Customers are constantly looking for ways to save money rather than spend more of it, so companies that position products in the premium price range may struggle. However, with the right formula, you can earn the right to charge customers more than your competitors do. If you’ve been marketing your products or services as low-cost options, it’s difficult to move up the price ladder without devoting significant dollars to aggressive marketing outreach and realistic differentiation between product offerings. The best approach is to launch products as premium offerings from the beginning--if that’s what your business model calls for--because it’s easier to mark products down (and nearly impossible to mark them up) once they’ve been identified with a specific price point.

Here are six factors that will influence your ability to establish and maintain your premium price position and reap the rewards:

   1. Become a Premium Provider. Identify the features that would be considered high-end on the value scale, and then highlight those crucial elements in your marketing. Resist the urge to offer a basic service level or baseline product. Stick with the premium level of service if you plan to maintain your premium pricing strategy.
       
   2. Define Your Value. Help your customers understand why your prices are higher. If you know how competitors are undercutting your prices, and you feel the competitors’ lower cost equates to poorer quality or service, explain this difference. In other words, don't hide your price; instead, explain your value to the customer, and be prepared to demonstrate the ROI associated with your service or product.
      
   3. Go the Extra Mile. You’d be surprised how many business owners declare they offer superior service simply because their people are friendly. Successful companies have more than friendly employees. They have employees who are so aware of customer needs that they anticipate them. I heard one business traveler's tale about a trip to a Florida hotel. A member of the housekeeping staff at the hotel saw my friend approaching the elevator. While my friend was still 70 feet away, the staff member pressed the elevator button and held it open until he arrived. My friend was certainly capable of calling his own elevator, and the housekeeper obviously had other tasks to perform, but that simple act of doing something extra and waiting patiently for my friend to enter the elevator left such an impression that he offered the highest praise for the hotel to other business associates.
       
   4. Don't Sacrifice Price, Even When Times are Tough. Just explain why your product or service is worth the investment, but be a little flexible for long-time customers. Do yourself a favor, though, and make a list of the customers you are willing to be flexible with; then make sure your sales team is aware of which customers are on the list so they won’t be pressured to make snap decisions. Give employees freedom in dealing with customers, but make sure they know which customers are worthy of special treatment.
       
   5. Don't Play the Lowest Price Game. Weaker competitors are quick to cut prices to earn business. Don't play their game. Many competitors will fail because they can't generate cash flow to sustain this discounting strategy. Another disadvantage to playing the discount game is that this strategy is the fastest way to push your product or service into the commodity category. Select businesses have carved out a distinctive market by not discounting their products. The challenge is to create and sustain a brand that supports your premium pricing strategy.
       
   6. Project Financial Stability. A colleague told me about his expensive dilemma. He needed to replace his entire home air conditioning system. He asked two local companies for estimates. The smaller, newer company, run by an entrepreneur, submitted a bid for $4,800. The more established AC company, celebrating its 30th anniversary, submitted a bid for nearly $5,300. While offering significant savings, the entrepreneur didn't realize he was competing based on both price and permanence. The owner of the smaller business told my friend he couldn't do the initial examination right away because his service truck was in the shop. My friend was worried that the 10-year warranty that both firms offered would be worthless if he went with the newer company. The entrepreneur would have won the business if he had projected more stability.

It’s natural for companies to focus on the weaknesses of their competition as a way to earn business. However, the true measure of a premium provider is a company that focuses less on what the competition does or doesn’t do and more on selling and delivering value to its own customers.

How to Formulate A Premium Pricing Strategy: 6 tips to earn the right to charge your customers top dollar
http://www.entrepreneur.com/management/columnistpaulspiegelman/article217176.html
Reprinted with permission of Entrepreneur Media, Inc.
Copyright 2010 by Entrepreneur Media, Inc.
All rights reserved. 

I saw a bumper sticker the other day that said "Refuse to Participate in the Recession." I have no idea if that driver had a job or was looking for one, but he was obviously electing to make the most of the challenges he faced.

