the intersection of hospitality and healthcare...cornell hospitality proceedings • march 2012 •...
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The Center for Hospitality ResearchHospitality Leadership Through Learning
www.chr.cornell.edu
Cornell Hospitality ProceedingsVol. 4 No. 021992 - 2012
th
ANNIVERSARY
The Intersection of Hospitality and Healthcare:
Exploring Common Areas of Service Quality, Human Resources, and Marketing
by Brooke Hollis, M.B.A., and Rohit Verma, Ph.D.
2, March 2012
Cornell UniversityCollege of Human EcologySloan Program in Health Administration
Advisory Board
The Robert A. and Jan M. Beck Center at Cornell University
Cornell Hospitality Proceedings, Vol. 4, No. 2 (March 2012)
© 2012 Cornell University. This report may not be reproduced or distributed without the express permission of the publisher.
Cornell Hospitality Report is produced for the benefit of the hospitality industry by The Center for Hospitality Research at Cornell University
Rohit Verma, Executive DirectorJennifer Macera, Associate DirectorGlenn Withiam, Director of Publications
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4 TheCenterforHospitalityResearch•CornellUniversity
AbouT The AuThors
TheIntersectionofHospitalityandHealthcare:
Exploring Common Areas of Service Quality, Human Resources, and Marketing
byBrookeHollisandRohitVerma
brooke hollis, MBA/HHSA, MArch&UD serves on the leadership team of the Sloan Program in Health Administration. In addition to his work with alumni and industry, he mentors students, and serves as a faculty member. Beyond his appointment at Sloan, his ongoing professional consulting activities straddle the area of mergers and acquisitions and management consulting primarily for health and professional services firms. His background includes over three decades working in both the public and private sector, serving in senior management positions in a number of organizations in the health and financial services fields. While serving as president of a national professional association, he was involved in advocacy work with the federal government on policy and financial issues. For almost a decade he was a partner and president of a private firm that developed and managed specialty outpatient clinics, ran a durable medical equipment company and provided contract staffing programs for hospitals in three states. His work
as a partner in mergers & acquisitions advisory firms has involved consulting and transaction advisory work in 20 states and Canada with private equity funds, and both public or privately held domestic and international companies.
rohit Verma, Ph.D., is professor of operations management and executive director of the Center for Hospitality Research at the Cornell University School of Hotel Administration ([email protected]). Among
his research interests are product-and-service design and innovation, customer choice modeling, and quality process improvement of supplier selection strategies. His work has appeared in such publications as MIT Sloan
Management Review, Journal of Operations Management, and Cornell Hospitality Quarterly.
CornellHospitalityProceedings•March2012•www.chr.cornell.edu 5
exeCuTiVe suMMAry
Heldinfall2011,thefirstHospitalityandHealthcareRoundtablerepresentedacollaborationbetweentheCenterforHospitalityResearchandtheSloanPrograminHealthAdministrationatCornellUniversity.Whilespacelimitationscannotfullycapturethedepthofdiscussionduringtheroundtable,theseproceedingsattempttocapturesomeoftheideasdiscussedanddevelopedduring
theprogram.Nearlythreedozenparticipantsfrombothindustriessharedtheirbestpractices,withthegoaloffindingcommongroundandcross-pollinatingtowardsthedevelopmentofimprovedstrategies. Beyondthemanyintersectionsofthetwofieldsnotedinthebodyoftheproceedings,arecurringthemefortheroundtablewastheideathatsuccessinbothhealthcareandhospitalitydependsonthecoreprincipleofcreatingacultureofrespectfultreatmentandvaluingallstakeholders.Aneffectivecultureengagesstaffmembersandensuresthattheyfeeltheirworkisimportantandappreciated.Atthesametime,effectiveoperationsdependoncontinualandcarefulmeasurementofcustomersatisfaction,usingsuchrubricsasnetpromoterscoresandthenationalHospitalConsumerAssessmentofHealthcareProvidersandSystems(HCAHPS). Aparticularchallengeformanyhealthcaresystemsinvolvesagedfacilities,particularlythoselocatedininnercities.Whilethefacilityitselfmaylargelybeinflexible,thestaff ’sapproachcanhelpovercomethatnegativefactor.Othersmalltouchesalsohelp,suchasmakingsurethefacilityissparklingclean,uncluttered,nicelydecorated,andproperlylighted.Foodserviceisacriticalpartofpatientsatisfactioninfacilitiesofallkinds.Manyhospitalsaremovingtoacatering-styleapproachthatbringsfoodtopatientswhentheyneedit.Seniorcareandcontinuingretirementcare facilities expresslyusehospitality-typeapproaches,withguestswhoare long-termrather thantransient.Asistrueofmanysegmentsofthehealthcareindustry,thecustomerforseniorlivingfacilitiesisnotonlytheclientbutalsotheclient’sfamily.Thus,aholisticapproachisneededthatinvolvesresidentandfamilyalike. The healthcare system faces financial challenges, as it is likely that hospitals in particular will see reducedpaymentlevels.Forthisreason,healthcaresystemsmustpayparticularattentiontocostsandfindwaystoapplyinnovativeideasfromhospitalityandotherareastoreduceinefficiencieswhilemaintaininghighqualityoutcomes.Forsocietyasawhole,thegreatestcostsavingsmaybetohelppeoplestayhealthy,andmanyhealthcaresystemsareencouragingbehaviorthatpreventsordelaysillness,oftenborrowingideasfromthehospitalityindustry. Finally, the flow of expertise between the two industries can run in both directions. While healthcare isbenefittingfromahospitality-styleapproachoffocusingonaserviceculture,thehospitalityindustrycanlearnfromhealthcare’sexpertise incomplex-systemmanagement,whichinvolvesasystemwithmanymovingparts,someofwhichareindependentofeachother,thepresenceofnumerousintertwinedlegal,humanresource,andsupplychainsubsystems,workingwithmultipledecisionmakersandstakeholders,andacollaborativeapproachtoproductandserviceinnovation.
6 TheCenterforHospitalityResearch•CornellUniversity
Cornell hospiTAliTy proCeedings
Withinthecontextofprovidinghighqualityclinicaloutcomes,managersintheU.S.healthcaresystemareworkinghardtosolveseveralproblems,includingthechallengingandinterrelatedproblemsofhowtocontroloperatingcosts,howtoimprove employee retention, and how to satisfy customers and stakeholders.
Beyond that, the industry faces substantial capital expenses when constructing new facilities andrenovatingormaintainingexistingagingstructures.Inshort,manyoftheissuesfacingthehealthcaresystemaresimilartothoseofthehospitalityindustry.
