"PACKAGING" FOR MARKETING SUCCESS.

Long-term care facilities in this new millennium must learn how to package their products to gain a marketing advantage. Packaging makes a product, any product, more attractive and appealing to customers. When something is attractive and appealing, it is obviously easier to market and sell.

Perhaps the greatest "packaging" challenge that long-term care facilities face today, and one that will remain into the foreseeable future, is their overall negative image. The last two years especially have been extraordinarily difficult, with "horror stories" prominently featured in the press and broadcast media. Marketing is difficult enough without pre-existing image problems tagging along. One director of nurses, writing in this magazine not too long ago, summed it up rather succinctly when she wrote, "Facilities of varying quality are grouped together in the public's eye into one stereotype across the nation. It is one of neglect, horror and death. This makes the many good facilities feel like dolphins caught in tuna nets. The many positive stories simply never make it to public view!"

What Is the Solution?

Every long-term care facility must become involved in trying to improve the industry's image. The national or state associations can't do it; only individual facilities can. The administrator of a good nursing facility in Illinois cannot change the image of a bad facility in Maine. The problem of a negative image might be national, but the solution is local.

It is within the power of each and every administrator to improve the quality of care and enhance the quality of life their residents receive. Professional associations can give encouragement and support, but each and every facility must do the actual heavy lifting to improve its image. If every nursing facility tries to create a favorable impression and is at the same time committed to providing high-quality care and superior service, then not only will their image be improved, but their marketing will be made easier as well.

Where Packaging Comes In

Since the product of every nursing facility is some kind of care, then the quality designation (excellent, fair or substandard) is going to be the packaging feature that makes the product more or less attractive. For example, two facilities are located in the same part of town. They both provide skilled nursing care, offer rehabilitative therapies and have a subacute unit. Both facilities, therefore, are offering the same kind of products. But one facility has a history of deficiency-free surveys and an outstanding reputation among healthcare professionals in the area. The other has been repeatedly written about in the local newspaper for patient neglect and cited by the surveyors for poor care. Which facility should have an easier time marketing itself?

There are two specific areas of concern for administrators trying to improve their facilities' image in the community. Both are internal failures but they can cause image and marketing problems externally: (1) absenteeism and (2) tolerance of mediocre work performance. These are quality killers and image busters.

Quality care is the result of competent well-trained employees performing daily assignments consistently well, guided by precise and unequivocal policies and procedures. Quality care must be universal and not limited to the workings of one department, i.e., nursing. Families do not buy he work of one department when they admit a loved one into a facility; they purchase the services of every department. So all de partments must perform their duties extremely well to reach the status of "high quality."

What good is it marketwise or imagewise if a facility has wonderful nursing care but deplorable housekeeping, which can be seen and smelled almost instantly? Even with nursing, what good is it if the facility has high-quality nursing care Monday through Friday but things go to pot on the weekends or holidays when the nursing assistants fail to show up (the very days, by the way, that families and members of the community come in to visit)?

Absenteeism destroys both the quality as well as the continuity of care. If unchecked or tolerated, it can devour entire departments and shifts. If staff is short, skin breaks down and residents are not repositioned; residents are not changed and kept dry; residents are not assisted with meals or kept hydrated. Residents are neglected and basic care is not provided not because the staff doesn't care or because they lack job skills; it's simply because the facility is short-staffed.

Absenteeism also impacts the facility's ability to maintain census. The admissions coordinator might be a great sales person--she admits residents. But no sooner are residents admitted than families get "second thoughts" about their decision because, every time they visit, their loved one has complaints. When families approach staff, they hear the same old refrain: "We are short today." Families become fed up and take their loved ones elsewhere. Empty beds turn up, even thought the marketing and sales functions were carried out correctly and 'produced an admission.

Another enemy of quality care is the. acceptance of mediocre work performance by supervisors or. department heads. In some facilities, employees are allowed to rush through their assignments simply to get the job done; in others, time management fails and some duties and assignments are simply never finished. Either way, quality suffers. Families rarely remember how fast the 'job was done; they will always remember how well it was done.

Notice that the common denominator in all the horror stories about nursing facilities is not the age of the building, nor the condition of the' furniture nor the decor or the design. People don't become upset and outraged by such factors. Rather, the horror stories revolve around case failures.

Instances of poor care can be traced back to absenteeism or the acceptance of mediocre performance. Both are management failures.

Quality is a packaging element that makes the product more attractive and appealing. The better the quality of care, the better the image and the easier it is to market.

Yes, we're back to packaging again. Not only are products packaged, but people, staff and employees can also be packaged as well. Just as the grade, color, size, design and shape of a product's package help a customer to stop, look and perhaps even purchase the item, the grooming, demeanor, attitude and appearance of employees influence a customer greatly.