Many say the U.S. economy is still in a recession based on the fact that unemployment is still high and consumers are continuing to temper their spending habits--two elements that define a recession. However, anyone with the desire to be an entrepreneur has to have the attitude of my friend with the bumper sticker.

So how does an entrepreneur succeed in a recession?

1. Become Indispensable
In a tricky economy, it's natural for people to want to protect the security they still have. In the service industry, one way to prove that your product or service is part of the solution is to point out the consequences that could occur if the service was not around. Try "secret shopping" your customers and document the outcomes; then secret shop a business that doesn't use your service or product. If there's an obvious difference, use these stories to sell your business back to your customers.

    2. Invest in the Future
Most recessions last only a year or two. Companies that fail to continually invest in business improvements, training and marketing are way behind when the economy recovers. In terms of training, consider how to cross-train your team members while business is slow. It may enable you to perform better later on.

3. Seek Out Referrals
Nowadays, many businesses assume there are no sales to be made, so they stop trying and sit on the sidelines. While sales may be harder to come by, make contacts now so they will pay off later. Furthermore, if you're pulling back on your advertising budget, referrals may be your best bet for generating customers. You should also create a program that rewards current customers for referrals.

4. Buy Weaker Companies
If you can manage the integration process, a down economy can be a great time to acquire a business.

5. Strengthen Your ROI Pricing Offers
Customers often question the cost of a product or service because they can't always tie it to a result, and that scrutiny only increases in a bad economy. Offer pricing related to specific results. For example, I heard of a PR firm that only charges for placements, not advice, writing or strategy development. This approach enables the agency to charge more for its services, but customers know upfront what they're getting.

6. Be Loyal and Focus on Retention
When the recession is over, your employees will be more likely to stick with you. This may mean eliminating free coffee, for example, but have an honest conversation with your employees, and they will usually help you cut costs even further.

7. Maintain a Fun Environment
When companies cut out the fun, it can negatively impact employee job performance. If you've sponsored parties at work for years, continue these events. A consistent culture will encourage your staff to provide consistent service to your customers.

8. Celebrate Being Small
Many smaller firms are more nimble than larger firms because they aren't loaded down by multiple management layers and overlapping operating units or debt, so they can make decisions quickly and focus their cash to take advantage of new opportunities.

  9. Don't Leave Room for Doubt
Competitors will take advantage of any opening, and they will be more aggressive in making promises during the recession, even if it means filling in your silence with a few tales of their own. Don't open doors for them by closing down communications with your customers. Instead, increase the frequency of communications with your customers.

10. Fight the Urge to Give Things Away
If you've been giving products and services away, it will be hard to charge for them again when the recession ends. Remember, if your product or service carries a benefit, it's worth charging for, even during a recession. However, for longtime customers who are having a hard time paying their bills, offer discounts and settlements. Offer this option as a one-time benefit, though, to get things current.

Bonus Tip: Drop Unprofitable Customers
The natural urge is to hang onto every customer, but use the spare time the recession provides to analyze your customer base and find out which ones are the most profitable and which ones are costing you money.

Recessions aren't fun, but they don't have to cripple your business. Smart business owners leverage recessions rather than lament them.

Strategies to Refuse the Recession: 10 ways to grow your company in spite of tough times
http://www.entrepreneur.com/management/columnistpaulspiegelman/article207236.html
Reprinted with permission of Entrepreneur Media, Inc.
Copyright 2010 by Entrepreneur Media, Inc.
All rights reserved. 

Most people do spring cleaning around the house and the yard, but have you ever thought of trying it at work? Company leaders can pump new life into an organization by transferring this springtime routine to the workplace. Here are eight spring cleaning principles that can help your business:

1. Clear out the clutter.
Think about business activities that no longer add value to your organization. If products or services have outlived market demand, sweep them out. It may be a difficult decision, but clear the clutter and focus your business energy on what will be hot in the coming quarters.