TheIntersectionofHospitalityandHealthcare:
Exploring Common Areas of Service Quality, Human Resources, and Marketing
byBrookeHollisandRohitVerma
CornellHospitalityProceedings•March2012•www.chr.cornell.edu 7
Beyondtheseoperationalandcapitalplanningissues,theintersectionsbetweenthefieldsofhospitalityandhealthcarecontinuetoexpand.Themanyareasofoverlapcallforin-novativethinkinginbothindustriesastheysharetheirbestpractices.Areasofcommoninterestincludemedicaltravelandtourism;hotelsastransitionalcarepartnersand,moretraditionally,asplacesforvisitingfamilymembers;there-cruitingofleaderswithhospitalitybackgroundsbyhealthcareorganizations;theexplodinggrowthoftheheavilyhospitali-ty-orientedseniorlivingandcareindustry;workingtomeetMedicare’snewHCAHPSperformancecriteria;increasedfocusonthemeasurementofpatientandstaffsatisfaction;recognitionoftheneedtobettermanagethe“hotelfunctions”ofhospitalsandothercarefacilities;servicesoutsourcedbyhealthcareorganizationstohospitalitycompanies;achang-ingparadigmwherefamiliesarenow“guests,”withstay-overfacilitiesdesignedintopatientrooms;thegrowthofcomple-mentaryandalternativemedicalspas—somewithaffiliationswithgroupsliketheClevelandClinic;hospitalscontractingwithhospitality-orientedcompaniesforserviceexcellenceandleadershiptraining(e.g.,Ritz-Carlton,FourSeasons,andDisney);increasedinterestinevidence-baseddesignresearchandhiringofhospitalityconsultantsinplanningnewhealth-carefacilities;andthegrowthofnewmodelsthatincorpo-ratehospitalityideasincreatingamorepatientandfamilycenteredenvironment(e.g.,likePlanetree™).
Pointingouttheimportanceofcross-pollinationbe-tweenthetwoindustries,ProfessorRohitVerma,roundtableco-chairpresentedsomeoftheprinciplesthathospitalityexecutivescanlearnfromthehealthcareindustry.Althoughhospitalityoperationshavetheirownlevelsofintricacy,theoperatingissuesthatfacehealthcareoperatorsareevenmorecomplex.Healthcaresystemsinvolvemultipledecisionmak-ersandnumerousstakeholders,includingphysicianswhooftenarenotemployees.Theyalsohavemanymovingparts—someofwhichareinterdependentandothersofwhichareonlypartiallyso.Healthcare’snumeroussub-systemsarelikewisecomplicated,astheyinvolvelegal,revenue,human-resources,andsupply-chainissues.Whilehotelsmusthavedisasterplans,healthcaresystemsareatthenexusofanydisasterandmustcarefullymanagecriticalprocesses.Inshort,healthcareisahighstressenvironment.Atthesametime,healthcareinvolvesacollaborativeproductmuchlikehospitalityandisalsofocusedonserviceinnovationinthemidstofthiscomplexity.
Thus,hospitalityandhealthcarehavemanychallengesandconcernsincommon,butthehealthcareindustryisgroundzeroforpoliticalpolicymaking,unlikethehospitalityindustry,andinteractionswiththehealthcaresystemexcitegreateremotionamongallstakeholdersthanthosetypicallyfoundinhospitality.AsexplainedinthisProceedings,perhapsthemostcriticalmanagementstrategyappliedbythehealthcareindustryistoinstillacultureofservice.Coupledwithafact-basedapproachthatsetsgoalsandconstantlymeasuresresultsinallareas,healthcaresystemscanmanagetheirinherentintricacy.Benchmarksaresetbymanagersandalsobyregulatorsandotherstakeholders,reinforcingthecomplexityofthemanager’sjob.Thus,althoughhealingpatientsremainsjobone—itisnolongersufficientmerelytohealthepatient.Surroundingthatcriticalgoalismeetingtheneedsoffamilymembersandcaregivers,whilecontrollingcostsandmeetingappro-priatestandards.Acomplexbusiness,indeed.
Opening Keynote Speech:ApplicationsofHospitalityTechniquesHelpDriveHospitalPerformanceandCultureInhisopeningremarks,GerardvanGrinsven,presidentandCEOofHenryFordWestBloomfieldHospital,WestBloomfield,Michigan,explainedthatpatientsatisfactionisaresultofaphilosophythatisembeddedintheculture—aphilosophythatalsoextendstoemployeeretentionandgrowth.FormerlyavicepresidentwiththeRitz-CarltonCompany,vanGrinsvennotedthatpeopleweresurprisedwhenahotelierwasappointedasheadofahealthcaresys-tem.Hepointedout,however,thatgiventhetwoindustries’commonissues,embeddingtheRitz-Carltonphilosophyofengagingstakeholderswasthekeytocreatingasuccessfulculture.AlthoughtheMichiganfacilitywasnewlyopened,heexplainedhowthisapproachcanbeeffectiveinanyfa-cility.Itisnotamatterofofferingluxuryorhavingfinefa-cilitiesbutisinsteadamatterofembeddingtheculture.Infact,whiletheWestBloomfieldfacilityisquitenice,itwasdesignedtobeacomfortablepatient-andfamily-friendlyenvironment—andnotaluxuryhotel-typefacility.
TheseeffortsarenotlimitedtoWestBloomfield—thishospitalispartofthelargerHenryFordHealthSystem(HFHS),whichhasasystem-widecommitmenttoqualityandimprovement.CEONancyShlichtingspecificallyse-lectedvanGrinsvenbecausehecouldsupplyideasthatshe
8 TheCenterforHospitalityResearch•CornellUniversity
ageofemployeeswhoareactivelydisengaged.Somearedisengagedbecausetheirunspokenneedsarenotmet,andsomearetrulyjustworkingforapaycheck.Needlesstosay,it’simportanttodeterminewhichemployeesarewhich.VanGrinsvensaidthatabout30percentofemployeestypicallyareengagedintheirjob,andanother50percentarenotengagedbutarealsonotdisengaged.Theydotheirjobbutdon’textendthemselves.Toengagetheseemployees,manag-ersmustidentifythoseworkers’unexpressedneeds.Forthe20percentthatareactivelydisengaged,abouthalfcanbeengaged,againbyworkingwiththeirneeds.Theremaining10percentprobablyneedtofindworkelsewhere.
Value-FocusedImprovementPresentingacasestudyofhowCayugaMedicalCenter(CMC),inIthaca,improvedpatientandemployeeratings,CEORobMackenzieoutlinedasimilarapproach,citingcultureandvalues,supportedbycontinualmeasurement.Alludingtoakeydifferencebetweenhospitalsandhotels,henotedthatahospital,unlikeahotel,maynoteasilyofferaVIPprogramnorissuchaprogramalwaysappropriateforitsparticularsituation.Ahospitalcan,however,expanditsservicesbeyondsickcaretoofferhealth-orientedservicesthatengagethecommunity,asCMChasdone,suchasafit-nesscenter,spa,andcenterforhealthyliving.
ButevenwiththeegalitarianapproachthatCMCat-temptstoprovide,hesaidthatit’simportanttomakeeachpatientandemployeefeelthattheyarecaredfor.EchoingvanGrinsven’sformulaforemployeegrowth,MackenziesaidthatCMClikewiseinvestsinitspeople,withagoalofaligningemployeesandcustomerservice.Asanexample,henotedthatsometimesafinancialbonusispartofthatalign-
feltcouldbeappliedtotheirentiresystem.Itappearsthatsomeoftheseideashavehelped,asHFHSwasrecentlyrec-ognizedasoneofonlyfour2011recipientsoftheMalcolmBaldrigeNationalQualityAward.
BuildingCultureTobuildacultureofsuccessinemployees,vanGrinsvenstartsbyrecruitingtalentedpeoplewhowillfittheoperationandtheninvestsinthemtoencouragetheirgrowthinthejob.Inthisregard,vanGrinsvendistinguishesbetweental-entandskillsets.Peoplewhohavethetalenttobenaturallycaringaboutpeoplecanestablishrelationshipswithclientsregardlessoftheirinitialskillset.Toidentifypeoplewiththesetraits,HFHShasadaptedtheapproachesusedatRitz-Carltontoscreenallapplicants—includingmedicalstaff.
