeted warmly. Something as simple as the appearance of your staff will make an impact. Does your staff adhere to a professional dress code? Do you have one? A well-respected long-term care corporation based out of Westerville, Ohio provides all staff with uniforms. Nurses wear white lab coats, nursing assistants all were scrubs of the same color, and the dietary and housekeeping departments have unique colors. Not only does this provide staff with the feeling that management cares, but the facility “presents well.” Am I saying all corporations must provide their staff with uniforms? No. But I am saying the expectation of a professional dress code must be established and imparted to staff as a rule. How a facility “presents” hinges, in part, on how the staff members look.
       Provide telephone etiquette for all staff. Answer the phone with statements like, “Thank you for calling. How may I be of service?” A courteous,

Table 1

pleasant voice can make a difference. Answer the telephone with a smile—the person on the other end will feel it. Your staff must avoid making the types of listening mistakes persons often make on the telephone (see Table 1).
       Do not let customers feel invisible. Start every face-to-face interaction with a warm greeting. Customers want to be where they feel welcomed and appreciated. Acknowledge everyone immediately, even if it is only to say, “I will be right with you.” Then make sure you do go back. Persons are more willing to wait patiently if you act like you know they are there or acknowledge their needs. Another approach that more and more facilities are establishing these days is a “refreshment station” for visitors.

Puzzle Piece #2
       Give the customer you are serving 100% of your attention. Talk less and listen more. Make it a goal to understand the customers’ needs and expectations rather than talking over and around them. Listen to what they are saying as if there was a test at the end and your next raise depended on passing it. Confirm understanding by paraphrasing—repeating back, in your own words, what you think the customer said. Many times, I have heard residents say that no one takes the time to listen or really try to understand what they need. Family members who come to the facility with concerns have voiced frustration over not having someone to talk to that really listens and understands without making excuses. What goes on in your facility?
       Teach your staff the 9 magic

Table 2

phrases to use and 10 deadly phrases not to use when dealing with both internal and external customers (see Table 2). It can mean the difference between happy customers (eg, residents and family members) and those who will call state surveyors when they get home.
       If you do make a mistake when dealing with a customer, admit it. Apologize for it, fix it, and move on. No one expects everyone to be perfect. They do, however, expect persons to be honest. They also expect you to do what you say. If you tell a resident you will return to his or her room in 15 minutes to check on him or her, do it. If you tell a family member you will follow up on a concern or issue and call them back before the end of the day, do it. You better follow through with what you say you are going to do, even if it is just to call and say you are still working on it. Customers occasionally make plans, schedule meetings, and make decisions based on what you tell them you will do. Fail to deliver and they may conclude that your practices and services are as bad as your word is.
       To follow are a few more pieces of advice. Never tell customers that you cannot do something unless you immediately follow with a description of what you can do for them. Also, if you do not know, find out. If you do not know the answer to a question, do not offer a guess. Never end the issue with, “I am not sure” or “I don’t know.” Always conclude with, “I will find out,” or, “But I will be happy to get that information if it would be helpful to you,” or, “I will get someone who can help you.”

Puzzle Piece #3
       Make sure everyone knows how to make it difficult to be difficult. All staff members must be provided the knowledge of how to handle problems and complaints. We all know most complaints are voiced when management is not in the building. How your staff handle the complaints could mean the difference in a resident being pulled out of the facility, the state being called, or a customer leaving with satisfaction and trust in your staff and facility.
       According to statistics complied by the White House Office of Customer Affairs, Technical Assistance Research Programs (TARP):
• 96% of unhappy customers never complain
• 91% of those who do not complain will not buy again from the business that offended them
• The average unhappy customer will share the negative story with at least 9 other people
• 13% will tell more than 20 people
• The average unhappy customer will talk about the unpleasant experience for 18 months.
       Again, it is the basics that staff need to know. As long as the customers (be they the resident, family member, and/or visitor) are not abusive, let them vent. Do not interrupt. Telling you their complete story and describing how upset they are allows them to release pent-up, negative energy. The sooner they let it out, the sooner they will calm down and participate more productively in the discussion.
       Be agreeable. One of the fastest and most effective ways to diffuse anger is to agree with the customer. Saying, “You’ve got a right to be mad,” or, “I can understand why you are upset—I would be, too,” can literally stop an upset customer in his or her tracks. His or her case has been made, and the fight that was expected never happened. If the next thing you say is, “Let’s see what I can do to make it right,” you will immediately take the discussion from negative complaining to constructive problem solving.