Take a quick inventory of the emotional baggage at work, too. There may be some things among your employees and colleagues that need to be dealt with for growth to occur. If mistakes have been made or goals haven't been met, one of the best ways to facilitate a fresh start is with a candid discussion. Then let the past be the past so there won't be any more distractions.

2. Hire some help.
If you're committed to a thorough cleaning, you may want to call in expert help to make sure nothing is overlooked. It's not unusual for people to hire housekeepers, tree-trimmers, landscapers and other service providers to enhance spring cleaning. In the business world, it's a good idea to bring in an objective third party to identify organizational clutter; hire an expert who has done the same for other companies.  

3. Repurpose things.
Martha Stewart is an entrepreneur who has made a living out of turning old hats into centerpieces and broken chairs into plant holders. Apply this type of thinking to your employees. Some of them might be happier and more useful if you thought of a different way to leverage their talents.

4. Dust off your mission statement.
Evaluate whether your mission and vision still match your company's strategic goals given how much the markets have changed.

5. Refresh your colors.
There are dozens (seems like hundreds) of home design shows on TV, and most recommend repainting rooms to give them new appeal. Maybe your brand could use a new look to give it a fresh appeal to customers. Don't misunderstand--a brand is more than colors, shapes and logos. It represents your company's value proposition and the expectations customers have when they encounter your company. However, if your company has begun to serve new markets in new ways, maybe it's time to modernize the company's brand.  

6. Sharpen your tools.
Lots of folks invade the garage in the spring to inspect the tools they use outdoors, and they usually find that the tools need sharpening. Spring may also be a good time for employees to review and sharpen their skills or learn new ones to improve work efficiency to last the rest of the year.

7. Plant new flowers.
With college graduation around the corner and an increasing number of businesses hiring again, think about how you can make your company more appealing to the best young job seekers entering the market. Many of these individuals, the "millennial" generation, are involved in social causes and often seek socially minded employers. If your company shares this commitment, try an innovative recruiting idea such as hosting a job day in conjunction with an employee-led food drive or community charity event, such as a Habitat for Humanity project. This approach gives current employees a chance to see if a candidate fits within your organization and vice versa.

8. Post a "pardon the dust" sign.
Anytime you start poking around the organization to improve it, employees will get nervous, especially in today's economy. If your purpose in auditing the business's operations is not to trim staff, reassure employees at the beginning of the process that you are on a mission to improve efficiency, not payroll. Then roll up your sleeves.

Organizational spring cleaning may not be an annual event, but each spring can serve as a reminder to look for ways to make your organization more effective.

Give Your Business a Spring Cleaning: 8 tips for clearing the clutter, streamlining your organization and giving it new life
http://www.entrepreneur.com/management/columnistpaulspiegelman/article206790.html
Reprinted with permission of Entrepreneur Media, Inc.
Copyright 2010 by Entrepreneur Media, Inc.
All rights reserved.

As part of its ongoing commitment to providing an exceptional patient and family service, Community Health Network (CHN) in Indianapolis, decided to turn to its employees for input on how it can continue to improve this aspect of its mission. As part of a recent survey to staff members at one of the system’s hospitals, CHN asked about potential barriers to improving patient experience.  This generated great energy among the staff with more than 300 staff members offering over 800 distinct responses regarding possible influences on the patient experience in their facility.  

From those responses ten top barriers were identified, including:

1.  Poor personal communication skills  

2.  Lack of time to spend with patients and families due to conflicting organizational priorities

3.  Managers and Administration not making Patient Experience a priority

4.  Lack of staffing

5.  Equipment and supply issues that both interrupt the ability to provide care and frustrate the patient

6.  Attitudes and mood of the staff that affect ability to relate to patient  

7.  Ineffective systems and processes

8.  Interdepartmental communication breakdowns

9.  Excessive “all staff” emails cut into patient care time

10.Breakdown in teamwork

One of the significant “ah-has” from the survey is that while many of the barriers are not surprising, they are clearly items that can (and should) be addressed and improved. While some are operational issues, such as staffing or equipment that may require longer decision cycles, the others get to the core of how staff at all levels engage with patients and one another. These provide potential opportunities for more immediate impact.  