Onceamanagerhasconfirmedthatapersonwillfitwellwiththeorganization,it’scriticaltohelpthatpersongrowintheposition.Thistakesinvestmentinemployees,andcoachingthemontalentsthattheyhave(ratherthantryingtogivethemskillsthattheydon’thave).VanGrinsvenpointedtoafailuretoinvestinemployeesasamajordriverforstaffturnover.Asheexpressedthisstaff-developmentformula:Talent + Fit x Investment = Growth.Additionally,thisapproachofencouraginggrowthinemployeessimplifiesthemanagementmodel.Toooften,hesaid,heseessystemsasbeingsocomplicatedthattheyaredifficulttocontrol.
Withapriorityofstaffgrowthandaculturalfocus,hehasseenthatahealthcaresystemwillachieveitsgoals,regardlessofthenatureofthefacility—becauseemployeeswillbeengagedandturnoverwilldiminish.Forthisreason,HFHSappliesemployeeengagementasameasureofsuccess.Standinginthewayofthissuccessmaybeacertainpercent-
Gerard van Grinsven: patient satisfaction is the result of a philosophy that is embedded in the hospital’s culture—and not just because of a modern facility.
Rob MacKenzie: it’s important to make both patients and employees feel that they are valued. For employees, monetary incentives are helpful.
CornellHospitalityProceedings•March2012•www.chr.cornell.edu 9
ment,andemployeeincentivesareapartoftheprogramforimprovingcustomerservice.
CMC’sfocusinthisregardistodrivepatientsatisfac-tion.Itmaintainsacustomerservicecouncilandmeasurescustomerservice,seekingtoincreasethepercentageofpatientsthatratetheirtreatmentat5outof5.Satisfactionlevelshaveincreasedsteadilysincetheprogrambeganin2007.CMCalsohasseenaconcurrentincreaseinrevenue.
Mackenziesuggeststhateffectiveemployeeevaluationgoesbeyondmeasuringwhat’sinajobdescription.Instead,employersshouldmeasuretheirassociates’senseofbelong-ingandofpurpose.Theissueforemployeeengagementisdeeperthansimplyaquestionofwhethertheyhavethetoolstodothejob.Employeesneedtofeelthattheyhavepowertoachievegoalsandthattheyarelistenedto.Indeed,theyneedtofeelthattheyarepartofanalignedteamatwork.
FindingPromotersamongEmployeesandClientsForJohnDeHart,co-founderandCEOofVancouver-basedNurseNextDoorHomeCareServices(andagraduateoftheCornellSchoolofHotelAdministration),thebasisofimprovementisanetpromoterscore(NPS).Ratherthanconductthetraditionalsatisfactionsurvey,hisfirmmakesregularphonecallstoaskjusttwoquestionsofbothem-ployeesandclientsacrossCanada.First,onascaleof0to10,wouldyouenthusiasticallyreferourservicetoafriend(inthecaseofclients)orasaplacetowork(inthecaseofemployees)?Second,whyorwhynot?Thisquestioniscriti-calforidentifyingissuesthatcausepeopletobepromotersordetractors.
TheNPSapproachlabelsthosewhogiveascoreof9or10aspromoters,7or8asneutrals,andthosewhogivea6orlessasdetractors.DeHartpointedoutthatthemostcritical
elementofthissystemisthatallfeedbackisinrealtime.Cultureandcustomerservicearemeasuredeachday,ratherthanwaitingforanannualorevenquarterlyreview.Thenetpromoterscorebecomespartoftheemployees’jobreviews.Giventherelativelylowsalariesforworkersinhealthcareandhospitality,heseesrecognitionforajobwelldoneasakeyincentive.Managersaretrainedtorecognizepeoplewhoreflectthesystem’scorevalues.DeHartaddedthatwiththisapproach,hisfirm’sturnoverhasplummetedto7percent—inanindustrythat,likehospitality,usuallyhasturnoverinthehighdoubledigits.Thishasalsoledtobusinesssuc-cess—asthefirmhasbeencitedasoneofthefastestgrowingcompaniesinCanadaandwasanErnstandYoungEntrepre-neuroftheYeardesignee.
CostofHealthcareVanGrinsvenopenedadiscussionontheelephantintheroom—theescalatingcostofhealthcare.Heseesthebiggestcostsasstemmingfromwasteandfailedcommunication.Staffturnoverisalsoseenasasubstantialcost.Costreduc-tionwillonlybepossibleifallstakeholders,includingpa-tients,areinvolved.Asanoutsidertothehealthcaresystem,hewassurprisedwhenhefoundoperatingandmanagementtrendsthatseemedtobecounterintuitive.Forinstance,nurseswereincreasinglypulledawayfrompatients,andtheirworkhadadecreasingfocusonpatientcare.Reversingthattrendledtomorecommunicationbetweenpatientsandnursesandmorestaffengagement.
Perhapsthegreatestopportunitytoreducethesocietalcostsofhealthcareistofocusonhealth,ratherthansickcare.ReflectingtheCMCapproachofcommunityinvolvement,VanGrinsvenpointedtothereturnoninvestmentthatcomesfrominvestingincommunitywellness.Hebelievesthatthecommunityneedstoknowthathealthcaresystems
Jill Guindon-Nasir: by getting senior leadership to demonstrate that they really believe that the organization can be the best, it will become the best, despite having an old facility or other challenges.
John deHart: A real-time net promoter score helps keep track of customer satisfaction, and employees need recognition for a job well done.
10 TheCenterforHospitalityResearch•CornellUniversity
wantresidentstoworkonstayinghealthy.Theideaistoswitchfrombeingahealthcareorganizationtobecomealife-styleandhealthpromotionorganization.
Oneapproach,suggestedbyStephanieAnderson,chiefacquisitionofficerofHealthCareREIT,istoensurethatthehospitalandpost-acute-careprovidersworkinpartnershiptodevelopprogramstohelppatientsbecomewellenoughthattheywillnotneedtobereadmittedtothehospital.Inthisregard,Cornell’sMaryTabacchiaddedthatembeddingwellnessactivitiesintreatmentisawonderfulapproach,butshenotedthatchangingpeople’shabitstakesconsiderabletime.
JohnRudd,CFOandseniorvicepresidentatCMC,pointedtotheCayugaCenterforHealthyLivingasapro-gramthatdoesattempttohelppeoplerecoverafterbeingsickbutalsoisaimedatincreasingpeople’swellnessbeforetheybecomeill,andistherebyintendedtocutcosts.Thisprogramworkswithphysiciansbycreatingareferralsystemthatengagespatientstoparticipateintheirownlife-styleimprovements.Forinstance,CMC’scardiacrehabilitationprogramislocatedinafitnesscenterthatwelcomesthegeneralpublicbutisalsoalignedwiththehospital.Therearealsophysicaltherapyandmassageandspaservicesinthesamebuilding.Averageageofthefitnesscentermembersis50.