People-packaging techniques are not new. They have been around for a long time in all service-oriented businesses. Airlines certainly use packaging techniques to train their flight attendants on how important it is for them to be friendly, attentive and well groomed. The bellman who carries your bags when you arrive at the Marriott is certainly not the product. The product is lodging, but how the bellman treats you makes that product more attractive.

Customer service has become so important because facilities have become almost identical in what they have to offer. All (or almost all) nursing facilities now have subacute units. All facilities have private and semiprivate rooms. Every facility has a dining room and perhaps even a beauty shop. So where can families detect significant difference? It is in the perception of friendly, attentive service.

Two factors are always considered by every customer: the process and the outcome. Both must match the customer's expectations for service to be judged satisfactory; both must exceed expectations for service to bejudged as superior.

When the meal you ordered (outcome) was wonderful (i.e., nicely prepared done exactly as ordered) but you went through hell to get it (process), i.e., waiter was slow, waiter was inattentive, you probably won't go back to the restaurant.

When you bring your car to the dealer because of a problem and the service agent greets you with a smile, calls you by name, arranges for transportation back to your job--you feel great. Your expectations are high. When you arrive back at the dealership to pick up your car, the service manager explains what was done. He thanks you for the opportunity to be of service and hands you your keys. Still very nice. As you pull out into traffic, the car starts to lurch and hesitate again. The process was fine (you were treated well), but they didn't fix the problem (bad outcome). It's unlikely you will use them again, either.

Families know when they have been treated well--and when they have been ignored or treated poorly. Since most lay persons cannot understand, much less evaluate, technical quality of care components, they are forced to judge quality of care (technical) by the quality of service that accompanies the care. Your facility can pass one accreditation survey after another but still provide poor service. Your facility can zip through the state survey but still fail miserably on service.

It's worth repeating: Service always involves outcomes and process. Both have to be met for a customer to be merely satisfied; both have to be exceeded to be rated superior.

Healthcare facilities must get serious about in-service training. Posters advising "teamwork" are not going to get the job done. To ensure quality, train your employees on how to do their jobs--but then also train them how to enhance customer service.

Let's take a look at some prime examples.

The Nordstrom Way. All newly hired Nordstrom employees on the first day of orientation are given an Employee Handbook. On the first page they find this message:

Welcome to our company. We're glad to have you join us. Our number one goal is to provide outstanding customer service. Set your personal and professional goals high. We do. We insist that you do the same.

What a simple, powerful message. Because Nordstrom is committed to superior customer service, from their first day on the job, employees understand exceptional service is expected of them. It's not something "extra" or "additional work"; it's part of the job.

BetsySanders was vice-president and general manager for Nordstrom's Southern California division. She frequently attended community events and fundraisers for charitable causes. Invariably on these occasions she would be taken aside by one of her competitors who wanted to know where Nordstrom found all those wonderfully motivated and helpful employees. Sanders would always give the same answer. "We get our people from the same pool you do," she replied, "only we train them according to our expectations."

The Ritz-Carlton Way. Mention the Ritz-Carlton Hotel chain and you know you are talking about a luxury hotel chain recognized the world over for luxurious accommodations and outstanding customer service. A lot of its jobs are similar to those found in a healthcare facility. There are housekeepers who clean rooms and wash toilet bowls. There are men serving as porters who polish and buff the corridors. There are kitchen staff who scrub pots and wash dirty dishes.

When the Ritz-Carlton hires housekeepers, they look for people who have had some experience in hotel housekeeping duties--then they train them to clean rooms the "Ritz-Carlton way." Near the end of the first interview, after the applicant's background has been discussed and the job duties explained, the human resources person hands each applicant 5" x 7" card. The card has the Carlton's Creed neatly typed on it.

Each and every Ritz-Carlton Hotel is more than a building made of brick and mortar. It is a place where the care and comfort of your guests is the highest Priority.

Every employee who works at the Ritz, no matter what department, title, or function, must pledge and promise to provide the finest personal service to each and every guest.

After the prospective employee reads that card, the hiring manager asks the job seeker simple question: "Will you pledge and promise to do that?"

Why can't long-term care facilities do the same? If you are as fed up as I am with all the negativity and poor images surrounding nursing facilities, then don't wait for an association to do something. Sit down with your department heads and determine three ways the quality of care will be improved in each department during the next six months. Make friendly, attentive, responsive service part of every job description. Then you will find, no matter what services your facility offers, that your marketing is getting easier and easier.

George E. Molloy, president of M & M Associates, heads a national marketing consulting firm for long-term care providers. He is the author of the recently published manual,Smart Marketing.