Hospitals that want to pursue improvements in patient experience can learn from CHN’s process. Take the important first step to identify organizational changes that can be made quickly. They can also learn from the list itself, in recognizing it may be some of the very fundamental aspects of organizational life that impede our ability to best meet patients needs. In CHN’s case, how can communication skills be improved, interdepartmental communications reinforced or stronger teamwork developed?

Let me be clear, in sharing these examples I am not suggesting the solution is simply training.  Rather, success is realized through an unwavering commitment to make fundamental changes in your organization. These are not cumbersome and large shifts taking great time, effort or resources. They are focused and purposeful improvements that will go a long way to change the experience for patients and their families, as well as your employees.

This week The Beryl Institute releases the first in our expanded series of white papers on improving the patient experience.  The paper provides insights from three individuals who are leading efforts to transform how their organizations address the patient experience, one of which is CHN.   For all three organizations, the patient experience starts well before the patients enter the physical hospital building at their first contact with the hospital - be it online, on the phone, or in the parking lot. This reinforces the idea that first impressions are just the start of creating truly lasting impressions. Through their stories, each individual helps us see is that it is often a commitment to identifying opportunities and then taking steps to address the fundamentals that can have a significant impact.

The healthcare marketplace is increasingly focused on what it will take to improve the patient experience. The trick is determining what steps matter, where we can make positive change quickly and what actions may require more time and resources.  Right now, having a top patient experience score translates into local market bragging rights. Soon it will equate to bigger reimbursements from CMS. So can we create a formula for improving the patient experience? Remember, as the experience at CHN shows, improving the patient experience is an individual journey for each organization; one that requires clear priorities, unwavering commitment and a bias for action. Perhaps the real question is can you afford not to?

Jason Wolf

Executive Director - The Beryl Institute

For most professional basketball players, training consists almost exclusively of playing basketball, lifting weights and running. Not so with the Dallas Mavericks' Dirk Nowitzki, whose training has included walking on his hands, fencing, rowing and learning to play a musical instrument. Huh?

Okay, some of this makes sense. Fencing helps with footwork and rowing helps build back and shoulder strength for rebounding, but these aren't obvious training options if you're aiming to become one of the world's best professional basketball players. You can't argue with the results--Dirk is an all-star-caliber player, and Dallas has excelled during his tenure.

Long ago at The Beryl Companies, we determined that unconventional training methods might yield the best results for our employees, too. We decided pursuing a standard approach wouldn't help our employees reach the next level, build the skills to successfully serve our customers or give them a desire to stay with our organization over the long term. While most companies say they are devoted to employee development, they don't give employees time to really engage in training. We are committed to sacrificing revenue and over-staffing our team so that personnel have time to participate in training. Ultimately, this commitment is one of the reasons we are more profitable than our publicly traded competitors and why our attrition rate is one-fourth the industry average.

Here are a few unconventional ways to keep your employees growing personally and professionally:

Add a dedicated internal training department. 
Having a dedicated internal training department that focuses on employee development around topics such as client interfacing skills, communications skills, software skills and delivering exceptional customer service is an essential element to sustaining a focus on training. Set a goal for every employee to log a specific minimum number of training hours each year; this forces management to monitor employee progress and makes training a priority for employees.

Start a company library and book club.
A true entrepreneur, Walt Disney once said, "There is more treasure in books than in all the pirate's loot on Treasure Island." Designate a centrally located room to be the company library and stock it with business books and videos. Make it easy for employees to access this library before, during and after work hours. To stimulate interest in the library, consider launching a book club, and even offer to host lunch once each month for employees to gather and discuss what they are reading.

Reimburse employees who purchase any learning or development book if they donate it to the library. However, they must write a one-page summary of what they learned from the book they are donating.  Encouraging employees to dig deeper into materials and report highlights to the team increases the likelihood they will absorb and use what they are learning, which is the goal.