RelationshipbetweenCultureandFacilityDesignFacilitydesignisalsoafactorinbothcostsandpatientsatisfaction.Manyhealthcarefacilitiesweredesignedinanearliererafordifferenthealthcarepatterns.VanGrinsventhoughtthatthosetraditionaldesignswereneitherneces-sarilyhealingforpatientsnorsupportiveofemployees.Newdesignphilosophiesincludebringinginnatureor
viewsofnatureandavoidingaclinicalfeel.So,insteadofasterile,whiteenvironment,newfacilitiesincludeenlargedtreatmentroomswithmoreprivacy,bothtoreducecross-infectionandtoimprovehealing.Inplaceofthetraditionalclinicallobby,hisfacilityentrancelookslike“mainstreetMichigan,”ashecalledit.
Increasingly,evidence-baseddesign(EBD)researchisreinforcingthevalueofanumberofthesedesignideasforpatientsandemployees,notedCornellProfessorFrankBecker,co-chairoftheCenterforHealthDesign’sResearchCoalition.RosieFeinberg,principalofSFADesign,addedthatcreatingspaceswherepatients,families,andstaffcanfeelmorecomfortablehasmultiplebenefits—someofwhicharereflectedinEBDresearch,andsomeofwhichcomethroughincommentsfrompeoplewhousethespace.Awelldesignedenvironmenttappingintoideasfromthehos-pitalityworldcanalsohelpenhancetheculturebyreinforc-ingemployeepride.
Thisincreasedinterestinapplyinghospitalitydesignideasinhospitalswashighlightedinthe2010Modern Healthcare DesignAwardsarticle,whichwastitled“Hospi-tableHospitals.”Thearticlestated:“Theblurringofhospitalandhospitalitycontinuedinthe25thannualdesignawardswithsomehealthcarearchitectsconsultingwithhotelandresortdesignersonhowtobesthelppatientsfeelathome.”Itappearsthistrendwillcontinue—tryingtodevelopcost-effectiveideasfromhospitalitythatcanbeadaptedtohealthcarefacilities.
TheSpecialProblemofOlderFacilitiesTherealityformuchofthehealthcareindustryisthatthesystemsmustfunctionwithintheirexistingfacilitiesintheirexistinglocations,andnewconstructionoramajor
Franklin Becker: grand style is not necessary to create a hospitable environment. even modest changes in the work environment can greatly improve employees’ attitudes.
Jennifer Schwartz: For aging inner-city hospitals, an excellent patient experience is the key.
John Rudd: Cayuga Medical Center has been focused on trying to influence life-style modification via their venture with the fitness facility which hosts their cardiac rehab unit.
CornellHospitalityProceedings•March2012•www.chr.cornell.edu 11
ModupeformerlyworkedfortheRitz-CarltonCompany,andhebelievesthattransferringthatcompany’sapproachtothehospitalbusinessmakesgoodsense—thatis,“ladiesandgentlemenservingladiesandgentlemen.”Thisisparticularlyimportantforthesupportstaffsincetheyoftenhavemoretimewithpatientsandfamiliesthantheclinicalstaff—andcanmaketheexperiencemuchmorepositive.
Nodifferentthanahotel,thehealthcarefacility’sgoalistocreateamemorableexperienceforthepatient.Thus,Modupeworkstohavethestafffocusedonbeingpartofahealingenvironment,takingtheircuesfromthepatientsthemselves.Managementassistsbyfocusingonthestaffneeds(ratherthanworryingabouttheinflexibilityoftherooms).Thisextendstosuchpracticesasstartingmeetingswithanybadnews,sothatthemeetingcanendonaposi-tivenote.Applyingthesehospitalitypracticesandideashashelpedmakesubstantialimprovements(gainsof50to60percentilepoints)inPressGaneypatientsatisfactionscoresandsimilarlevelimprovementsinHCAHPSscores(HospitalConsumerAssessmentofHealthcareProvidersandSystems,agovernment-mandatedstandard).1
Excellentstaffmaynotbesufficienttobringinpatients,however,ifphysiciansdonotwanttoworkinafacility,cau-tionedFoxrothschild’sSchwartz.Cityhospitalsoftenlocate
1Administereduptosixweeksafterapatientisdischarged,theHCAHPSsurveyaskspatients27questionsabouttheirrecenthospitalstay.Eighteencorequestionsexaminesuchmattersascommunicationwithnursesanddoctors,theresponsivenessofhospitalstaff,thecleanlinessandquietnessofthehospitalenvironment,painmanagement,communicationaboutmedicines,dischargeinformation,overallratingofhospital,andwhetherpatientswouldrecommendthehospital.Otheritemsadjustforthemixofpatientsacrosshospitals,andexamineCongressionallymandatedreport-ingissues.
renovationisnotaprospect.JenniferSchwartz,apartneratFoxrothschild,pointedtothefinancialanddesignchal-lengesofaginginner-cityhospitals,builtinthe1950sorearlier.Suchfacilitieshavesemi-privateroomsforobstetrics,forinstance,butmanypatientsareunwillingtocometothehospitaliftheycannothaveaprivateroom.Complicatingthismatteristhepaymentsystem,particularlyasitrelatestotheproportionofcharitycases,whichareafunctionofthehospitals’locationandwhichthemanagementteamcannotcontrol.Often,theonlywayforthistypeoffacil-itytodistinguishitselfisbyofferinganexcellentpatientexperience.
Evenwhenafacilitycannotberedesigned,legacyfacilitiescanbemademorehomeliketopromotearesiden-tialfeel,suggestedSFA’sRosieFeinberg.Simplyhangingartworkinacorridorhelpsimprovethepatientexperiencebygivingpeoplesomethingtoseeandlookforwardtoontheirwaypast.FranklinBeckeraddedthatgrandstyleisnotneededtocreateahospitableenvironment.RobMackenziepointedoutthatoneinexpensiveandhighreturninvest-menttheyhavemadeisinenvironmentalservicesthatkeeptheirfacilitycleanandsparkling.
KunleModupe,directorofNewYorkPresbyterianHospitalatWeillCornellMedicalCenter,pointedtothecriticalroleofpeopleinallfacilities,particularlythosethatarenotnew.SpeakingofhisNewYorkfacility,heexplainedthattheentryareamakesonefeellikebeinginahotel,buttheroomsthemselvesareold.SupportingvanGrinsven’sandDeHart’sfocusoncultureandpeople,Modupesaidtheanswertothechallengeofolderfacilitiesispeople.Lead-ersmustinculcatethecultureinthestaffsothattheyseethatwhattheyaredoingisworthwhile.LikevanGrinsven,
Stephanie Anderson: hospitals can partner with post-acute-care facilities to help patients maintain their health after a hospital visit.
Rosie Feinberg: simple design elements can improve patients’ attitudes, even when health-care facilities cannot be redesigned.
12 TheCenterforHospitalityResearch•CornellUniversity
physicianserviceofficesinsuburbanareasinanattempttodrawinpatients.Theroleplayedbydoctorsiscriticalinthiseffort,sincetheycareaboutfacilitiesandequipmentandmanyarenotemployedbythehealthcareorganizationitself.Sometimesittakesafinancialincentivetodrawphysicians.
