若い院長が古参職員を指導できず苦慮 プライドを傷つけない教育法とは

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若い院長が古参職員を指導できず苦慮 プライドを傷つけない教育法とは

スタッフとの間に溝を作ってはいけない

父親が経営していたAクリニックを30歳代で事業承継したA院長。
受付職員と看護師もそのまま引き継いだが、
父親の開業当初から勤めてきたベテランばかりで、
これまでのやり方を変えようとせず、電子カルテの導入にもついていけない。
自分がランドセルを背負っていたころからかわいがってくれた
古参職員たちに厳しい指導をすることも難しく、A院長は困り果てた。

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写真をクリックで日経ヘルスケアのサイトにいきます。

 

Aクリニックのスタッフの平均年齢は52歳。
最年長は61歳で、地元では「熟女クリニック」と呼ばれている。

A院長は承継に際し、改装したり
医事会計・電子カルテ一体型システムを導入するなどリニューアルを図った。
だが、スタッフの中には、
「パソコンに全く触ったことがない」
「キーボードの文字が小さくて読めない」
という者もいた。

業者から「操作が一番簡単」と言われて導入した医事会計システムも、
まともに操作できそうなスタッフは一人もいなかった。

それにも増してA院長の頭を悩ませたのが、接遇の悪さだった。
今でこそ医療はサービス業と認識されるようになり、
医師の患者応対も変わってきたが、
先代が開業したのはパターナリズム(父権主義)が主流の時代。
前院長自身も、
「おれの診立てに文句があるならよそに行け」といったタイプだった。
スタッフたちは、そんな前院長の下で診療を補助してきたため、
患者への「上から目線」の対応が染みついていた。

A院長はそれまで、接遇教育の行き届いた大学病院で
勤務医として働いていたため、自院の接遇改善が不可欠と感じた。
だが、A院長が
「患者さんへの言葉遣いを『〜してもよろしいですか?』と同意を求める表現にしてほしい」
と指導しても、
「患者さんが迷うから、そういう言い方はするなと先代に教えられた」
と言い張り、自分たちのやり方を変えるつもりがない様子だった。

「スタッフとの間に溝を作ってはいけない」と思うと、
A院長はそれ以上強くは言えなかった。
何より、自分が小さいころから世話になっている
ベテランのプライドを傷つけるようなことはしたくなかった。

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パソコンスキルは伝達講習を活用

筆者は事業承継のタイミングで、
A院長から接遇トレーニングの依頼を受けた。
現状を聞けば聞くほど、
診療しながらの研修ではとても乗り越えられないと思えたため、
改装工事を行う1カ月の間、
思い切って休診して医事会計システムの操作と接遇を
集中的にトレーニングすることを提案。
院長は即座に決断してくれた。

医事会計システムに関しては、まずはパソコンの操作を覚えてもらう必要があり、
最年少で40歳代のBさんをリーダーに指名。
パソコン教室に通い、習得した内容を院内で「伝達講習」してもらう形にした。
全体のスキルが低い状況で、
スタッフ全員がパソコン教室に通って一から学んでいたのでは、
費用がかかりすぎてしまう。
また、リーダーを一人決めておき、分からないことがあれば
その都度リーダーに聞いて覚えてもらう方が効果的と考えられた。

*******************************************************

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****************************************************

「同僚に教えるために習いに行く」という明確な目標があったため、
Bさんのパソコンスキルはすぐに上達し、教え方もうまくなった。
筆者は伝達講習に立ち会い、
「教わる側の人の目線に立った分かりやすい説明ですね」
とBさんを「承認」し、
「こんなふうに相手が知りたいことを分かりやすく伝えることが
本当の顧客目線であり、診療も同じ」と強調した。

Bさんは、
「最年少の私でも先輩の役に立てて、自分の居場所ができたような気がします」
と語った。Bさんをリーダーにしたことは、
彼女に自信をつけさせる上でも役に立った。

 

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他者からの見方に気づかせる

一方、接遇研修は、ビデオ撮影によるチェックを柱に据えた。
普段の接遇の様子を筆者が撮影し、
その動画を見せることで自分の接遇の問題点に気づいてもらうのが狙いだ。

人は人生経験が長くなるほど、
「今まではこうやってきたのだから」と自分のやり方に固執し、
他人から問題点を指摘されると反発しがちになる。
指摘した相手が年下となれば、なおさらだ。

そんなベテランに接遇の問題点に気づいてもらうには、
ビデオによるチェックなど自分を客観視する機会を作るのが効果的だ。
もともと、うんちくを述べるのが好きな世代であれば、
自分の動画への「駄目出し」も早い。

Aクリニックでは、ビデオ撮影の際の模擬患者役を、
付き合いのある製薬会社の営業マンに依頼。
発生しがちなクレームを想定し、その場面の演技をしてもらった。

すべてのスタッフの応対を撮影、チェックした後、
自分たちの接遇をどう思ったかを一人ずつ発表してもらったところ、
全員が「自分の対応は感じが良くない」と述べた。

筆者が「無理に説得しようとせず、
まずは相手が何を望んでいるかの情報収集に努める」といった
クレーム対応のスキルを伝え、
再度、同じ設定で模擬患者に対処してもらったところ、
見違えるほどの応対になった。
すると、ベテランたちが
「なるほど、こうすればよかったのねぇ」
とこれまでのクレームの場面を振り返り、
「こんなときはどうすればよかったのか」
と質問や意見が続出、研修は大いに盛り上がった。

今回のケースでは、
ベテランスタッフのプライドを傷つけることなく学習の動機づけができたので、
その後のあいさつや敬語、マナーなどのスキル研修もスムーズに進められた。

それまでスタッフが積んできた経験を否定せずに「教材」として生かし、
他者からの見方(他者視点)に気づかせる機会を演出できれば、
経験の長いスタッフの方がむしろ成長のスピードは速くなる傾向がある。
失敗体験が多いほど、「教材」に恵まれていることになるからだ。

事業承継後、Aクリニックの評判は高まっており、
承継時に一時落ち込んだ患者数も順調に増え続けている。

 

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こんな事例でお困りではありませんか??

・学生に「この人の問題点を考えて下さい」と言われた
・スタッフの状況を考えないで、「ハンコ押して下さい」「チェックまだですか?」と言われる
・技術チェックを受ける際、学生が自分で患者選定ができない
・バイタルサインが異常値でも、すぐ報告に来ない
・患者さんと仲良くなると言葉使いが敬語ではなくなる
・スタッフが言ったことが、行動記録にそのまま書かれている。学生の考えが記入されていない
・指導しても返答がない言い訳をする。など。
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