Create your own curriculum led by your best employees (regardless of titles).  
In addition to an official internal training department, create a development team that includes employees from across the company. Charge them with creating a curriculum that will help employees at all levels enhance their skills. These training forums can be offered through a "lunch and learn" platform or on Saturdays so that more employees can find time to participate. Some suggested courses: Time Management, Social Styles, Situational Leadership, Effective Business Writing, and Planning for Results. If possible, invite outside inspirational speakers.

For employees with high leadership potential, create a more intense learning track. Think of this as your internal MBA program--perhaps a 10-week curriculum for current leaders and other high-potential employees to help them learn advanced business and relationship skills. Modules might include Managing by Values, Business Acumen, Change Management, and Crucial Conversations. These courses should be led by senior leaders in your company to give the up-and-comers exposure to the "war stories" that only seasoned employees can share.

Bring rising stars out of the "shadows."
Create a formal job shadowing program that will allow team members interested in a new position to shadow an individual in that role for several hours each week. This allows them to learn the job responsibilities and determine if that job is a good fit for their future.

Invest in higher education.
It's not unusual for companies to provide tuition assistance; however, in a tight economy it's tempting to trim this benefit. Don't. Furthermore, don't place limitations on reimbursement. Provide assistance to any employee pursuing a degree, no matter the subject.

How will you know if your training program is paying off? Hopefully, you'll improve your ability to hire from within, enabling the organization to tap into employees who know your business and culture.

Diversify Your Training Strategies: Get the most out of your employees by helping them develop well-rounded skills.
http://www.entrepreneur.com/management/columnistpaulspiegelman/article206274.html
Reprinted with permission of Entrepreneur Media, Inc.
Copyright 2010 by Entrepreneur Media, Inc.
All rights reserved.

There is no disputing the name Ritz-Carlton is synonymous with customer service.  Part of the credo of Ritz-Carlton is, “Where the genuine care and comfort of our guests is our highest mission.” And now more and more hospitals are adopting the Ritz-Carlton service excellence model.  This isn’t surprising given that hospitals will soon receive a portion of their Medicare reimbursement based on patient satisfaction scores. With this imminent reality, I wasn’t surprised when Henry Ford West Bloomfield, a new suburban Detroit hospital, chose a former Ritz-Carlton executive as its CEO, nor was I shocked to learn about the Concierge Care program at New Jersey-based Riverview Medical Center.  Through this service, Riverview patients can order a massage or manicure during their stay, make arrangements for pet care, take care of gift lists with gift selection, wrapping and shipping services, and order delicious meals from participating area restaurants.  These services dramatically reframe the traditional expectations of a hospital experience.

What did catch me by surprise is that some hotels are now purposefully shifting to act more like hospitals.  The Ritz-Carlton in Philadelphia has rolled out a new concierge service developed exclusively for discharged patients who aren’t ready to go home and don’t want to stray too far from the medical team that provided care.  The service appears ideal for patients who have lengthy but uncomplicated recovery times or lengthy treatment scenarios.  For patients, the hotel offers more pampering than if they had stayed at the hospital. For the hotels, the recovering guests present the opportunity for new revenue streams. A medical concierge at the hotel tends to each guests needs. The concierge does not perform medical procedures or administer drugs, but the concierge can provide wake-up calls for medical appointments, transportation to and from doctors' offices, special sleep arrangements, custom dietary options, prescription pickups, etc. Because the hotel is close to the hospital, medical teams can more easily provide necessary follow up care.  The hotel shuttle can even pick them up.  All the services are a la carte, added to a guest's final bill much as an in-room movie would be. Whether specific services are covered by health insurance is up to the guest's provider.

Philadelphia, with its abundance of internationally recognized hospitals, was a natural fit for the hotel chain's pilot program, said Michael Walsh, general manager of the city's Ritz-Carlton.  Hotel analysts say the medical-concierge idea is the latest competitive strategy for luxury hotels, which boast of having the best of everything.  If the medical-concierge program is successful, the Ritz-Carlton Hotel Co. says it plans to expand it nationally and abroad.