Roundtableparticipantsofferednumeroussuggestionsforimprovingasuperannuatedenvironment,butmostagreedwithModupethatacaringcultureiscritical.Ran-dalRichardson,presidentofHyatt’sseniorlivinggroupVi(formerlyClassicResidencebyHyatt),pointedoutthatevenifyouhaveahigh-endenvironment,thefacilitywillnotbesuccessfulwithoutacaringculture.EstherGreenhouse,anenvironmentalgerontologist,commentedthatolderenvi-ronmentssometimeshavethebenefitofconferringmeaningtopatients.Thatsaid,shesuggestedthatthevisualenviron-mentiscritical.Sometimesthatrequiresnothingmorethanmodifyingorgivingpeoplecontroloverthelighting—espe-ciallysinceatage65peopleoftenneed3to4timesasmuchlightaswhentheywereyounger.Feinbergurgedareductioninclutterasafirststepforrenovationwhenbudgetsaretight.Suchitemsasdeadplantsandburnedoutlightbulbs—whichcanbeeasilycorrected—sendanegativemessage.
BrookeHollis,executivedirectoroftheSloanPrograminHealthAdministrationandroundtableco-chair,pointedoutthatevencosmeticchangescanmakeadifference.HenotedpriorworkbyProfessorBeckerandcolleaguesthattestedmodestcostchangesinanursingstationarea,asoneexample.Thestudyfoundthatemployees’ratingoftheen-vironmentimprovedwiththechanges,andthatthepatients’andfamilies’perceptionsofqualityimprovedaswell.
ACloudyRevenuePictureForallU.S.hospitals,theprospectofreducedrevenueloomslargeasthepopulationages.Anagedpopulationtendstohavemoreillnesses,andhealthcaresystemsmustdeterminehowtodealwiththatissue.Morecritically,theU.S.healthcaresystemmustbere-engineeredtomeettherealityofareducedrevenuestreamasanincreasingnumberofpeopleretireandareinsuredbyMedicare,ratherthantheiremployer’sprivateinsurance.LookingattheprospectofoperatingincreasinglyonwhatarelikelytobefurtherreducedMedicarereimbursementrates,Mackenzie,whoishimselfaphysician,believesthatpartofthesolutionmaybeidentificationofwasteandduplicationintheoverallsystem.Hefeltthatitmightbepossibletoreducecostsbyperhaps20percentthroughre-engineeringandappropriateuseoftechnologythatwillallowconsolidationofprocedures.Forexample,henotedthatasingleradiologistcanremotelyreadx-raystakeninavarietyoflocations.Similarly,ratherthanhavingeachhealthcareprofessionalordermultipleversionsofthesametest,theresultsofonetestcanbesharedthroughtechnology—partofthepromiseoftherecentpushforinte-gratedelectronichealthrecordsandrelatedsystems.
ContinuousCareCommunities:SupportServicesandCustomerRelationshipsLife-care,orcontinuouscareretirementcommunities(CCRC),whichareeffectivelyahybridofhotelandhospi-tal,offertheirownsetofcomplexities.Obviously,ahotel’sclienteleistransient,unlikethoseoflife-carefacilities,andanotherdifferencebetweenthecommunitiesandhotelsisthatthelife-carecommunitieshaveasclientsboththeresi-
Kunle Modupe: one key to working in old facilities is to have an excellent staff with a service-related culture.
Elizabeth Ambrose: Facilities can use technology to share daily moments of their patients with their families, for example by sending photos from mobile devices.
CornellHospitalityProceedings•March2012•www.chr.cornell.edu 13
dentsandtherelativesofthoseresidents.Evenwiththosedifferences,theoperatingprinciplesofbotharesimilar.AsexplainedbyVi’sRandalRichardson,thegoalistobringahospitalityapproachintothehealthcaredomain.Thusthesecommunitieshavebothahospitalitysideandahealthcareside.Mostcritically,residentsexpecttheenvironmentandservicelevelstoremainthesameastheymovefromonelevelofcaretoanother.
Onceagain,astrongculturalapproachisessential,Richardsonsaid.Itischallengingtotranslatehospitalitytoacareenvironment,buttheavailabletoolsarefamiliar.Employeesfeltthattheyweremakingadifferenceinpeople’slives,andtheculturalthemeisservicewithapurpose.Thus,abigsellingpointforthosewhowanttoworkwithViisthattheyhaveagreatandmeaningfulplacetowork,whichstemsfromthethemeof“hospitalityserviceswithapurpose,”asRichardsonputit.Employeesworktounderstandguests’interestsandtohelpthemdoasmuchastheycanduringthedifficulttransitionsofadvancingageandlifechanges.Richardsonsaidthestafffoundhospitalitytrainingtobevaluable.Toensurequalityservice,thecompanyusedqual-ityauditsandmonitoring.Alludingtothemanydifferenttypesoffacilities,Richardsonechoedtheopinionsvoicedbythehospitaloperators:somefacilitiesaresimplyinflex-ible,butthepeopleintheorganizationmakethedifferenceregardlessofthefacility.
CollaborationOpportunitiesAmongSeniorLivingandOtherProvidersCooperationbetweenhospitalsandnearbyCCRCs,othervariationsonseniorliving,orotherhealthfacilitiesen-hancesthehospitalitycapabilitiesofboth.JudyKaufman,directorofspecialpatientservicesforStanfordHospitalandClinics,notedthesharingbetweenherfacilityandthenearbyVilife-carefacility.ThehospitalofferstopservicesfortheViresidents(includingvaletservice),andhospitalemployeesbringeducationalservicestotheresidentsintheirfacility(includingwellnessprograms).
Forlife-carefacilitiesornursinghomes,WilliamSims,managingprincipalofHerbertJ.SimsandCompany,suggestedthatcertainactivitiescanenhanceafacility’sreputation—evenwhenthosefacilitiesareold.Forexample,residentscanbeorganizedtovolunteeratsuchtasksasstuffingenvelopestohelpanadjacentornearbynon-profitorganization,orthefacilitycouldarrangetraveltolocationswhereresidentsandstaffcanvolunteeron-site.Henotedoneorganizationthatenhanceditsreputationusingahospi-talityapproach—organizingatriptoIsraelfor15residentsandtheircaregivers.
HealthcareREIT’sStephanieAndersonpointedtopotentialopportunitiesunderMedicare’spost-acutecarebundlingpilot—notingitspartnerorganizationGenesis
Healthcare,whichprovidespost-hospitalcare,asaninterest-ingmodelthatdeservesfurtherstudy.Andersonsaidthatbyworkingtochangehabitsofpatientsandhavinghospitalsplusotherproviderssuchasskillednursingfacilities(SNFs)worktogether,modelslikethesemaybeabletoreduceread-missionsandimproveoutcomes.
CayugaMedicalCFOJohnRuddagreedthatthishadpotential,butsuggestedthatitisstillunclearexactlywhatwillhappenregardingpayments.Henotedthattheyaretrackingthismatterandagreesthatcollaborationisimpor-tant.CMCisalreadyworkingcloselywithanumberofpost-acuteproviders.Regardingencouragingchangesinhealthbehaviors,henotedthatCMC’sCenterforHealthyLivinghasbeenfocusedontryingtoinfluencelife-stylemodifica-tionandtoofferphysicaltherapyandsportsmedicineattheiroff-sitefacility,knownasIslandHealthandFitness.Thefacilityalsohasphysicianswhocanengagewithpatientsonthe“frontend”andhopefullyinfluencebehaviorstoim-provehealth.Theyalsoprovide“back-end”servicesaswellthatareintegratedwithcardiologists’care.
TheFood-ServiceChallengeForsenior-livingfacilities,excellentfoodserviceiscriti-cal,saidRichardson.Inparticular,theleveloffoodserviceneedstobeconsistentwhenresidentsmovefromonecareleveltoanother,eveniftheirdietarysituationchanges.
