1. Section Editor(s): Schaffner, Marilyn PhD, RN, CGRN

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About a year ago, I was searching for a more effective means of connecting with staff. I had been hosting quarterly open forums on all shifts. Despite various marketing attempts as well as food enticements, they were poorly attended. I knew silence was not golden and I needed to find an improved method of communicating with front-line staff. That is when I discovered the power of less than 1 hour.


The new method of connecting with staff involves weekly scheduled breakfast (for staff working nights) or lunch (for staff working days) with seven invited staff. The staff members are selected by their manager. Because my role includes responsibility for nursing and professional ancillary services, the staff who attend come from varied departments. Money for food and invitations is included in the budget. Personal invitations are sent to the staff member's home. An RSVP is requested to ensure an accurate amount of food.


Each "Chats with Staff" begins with introductions: name, role, area of work, and length of time with the organization. I thank them for coming and tell them a little bit about me, my role, and let them know I invited them to appreciate what was going well and to understand what needs to be improved in their work area. I give them an overview of the 45 minutes we will spend together. I spend a few minutes discussing what is going on in the organization from a 35,000-foot view. This is a time when I can communicate the case for change occurring in the organization.


The focus then shifts to listening to the staff. Two questions are asked. The first is, "What is going well in your area?" This provides them an opportunity to highlight positive changes in their unit or department; great peers, leaders, and colleagues; and/or global changes in the organization that staffs perceive as positive. Starting with "what is going well" sets a positive tone for the entire session. The second question is, "If you were to write my 'to do' list, what would it include?" This permits the staff to tell me what needs to be improved. Some staff members arrive with notes. Many consult peers prior to attending and convey input from other staff that widens my circle of knowledge and understanding of what is important to the staff.


Follow-up is essential. The staff members are told upfront that notes will be taken. Positive feedback is summarized and e-mailed to the hospital leaders. This information reinforces the great things that are happening in the organization and recognizes specific individuals with particular positive comments unique to the person(s). All items on my "to do" list are investigated. Once I have completed the follow-up on all "to dos," I send a follow-up e-mail to all of the attendees. My goal is to provide them feedback in less than 3 weeks. Some items require further follow-up and subsequent e-mails to the attendees.


While a good portion of the follow-up is clarifying misperceptions, some great ideas for change are proposed and implemented. For example, a nurse anesthetist who worked in the outpatient operating room voiced concern about the lack of space for staff to take breaks or eat. She recommended installing picnic tables and park benches in a grassy area outside of the facility. This idea was proposed, accepted, and is being implemented. The nurse was even involved in the design of the area for staff!!


The outcomes have reinforced that this is an effective means of communicating with staff. From a quantitative perspective, staff satisfaction scores from close to 3,000 staff within my area of responsibility improved on all questions posed on the Press Ganey Employee Perspectives Survey over the results from the previous year. From a qualitative perspective, I receive "thank you" e-mails and written notes from some of the attendees, particularly after my follow-up summary e-mail. Managers and directors provide positive feedback about the "chats." An unintended outcome of integrating the attendees from various areas throughout the organization is the ability for staff in unlike roles to achieve a better understanding of responsibilities in areas outside of their workspace.


The forums and consistent, timely follow-up require a commitment from the leader. The key is to make it safe for staff to provide their perspectives and ask their questions. This is one method to help staff understand you care.