You may be thinking to yourself, “We don’t have a Ritz-Carlton next to our facility or even the internal bandwidth to offer concierge-like services.”  This shouldn’t limit you in this effort. Perhaps you can partner with other businesses in your community to provide special services for your patients while they are undergoing outpatient treatment or in the hospital.  For instance, are you near a bakery that will deliver get-well cookies, or a drycleaner who is willing to pick up patient clothing?  Could a local hotel shuttle pull double-duty as a hospital shuttle for outpatient visits or doctor’s appointments?   If a service could be viewed as a value-add for the patient or family member, consider how to make it work.  It will be sustainable if the concept benefits both the hospital and the local business, plus it will have you stand out for your commitment to service.

As someone whose organization is committed to helping hospitals provide the optimum customer experience to patients and families, I’m struck by the genius behind the Ritz-Carlton effort. This type of commitment to the patient experience before, during and after the delivery of care should be at the core of all we do in health care. It is a chance for you to become an extended business partner in the communities you serve and more importantly have your institution be the place patients choose not only for care, but for superior service.  Go ahead…surprise them!

Jason Wolf

Executive Director - The Beryl Institute

Have you ever wondered how Beryl got its name? I thought I would share this story as we continue to reflect on 25 years at Beryl.

In 1998, we needed to change the name of our company to be more reflective of what we do (it used to be called Emergency Response Systems from our original business).  At the time, my older brother Mark was single and taking lessons to become a pilot.  He met a beautiful Italian woman who worked at the flight school and wanted to ask her out.  He noticed that she was wearing some interesting, unusual jewelry so he bought a book on gemology so he could strike up a conversation with her (not kidding).  He came upon the word “Beryl” which means a “family of gemstones.”  Since we were a family business and worked with great people, he suggested to me and Barry that we name the company Beryl.  We loved the idea.  That’s how we got the name.  He didn’t get the girl, however….she moved back to Italy.

Fifty years ago, if you said you wanted better work-life balance, most managers would have smiled and assumed that meant you wanted to work until the balance of your life was over. Fortunately, times have changed. The best employers strive to help workers strike the right balance between work and enjoying life away from the office so they are re-energized when they return each day.

Every manager or business owner must ask, “Do my employees like coming to work or is work a repressive grind that they can’t wait to get away from, unwilling to spend an extra minute at work?”

Helping employees balance work and life has been a hot topic for years. Overlooking this need can cost business owners productivity, increased turnover, morale and--according to the Mayo Clinic--even contribute to poor employee health.

Here are a few ways we make our workplace less like work and more like a club that employees want to be part of.

Take work home

We publish a fun company newsletter called Beryl Life and send it to every employee's home address. It has photos from recent events and articles highlighting coworkers and their contributions to our work family. We also include personal touches, such as baby announcements, pictures of new homes, vacation photos, and other milestones. We know family members read the newsletter, and we hear it helps them feel connected to what their family members are doing at Beryl, which helps them cope when work takes more time than usual.

Bring home to work

Let’s face it. We spend so much of our lives at work that there’s no way to truly separate the two environments, so we embrace the blending of both worlds by hosting events that involve employee families. On Family Day, coworkers bring their families to work to enjoy hamburgers, bounce houses, games, rock climbing and other special events. We even encourage employees and their family members to participate in a T-shirt design contest. The winning design is chosen by the employees and replicated on T-shirts that we all wear on Family Day.

Our Halloween Extravaganza and July 4th Cookout are additional examples of our efforts to help employees bring home to work.

Work out at work

Work environments are notorious for promoting sedentary lifestyles and diets full of break room junk food. Even worse, a busy work schedule can crowd out time to go to the gym after work. To help employees we opened a wellness area in our office so people can grab a stability ball, use a peddle machine or other exercise equipment at their desks. The wellness area also offers blood pressure monitors, healthy recipe books, health magazines and more. We also have an exercise room, equipped with cardio and weight machines. For employees who prefer not to workout at work, we reimburse a portion of their community gym fees. As for the vending machine, we've stocked it with healthier options and tagged the unhealthy snacks with higher prices, making it a little easier to eat healthy.