CMC’sRuddexplainedthechangehisfacilitymadeinfoodservicewhentheytookapatientsurveythatplacedpatients’satisfactionwithfoodinjustthe10thpercentile.CMCstartedwithbasicfoodindustrypractices:hotfoodwouldbeservedhot,andcoldfood,cold.Theymovedstaffpeopleoutofthekitchenandintothepatientroomsto
Randal Richardson: A critical goal is to bring a hospitality approach into the healthcare domain to ensure consistent service levels in all facilities.
14 TheCenterforHospitalityResearch•CornellUniversity
HospitalityCanMakeaDifferenceEveninFacilitiesinChallenging,LowIncomeEnvironmentsFoxrothschild’sJenniferSchwartzremindedthegroupthatmanyhospitalswhichoperateinlow-incomeneighborhoodshavenotonlyfacilityproblemsbutalsoissuesaroundfeel-ingsecure—inanalreadyhighstresssituationofamedicalemergencyorillness.
BrianGrubbandJillGuindon-Nasir,bothleadersattheRitz-CarltonLeadershipCenter,explainedthattheyhaveworkedforanumberofyearswithfaith-basedhospitalsservinglowincomeneighborhoods,andtheyhavebeenabletotakeabrokencultureandhelpgetpsychologicalowner-shipandemployeebuy-intomakeasignificanttransforma-tion.Oneinner-cityhospitalthatwaspartofafaith-basedsystem,forinstance,wasreadytoclose.However,eventhoughthiswasanoldfacility,theywereabletoimprovetheiremployeeengagementscorestobethetopoftheentiresystemperGallup’sanalysis.Thehealthsystemalsohadfacilitiesinotherareaswithmodern,well-appointedbuildings—butaftertheirintervention,thisolderfacilityexceededeventhehigh-endfacilities’Gallupscores.Withtheimprovementsinperformance,thesystemdecidednottoclosethefacility,whichisnowmoreviableandcontinuestoservethecommunitywiththeirmission.
Guindon-Nasirsaidthatitiskeytogettheseniorlead-ershiponboard,anddemonstratethattheyreallybelievethattheorganizationcanbethebest,despitehavinganold
Co-chairs Rohit Verma (left) and Brooke Hollis (right) flank keynote speaker Gerard van Grinsven: Additional collaboration between the healthcare and hospitality industries will yield benefits for both.
enhanceservice.Insteadofhavingpatientsfilloutslipsofpapertochooseentrées,thefacilityusedmenusandhadnu-tritionattendantsworkwithpatientstomakefoodchoices.Theresultwasanimprovementinsatisfactiontothe90thpercentileinthespaceof18months.
Stanford’sKaufmansaidherfacilityshiftedtoaroom-serviceapproachthatallowspatientstohavefoodwhentheyactuallyhavetimeorinclinationtoeatit.Notonlydidthatimprovepatientsatisfaction,butitcutdownonfoodwaste.
LynneEddy,anassistantprofessorattheCulinaryInsti-tuteofAmerica,saidthattheCIAhadrecognizedademandforgood,nutritiousfoodinseniorlivingandotherhealth-carefacilities.Asaresult,CIAnowhasaprogramtogivehealthcarechefsthetoolstoapply5-starcuisinetohealth-caremenus.Lynneheadsthateffort.Amongothers,Rich-ardson’sorganizationhaspartneredwiththeCIAintrainingcooksandchefs—andnotedhowimportantthefoodisforresidentsinallacuitylevels.
Co-chairHollisnotedthatplaceslikeGriffinHospitalandotherPlanetree™organizationshavealsoutilizedfoodinnovationstoimprovethepatientexperience.Amongtheirmanyideasaresatellitekitchensthatfamiliescanusetocookonthepatientfloors,andvolunteerswhobakechocolatechipcookies—providingadecidedlyfriendlieraromathanistypicalinmosthospitals.Theseandotherhospitality-typeinnovationshaveledGriffintostrongperformanceandlongwaitlistsforclinicalstaffhiringevenduringtimesofshortage—despitebeingwithin20minutesofYale’shighlyregardedmedicalcenter.
CornellHospitalityProceedings•March2012•www.chr.cornell.edu 15
facilityorotherchallenges.Oneexamplewashavingwell-trainedstaffassignedtohelpwithpatientsandfamiliesintheER.Thishasthepotentialtoimprovecustomersatis-factioneventhoughtheremightbeawaitanddespitethefactthattheenvironmentcanbeintimidating—especiallyinpoorerneighborhoods.Engagedemployeesareabletohelpassistandreassurethepatientandfamily.Inonecaseafamilymemberwrotethehospitaltosaythattheextraeffortstohelpandthelevelofcourtesyfromoneperson,avaletservingtheER,hadmadeasignificantimpactontheirexperience.Notonlywashishelpgreatlyappreciated,butitalsohelpedmakethemconfidentthatthehospitalhadreallydoneallthatitcouldforthefamilymemberunderitscare.
VIPPrograms—OneSizeDoesNotFitAllEchoingthecommentfromCMC’sMackenziearoundVIPprograms,Stanford’sKauffmanlikewisepointedoutthatherfacilitydoesnothaveaspecialdedicatedwingforinterna-tionalorotherhighprofilepatients—althoughsomehos-pitalsdohavesuchprograms.InsteadtheStanfordfacilityhasadecentralizedprogramthatworkswithpatientsintheregularunits,butprovidessomeadditionallevelsofserviceandlimitedamenities.TheyalsoworkwiththeAcademicHealthcareCoalitiontocoordinatecareforpatientswhomightbetravellingtootherlocations.Additionally,theyhavealsoempoweredstafftomakeappropriategestures.Ahousekeepercanofferacomplimentarymassage,forex-ample,eitherfor“servicerecovery”oriftheysensetheneedinaparticularsituation.
KellyAbramson,anadministrativedirectorwhoheadsanumberofprogramsatPennMedicine,agreedthatitisnotjustthefacilitybutthestaffwhomakethedifferenceinahealthcaresetting.WhilePenndoeshavestaffwhocoordinateservices,theimportantthingishavingstaffwhoprovideexcellentservice—thosethatthink“Wowvs.Woe,”assheputit.Abramsonalsopioneeredanarrangementwithalocalhotelorganizationasasortoftransitionalsettingforpatientsnotreadytogohome,butnolongerinneedofthehospitalsetting.Theymayarrangeforhomehealthornurs-ingsupportasneeded.
AsforhospitalsthatdohavespecialVIPwings,therehasbeensomecritiqueofVIPprogramsinthepress.How-ever,thefactisthatmostorganizationsneedtofindwaystoimproverevenue,inthiscasebyoffsettingthelowerreim-bursedpatientsviaattractingpatientswhocaneffectivelyhelpsubsidizetheorganization.Afterall,hospitalsmustbefinanciallyviable.Theoldadage“nomargin,nomission”isafactoflifeformosthospitalstoday.
EngagingClinicalStaffinProcessImprovementTwootherphysicianparticipantsprovidedadditionalclini-calperspectives.SitashDevapatla,aphysicianwhoheadstheNeonatalICUandleadshishospitalmedicalstaff,reportedsignificantimprovementsfromprocesschangesthatac-tivelyengagedthestaff,alongwithaprocessimprovementspecialistadvisor.TheysignificantlyreducedthetimefromidentificationoftheneedforaC-sectiontotheinitiationoftheprocedure,forinstance.Notonlydidthishelpimproveclinicaloutcomes,buttheprojecthashelpedstaffmoraleandgeneratedanincreasedsenseofpride.