Table 3

       Ask the customer to identify the solution he or she would like. Just be careful to not say things like, “So, what do you want me to do about it?” Use a more tactful approach, like, “We want you to be satisfied. What would you consider to be a fair solution?” If you can meet the request, do it. If you cannot, at least make sure to say what it is you can do.
       Do not play the blame game. Blaming the customer for the problem will not get you anywhere. Blaming others in the facility is bad form. The fact is that most customers could not care less about your “innocence.” They just want the problem solved. So, accept responsibility and focus your efforts on problem solving.
       Snap to attention. Give the person with the complaint your undivided attention. If you cannot, or if you are not the person who should be handling the situation, inform the customer that you will take him or her to someone who can appropriately handle the complaint. If it is all up to you, then focus on the customer. If you are face to face, maintain eye contact and be conscious of your body language. Remember that you are trying to restore this person’s confidence in your organization.
       To follow are some things not to do. Do not make excuses, and do not quote your policy manual. Once again, the person is not interested. The absolute best thing you can do it focus on the fix. One of the best ways to minimize tension is to keep your “verbal finger” pointed at you rather than the customer. See if you feel the difference between these statement combinations:
• What do you need?/What can I do to meet your needs?
• You didn’t complete the form/I need a little more information
• You need to call this number/Let me give you a number.
       Use the person’s name to stop abusive ranting and raving. Calmly say, “Mr. Jones,” and then wait. You may have to say it again, but most customers will stop when they hear their names—and they will typically respond with “Yes?” You can then steer the discussion toward more productive problem solving.
       During the conversation, remember that “you” does not not necessarily mean you. When customers are frustrated, they often say things like, “You screwed things up!” Most of the time, they are using “you” to mean your organization. Occasionally, they mean you the individual, the specific representative of your organization. In neither case do they mean you the person, unless, it was you who that promised something and did not deliver. Then it is up to you to make it right.

Puzzle Piece #4
       Develop an “attitude of gratitude.” Henry Ford said, “It’s not the employer who pays the wages. Employers only handle the money. It is the customer who pays the wages.”
       You must remember why your organization exists: to serve the customer. If you find you or your staff falling into the “if only these customers would leave me alone so I can do my job,” trap, visualize what would happen if you got your wish. What would happen to you or your staff if customers never “bothered” you again? Customers have choices as to where they go. Be grateful when they choose you and your organization, and give them a reason to choose you again or recommend you to others.
       Attitude really is a matter of choice. As much as we would like to blame others for our bad feelings, the fact is we all choose how we respond to situations. So, make picking your attitude part of your daily start-up routine. Many large corporations start each shift off with “attitude awareness” or “motivational time.” Each one of us has the choice of how we are going to start our day. Staff in our facilities may come in to work mumbling and grumbling only to be met by the staff leaving as they mumble and grumble. We tend to be creatures of misery, and we want to be the most miserable person in the unit. Have you have had days in your facility when one staff member complains of a headache and the next person not only a headache but a stomachache? And the third a headache, stomachache, and, alas, achy muscles? On and on it goes. We must get into the practice of spreading contagious enthusiasm, not negativity.
       Remember that who you are being is just as important as what you are doing. Focus on the attitude behind your behavior. You can have decent service skills and techniques, but if your attitude is out of whack, the behaviors will be close to meaningless.

Puzzle Piece #5
       Now, let us focus on what do to when you feel yourself becoming angry with the customer. And you will. There will be those days when it seems you cannot please anyone. Stop and take a look at how you are approaching each and every person you come into contact with. Remember, feelings are contagious, both good and bad.
       You do have 3 choices when you find yourself at the end of your rope.
• You can be indifferent to customer relations: “Who cares? I can do what I can and go home at the end of the day. Let someone else deal with it.”
• You can let the customer upset you. (Only you allow yourself to feel the way you are feeling. You have a choice to become mad, upset, angry, or sad.)
• You can use each contact as an opportunity to build your image and your facility’s image. You can make the effort to do the right thing each and every time. It may be a matter of making an effort to rethink the situation.
       Putting all of the pieces of this puzzle together will hopefully assist your staff with the, “Why bother?” question when it comes to customer service. It is one of today’s most challenging situations: satisfying and keeping the customers that pay the money that pays the salary. That, in itself, should be reason enough. You owe it to the customer, the facility, and yourself. You owe it to the customer who has chosen to give his or her hard-earned money to your facility. He or she deserves the best you have to offer. You owe it to your facility—the one that not only provides the salary but also entrusts you with its livelihood and future. The facility

Figure 1

deserves the best you have to offer. And you owe it to yourself—the one who enjoys the pride, satisfaction, and reputation that comes from giving your all. You deserve the best you have to offer.
       Upon hire, give each employee this letter (see Figure 1), which nicely puts the customer service puzzle together.