Helping employees workout at work has also been a benefit to our company. Our medical costs have dropped, and I’m certain the mental health of our employees has improved because they’ve been able to burn off some of the stress that can build up at work.

Make work like family

I started Beryl as a family business and I want everyone to feel part of our family. I personally recognize every coworker’s employment anniversary, as well as their engagements, marriages, wedding anniversaries and the arrivals of new family members.

One aspect of life that none of us can escape is that we all go through tough times, which is why we have a program called Beryl Cares. This program is dedicated to providing emergency financial help, including purchasing school clothes for coworkers’ children, helping with unexpected bills and providing emotional support to colleagues who are going through a rough period in life.

It’s easy to say you support your workers when their lives are going well, but workers truly appreciate employers that stand by them when life is messy. I’ve heard of some employers cutting employees loose when they hit a rough patch. For me, that’s not leadership for the long run.

Make work personal

Many people confess to being one person at work and another at home. To help employees bridge their work and home personalities, we offer opportunities for employees to have a little fun and express themselves at work. When we ask employees to “dress up,” we aren't referring to suits and ties. Instead, we sponsor theme days that encourage employees to dress like their favorite movie characters or 80s music stars. I’ve even been known to don a matador outfit for our own version of “Dancing with the Stars.”

We also know none of our employees live in dark caves, so we make sure our building décor is bright and modern; and we let employees decorate their spaces to reflect various holidays. In addition, our lounge area is outfitted with a large screen television, pool table and a foosball table so workers to unleash their inner champions. Naturally, we encourage employees to take their winning attitudes back to their desks after their breaks and to always remember they’re working with their teammates.

Prioritize it

Great workplaces don’t develop by accident. To make sure we keep things on course, we have an executive whose official title is “Queen of Fun and Laughter.” Her sole responsibility is to make sure that we stay true to our unique culture and that coworkers’ lives stay in balance. The title doesn’t sound serious, but her role is.

If you take the time to create an environment that effectively supports employees in blending work and life, you'll create employees that generate energy, excellence and enthusiasm. That’s the real formula for work-life balance.

Happy Employees Make Thriving Companies: Create programs that promote a healthy work-life balance and enrich your employees' lives.
http://www.entrepreneur.com/management/columnistpaulspiegelman/article205146.html Reprinted with permission of Entrepreneur Media, Inc.
Copyright 2010 by Entrepreneur Media, Inc.
All rights reserved.

If you’ve spent time near urban downtown traffic intersections, you’ve likely seen these brave souls…. traffic cops.  Nowadays, of course, traffic police can be spotted near malls, busy school zones and large churches. They are indispensible.

As health care policy experts talk about health care reform, one of the central aims of reform is improving care coordination, and the overriding assumption is that hospitals will be the traffic cops.  Health care’s busiest intersection is the nexus where hospitals, insurers, other health care providers and payers mix together.  It’s a loud and busy place. In the future, physicians will no doubt play a role in care coordination, but hospitals will be deciding when patients need to be released, where they should go for care after discharge, and what the care continuum will look like.  This is all the more likely as an increasing number of physicians become employees of hospitals as part of growth initiatives or due to the fact that they are seeking some level of economic security.

Many health care experts are betting that Accountable Care Organizations will form across the country to manage care coordination.  That’s not necessarily the case everywhere when you consider that setting up an ACO is a complex proposition.

With or without ACOs, my instincts tell me that hospitals will be the central drivers in a new care coordination system.  To operate effectively, though, hospitals will need a more sophisticated system of communications to accomplish their work, meaning integrated voice, IT and patient records systems and channels.