KristinaGestuvo,ageriatrician,aMt.SinaiMedicalSchoolfacultymemberandaSloanMHAgraduate,foundthatcreatingapatient-centeredmedicalhomeandworkingtomorefullyengagethevariousdirectandclinicalsupportstaffcanpotentiallymakeimprovementsinbothclinicaloutcomesandpatientandfamilysatisfaction.
FutureDirectionsTherewasaclearsenseofthevalueofthecross-fertilizationofideassharedbetweenhealthcareandhospitality.Partici-pantsunanimouslyagreedthatCornellshouldrepeatandexpandthisRoundtabletocontinueanalyzingtheconver-genceofthehospitalityandhealthcare.Giventhelimitedtimewhichallowedparticipantsonlytoaddresssomepartsofthefield,itwassuggestedthatadditionaltopicsbeaddedinthefuture,withfollow-ondiscussionstoseehowsomeoftheinnovationsandideaswereprogressingattheorganiza-tionsrepresented.n
16 TheCenterforHospitalityResearch•CornellUniversity
Kelly Abramson Administrative Director, Penn Global, PFS, Penn Passport Hospital of the University of Pennsylvania
Elizabeth Ambrose Founder and Principal Bridges Cornell Heights
Stephanie Anderson Chief Acquisition Officer Health Care REIT
Franklin Becker Professor Cornell College of Human Ecology
Dave Caleca Partner & Senior Director CSCA Capital Advisors
John DeHart CEO and Founder Nurse Next Door
Jan deRoos HVS Professor of Real Estate Finance Cornell School of Hotel Administration
Srisatish Devapatla, MD Physician and President of Medical Staff Cayuga Medical Center
Lynne Eddy Professor and Head of Program on Health Services The Culinary Institute of America
David Eilers VP Business Development Blue Highway, Inc.
Rosie Feinberg Senior Designer SFA Design
Kristina Gestuvo, MD Assistant Professor, Geriatric Medicine Mt Sinai Medical Center, NYC
Rita Ghatak Director, Aging Adult Services, Geriatric Health Stanford University Medical Center
Esther Greenhouse Doctoral Candidate—Certified Aging in Place Specialist Cornell University—Design and Environmental Analysis
Brian Grubb Senior Corporate Director & Senior Corporate Advisor Ritz-Carlton Leadership Center
Jill Guindon-Nasir Vice President, Global Business Development Ritz-Carlton Leadership Center
Meredith Johnson Chief Operating Officer Cleveland Clinic Canada
Judy Kaufman Director of Special Patient Services Stanford Univ. Hospital and Clinics
Rob Mackenzie, MD CEO Cayuga Medical Center
Kunle Modupe Director of Support Services (former Senior Manager at Ritz-Carlton) New York Presbyterian Hospital/Weill-Cornell
Randal Richardson President Vi (formerly Classic Residence by Hyatt)
Stephani Robson Senior Lecturer Cornell School of Hotel Administration
John Rudd Chief Financial Officer and SVP Cayuga Medical Center
Betsy Schermerhorn Director of Marketing and Admissions Kendal at Ithaca (CCRC)
Jennifer Schwartz Partner FoxRothschild LLP
William Sims Managing Principal Herbert J. Sims & Co.
Christy Stone Vice President Health Care REIT
Mary Tabacchi Associate Professor Cornell School of Hotel Administration
John Turner VP Public Relations Cayuga Medical Center
Gerard van Grinsven CEO (former VP at Ritz-Carlton) Henry Ford West Bloomfield Hospital
Beth Xie Director of Marketing Strategy and Sales Enablement eCornell
pArTiCipAnTs
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CornellHospitalityProceedings•March2012•www.chr.cornell.edu 17
Celebrating 20 Years of Hospitality Research
021992 - 2012
th
ANNIVERSARY
Download our free research at:
www.chr.cornell.edu489 Statler Hall · Ithaca, NY 14853
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Friends4Hoteliers.com • Berkshire Healthcare • Center for Advanced Retail
Technology • Cleverdis • Complete Seating • Cruise Industry News • DK Shifflet & Associates • ehotelier.com • EyeforTravel • Gerencia de Hoteles & Restaurantes • Global Hospitality Resources • Hospitality Financial and Technology Professionals (HFTP) • hospitalityInside.com • hospitalitynet.
org • Hospitality Technology Magazine • HotelExecutive.com • International CHRIE • International Hotel Conference • International Society of Hospitality Consultants (ISHC) • iPerceptions • JDA Software Group, Inc. • J.D. Power and Associates • The Lodging Conference • Lodging Hospitality • Lodging
Magazine • LRA Worldwide, Inc. • Milestone Internet Marketing • MindFolio • Mindshare Technologies • PhoCusWright Inc. • PKF Hospitality Research • Questex Hospitality Group • Resort and Recreation Magazine • The Resort
Trades • RestaurantEdge.com • Shibata Publishing Co. • Synovate • UniFocus • Vantage Strategy • WageWatch, Inc. • The Wall Street Journal • WIWIH.COM
Senior PartnersASAE Foundation, Carlson Hotels, Hilton Worldwide,
National Restaurant Association, SAS, STR, and Taj Hotels Resorts and Palaces
PartnersDavis & Gilbert LLP, Deloitte & Touche USA LLP, Denihan
Hospitality Group, eCornell & Executive Education, Expedia, Inc., Forbes Travel Guide, Four Seasons Hotels and Resorts, Fox Rothschild LLP, French Quarter Holdings, Inc., HVS, Hyatt Hotels
Corporation, InterContinental Hotels Group, Jumeirah Group, LRP Publications, Maritz, Marriott International, Inc., Marsh’s Hospitality
Practice, McDonald’s USA, newBrandAnalytics, priceline.com, PricewaterhouseCoopers, Proskauer, ReviewPro, Sabre Hospitality Solutions, Sathguru Management Consultants (P) Ltd., Schneider
Electric, Thayer Lodging Group, Thompson Hotels, Travelport, WATG and Wyndham Hotel Group
18 TheCenterforHospitalityResearch•CornellUniversity
Cornell Hospitality Quarterlyhttp://cqx.sagepub.com/
2012 ReportsVol.12No.6StrategicRevenueManagementandtheRoleofCompetitivePriceShifting,byCathyA.Enz,Ph.D.,LindaCanina,Ph.D.,andBreffniNoone,Ph.D.
Vol.12No.5EmergingMarketingChannelsinHospitality:AGlobalStudyofInternet-EnabledFlashSalesandPrivateSales,byGabrielePiccoli,Ph.D.,andChekitanDev,Ph.D.
Vol.12No.4TheEffectofCorporateCultureandStrategicOrientationonFinancialPerformance:AnAnalysisofSouthKoreanUpscaleandLuxuryHotels,byHyunJeong“Spring”Han,Ph.D.,andRohitVerma,Ph.D.
Vol.12No.3TheRoleofMulti-RestaurantReservationSitesinRestaurantDistributionManagement,bySherylE.Kimes,Ph.D.,andKatherineKies
Vol.12No.2Compendium2012
Vol.12No.12011AnnualReport
2012 ProceedingsVol4.No.1TheHospitalityIndustryConfrontstheGlobalChallengeofSustainability,byEricRicaurte
2012 Industry PerspectivesVol.2No.1TheIntegrityDividend:HowExcellentHospitalityLeadershipDrivesBottom-LineResults,byTonySimons,Ph.D.
2011 ReportsVol.11No.22EnvironmentalManagementCertificationandPerformanceintheHospitalityIndustry:AComparativeAnalysisofISO14001HotelsinSpain,byMaría-del-ValSegarra-Oña,Ph.D.,ÁngelPeiró-Signes,Ph.D.,andRohitVerma,Ph.D.
Vol.11No.21AComparisonofthePerformanceofIndependentandFranchiseHotels:TheFirstTwoYearsofOperation,byCathyA.Enz,Ph.D.,andLindaCanina,Ph.D.
Vol.11No.20RestaurantDailyDeals:Customers’ResponsestoSocialCouponing,bySherylE.Kimes,Ph.D.,andUtpalDholakia,Ph.D.
Vol.11No.19ToGrouponorNottoGroupon:ATourOperator'sDilemma,byChekitanDev,Ph.D.,LauraWinterFalk,Ph.D.,andLaureMougeotStroock
Vol.11No.18NetworkExploitationCapability:MappingtheElectronicMaturityofHospitalityEnterprises,byGabrielePiccoli,Ph.D.,BillCarroll,Ph.D.,andLarryHall
Vol.11No.17TheCurrentStateofOnlineFoodOrderingintheU.S.RestaurantIndustry,bySherylE.Kimes,Ph.D.
Vol.11No.16UnscramblingthePuzzlingMatterofOnlineConsumerRatings:AnExploratoryAnalysis,byPradeepRacherla,Ph.D.,DanielConnolly,Ph.D.,andNatasaChristodoulidou,Ph.D.
Vol.11No.15DesigningaSelf-healingServiceSystem:AnIntegrativeModel,byRobertFord,Ph.D.,andMichaelSturman,Ph.D.
Vol.11No.14ReversingtheGreenBacklash:WhyLargeHospitalityCompaniesShouldWelcomeCrediblyGreenCompetitors,byMichaelGiebelhausen,Ph.D.,andHaeEunHelenChun,Ph.D.
Vol.11No.13DevelopingaSustainabilityMeasurementFrameworkforHotels:TowardanIndustry-wideReportingStructure,byEricRicaurte
Vol.11No.12CreatingValueforWomenBusinessTravelers:FocusingonEmotionalOutcomes,byJudiBrownell,Ph.D.
Vol.11No.11CustomerLoyalty:ANewLookattheBenefitsofImprovingSegmentationEffortswithRewardsPrograms,byClayVoorhees,Ph.D.,MichaelMcCall,Ph.D.,andRogerCalantone,Ph.D.
Vol.11No.10CustomerPerceptionsofElectronicFoodOrdering,bySherylE.Kimes,Ph.D.
Vol.11No.92011TravelIndustryBenchmarking:StatusofSeniorDestinationandLodgingMarketingExecutives,byRohitVerma,Ph.D.,andKenMcGill
Vol11No8Search,OTAs,andOnlineBooking:AnExpandedAnalysisoftheBillboardEffect,byChrisAndersonPh.D.
Vol.11No.7Online,Mobile,andTextFoodOrderingintheU.S.RestaurantIndustry,bySherylE.Kimes,Ph.D.,andPhilippF.Laqué
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Vol.11No.5TheImpactofTerrorismandEconomicShocksonU.S.Hotels,byCathyA.Enz,RenátaKosová,andMarkLomannoVol.11No.4ImplementingHumanResourceInnovations:ThreeSuccessStoriesfromtheServiceIndustry,byJustinSunandKateWalsh,Ph.D.
Vol.11No.3Compendium2011
Vol.11No.2PositioningaPlace:DevelopingaCompellingDestinationBrand,byRobertJ.Kwortnik,Ph.D.,andEthanHawkes,M.B.A.
Vol.11No.1TheImpactofHealthInsuranceonEmployeeJobAnxiety,WithdrawalBehaviors,andTaskPerformance,bySeanWay,Ph.D.,BillCarroll,Ph.D.,AlexSusskind,Ph.D.,andJoeC.Y.Leng
2011 Hospitality ToolsVol.2No.4ServiceSimulatorv1.19.0,byGaryM.Thompson,Ph.D.
Vol.2No.3TheHotelCompetitorAnalysisTool(H-CAT):AStrategicToolforManagers,byCathyA.Enz,Ph.D.,andGaryM.Thompson,Ph.D.
Vol.2No.2HotelValuationSoftware,Version3,byStephenRushmoreandJanA.deRoos,Ph.D.
Vol.1.No.7MegaTips2:TwentyTestedTechniquesforIncreasingYourTips,byMichaelLynn
2011 Industry PerspectivesVol.2No.1TheGameHasChanged:ANewParadigmforStakeholderEngagement,byMaryBethMcEuen
2011 ProceedingsVol.3No.7ImprovingtheGuestExperiencethroughServiceInnovation:IdeasandPrinciplesfortheHospitalityIndustry,by:CathyA.Enz,Ph.D.
Vol.3No.6FreshThinkingabouttheBox,by:ChekitanS.Dev,Ph.D.,andGlennWithiam
Vol3,No.5BuildingBrandsintheInternetAge:Analytics,Loyalty,andCommunication,byGlennWithiam
Vol.3,No.4BraveNewWorld:OnlineHotelDistribution,byGlennWithiam
Vol.3,No.3SocialMediaandtheHospitalityIndustry:HoldingtheTigerbytheTail,byGlennWithiam
Vol.3No.2TheChallengeofHotelandRestaurantSustainability:FindingProfitin“BeingGreen,”byGlennWithiam
Vol.3No.1CautiousOptimism:CHRSExaminesHospitalityIndustryTrends,byGlennWithiam
2010 ReportsVol.10No.18HowTravelersUseOnlineandSocialMediaChannelstoMakeHotel-choiceDecisions,byLauraMcCarthy,DebraStock,andRohitVerma,Ph.D.
Vol.10No.17PublicorPrivate?TheHospitalityInvestmentDecision,byQingzhongMa,Ph.D.andAthenaWeiZhang,Ph.D.
Vol.10No.16BestPracticesinSearchEngineMarketingandOptimization:TheCaseoftheSt.JamesHotel,byGregBodenlcos,VictorBogert,DanGordon,CarterHearne,andChrisK.Anderson,Ph.D.
Vol.10No.15TheImpactofPrix Fixe MenuPriceFormatsonGuests’DealPerception,byShuoWangandMichaelLynn,Ph.D.
Vol.10No.14TheFutureofHotelRevenueManagement,bySherylKimes,Ph.D.
Vol.10,No.13MakingtheMostofPriceline’sName-Your-Own-PriceChannel,byChrisAnderson,Ph.D.,andRadiumYan,D.B.A
Vol.10,No.12CasesinInnovativePracticesinHospitalityandRelatedServices,Set4,byCathyA.Enz,Ph.D.,RohitVerma,Ph.D.,KateWalsh,Ph.D.SherylE.Kimes,Ph.D.,andJudyA.Siguaw,D.B.A
Vol.10,No.11Who’sNext?AnAnalysisofLodgingIndustryAcquisitions,byQingzhongMa,Ph.D.andPengLiu,Ph.D.
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