We know the government has pledged to help hospitals upgrade their IT systems to advance use of electronic health records.   The government hasn’t pledged financial support for upgrading phone communications systems and triage networks, leaving that to each hospital to manage.  But this work isn’t merely a technological issue; it’s also an issue of customer relationship management.  How will hospitals maintain connections with patients, payers and other providers so that care is better coordinated?  The same way they do it now?  Let’s hope not.  I say this simply because we’ve seen only limited examples of successful and effective care coordination, primarily in markets that have sole providers in a tight geographical region--Geisinger Health System comes to mind.  The Medicare Advantage program also deploys care coordination teams for some, but not all, of its covered lives.

The real challenge for hospitals that will carry out the job of traffic cop will be setting up the care coordination teams, creating infrastructure to support them, and paying for this new and intense level of service.  Some health systems are large enough to manage this endeavor on their own having the needed staff resources on hand, but my guess is most hospitals are not prepared for the potential scope of this effort.   In terms of the financial implications for this effort, it’s anyone’s guess.

We know care coordination holds the promise of improved health outcomes for many patients, especially patients with chronic illnesses. We believe better care coordination will ultimately generate savings through reduced hospitalizations and readmissions and eliminating duplicative services. Maybe the savings will balance the expense. More often than not, the savings don’t fall to the hospitals, but to the payers.  My hope is that regulatory issues won’t prevent all the parties involved from sharing the savings with hospitals and ultimately the consumers of healthcare themselves.

One consistent theme in the discussions around health care reform is that hospitals are being asked to invest a great deal of their limited resources up front to help fix the system, with the hope and promise that they will reap a legitimate ROI later.  I sincerely hope this is the case.  No sane traffic cop would enter an intersection without a whistle, orange vest and white gloves.  We can’t expect hospitals to perform the vital activities that are linked with care coordination without providing them adequate resources and support.

Jason Wolf

Executive Director - The Beryl Institute

Mother’s Day is just around the corner, and AT&T estimates that nearly 123 million will call Mom that day--in percentage terms, 68 percent of people in the U.S. will call Mom to say hello that day.   Ask yourself, though, what makes Mom feel special?  Is it the one call on a day when everyone feels obligated to touch base with Mom, or all the calls in between?    The answer is obvious, and that rule might apply to patients, too.

More studies show that the key to preventing hospital readmissions is contacting patients within the first week following discharge.  That’s a great idea that needs to be more universally implemented.  However, in an era when patient satisfaction is becoming almost as important as preventing readmissions, contacting patients only after they’re discharged may seem like the bare minimum effort…like the call on Mother’s Day. 

Maintaining some sort of consistent connection with patients will likely be a key ingredient to improving the patient experience overall, since we know that the definition of “the patient experience” is expanding beyond the actual acute care stay or outpatient visit.    Health care providers that can build a connection with their patients and potential patients will fare better than those that don’t.  Prioritizing patient contacts means your organization will have to abide by spam laws and no-call rules, but it can be done….if you focus on capturing the information and permissions you need as patients engage your services early in the care process.

As I’ve stated before, I believe one of the major trends that will come from health care reform, now that it’s finally passed, is the development of accountable care organizations.  By their nature, ACOs will require some sort of frequent communication with patients between visits.   If promotional mail is filtered out, and email systems are clogged, the phone may be the best and most personal tool for hospitals that want to connect with and market to patients and potential patients.

For an acute care hospital with an active patient base of about 50,000--the base being defined as the number of individuals treated as inpatients or outpatients within the last 12 months--it’s actually possible to call all of them once each year, if you have a team of six callers working every day in eight-hour shifts.  During these calls, you could discuss their last stay, any new health issues, and recommend preventive or diagnostic screenings.   How realistic is this scenario?   For most hospitals, this approach would not be realistic, nor very useful in terms of helping patients manage their health, because not all of these patients would need or appreciate that sort of call.  However, there would be a tremendous ROI, both in improving satisfaction and increasing patient long-term loyalty. 

The key is to develop a patient contact strategy, determining which patient subset is appropriate to call and setting up the systems to support those patients’ needs, such as scheduling, etc.  One thing I don’t recommend when calling patients -- don’t be like the 3 percent of people who call collect on Mother’s Day!