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Rogé, Carroll M.B.A.

ACSM's Health & Fitness Journal: July-August 2010 - Volume 14 - Issue 4 - p 29-33
doi: 10.1249/FIT.0b013e3181e43919

LEARNING OBJECTIVE • This article explains the challenges and benefits of creating a customer-focused culture in the medical fitness center environment and outlines how to develop a structured and comprehensive approach to fostering service excellence.

Service is an important way organizations meet customer needs and increase loyalty. Creating a customer-focused culture is a challenge, but medical fitness centers can follow a structured and comprehensive approach to develop and implement a customized service excellence program that gets results.

Carroll Rogé, M.B.A., is corporate marketing director for the ETMC Regional Healthcare System, where he is responsible for the marketing and public relations program of a 15-hospital health care network. Rogé also teaches marketing at the University of Texas at Tyler. He holds a master's of business administration degree from the University of Texas at Tyler and a bachelor's degree in journalism from Louisiana Tech University.

Whether they're known as customers, guests, or members, the people who seek the services of a medical fitness center expect many things. Some expectations are obvious - a gym, a pool, exercise classes, locker facilities, and other tangible aspects of care.

What's not so obvious are more intangible guest expectations, such as reassurance, encouragement, empathy, and a general sense of caring. It's important that management and staff realize that fitness center members expect clinical skills to be delivered with a sense of kindness and compassion that make members feel special.

In short, customers, especially those dealing with medical issues, want to view clinical personnel as heroes - people who care about them, people they can count on each step of the way in the journey to fitness and a better quality of life. A focus on service issues is an important way to meet this critical need.

Now, is this to say that clinical expertise is unimportant? Of course not. But it's vital to recognize that fitness center members often can't discern clinical excellence. Do they know if 10 light repetitions are more effective than 6 heavy ones? Do they know if the position of the foot during a leg extension really matters? Probably not. But they can tell when fitness center employees are concerned with how they feel and how the staff meets personal needs. Giving great service is an important way to signal to members that they are cared about, not just as patients or even as customers, but as people.

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Sometimes, this whole idea of creating an experience is a challenge to convey to fitness center staff. Often, service programs are met with internal skepticism, manifested by grumbling and negative comments such as, "This is a health and fitness center, not a social club." Usually, the reason for this type of attitude is fear, ignorance, or some combination of both. The staff may be afraid of becoming more service-oriented simply because they may not know what that means. Telling the staff to "go out and be friendly" isn't helpful managerial advice; employees need to be shown. The staff also needs to be a part of the service program's development to take ownership.

When a program is developed from the ground up and customized for a specific organization to meet specific needs, the staff will much more readily accept and embrace its overall goals and tenets. And if the overriding aim is to create a sense of heroic care, an even more ambitious goal is to deliver "superheroic" care. When properly framed and explained, it is very difficult to rationally argue that this should not be the goal of every service organization, especially those involved in helping individuals improve their health and quality of life.

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Every customer, no matter what the industry, is looking for the same basic things.

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Customers expect medical fitness centers to deliver consistently high levels of customer service. And that's a challenge in any situation where people are delivering services to other people, so training and continual reinforcement of the principles of outstanding service are crucial.

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Customers want employees to be there when they need assistance.

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Guests want to know that they can trust the staff to help them meet their goals.

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Fitness center staff need to understand what customers are experiencing and to express compassion that creates a personal connection.

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Immediate actions should be taken to help a customer overcome disappointment and regain trust. Recovery is very important, and most fitness facilities don't talk about it nearly enough.

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To help improve customer focus, the ETMC Regional Healthcare System, a 15-hospital health system based in Tyler, TX, developed its own service excellence program called ETMC WOW!™ The goal of the program is to help the customers feel appreciated and cared for while instilling pride in its staff. The end result for both audiences is that feeling of "wow" that lets everyone know they've succeeded.

Using a comic book theme with superhero icons to graphically convey the idea of superheroic service, the ETMC WOW! program was designed to be inspirational, lighthearted, and fun. The ETMC WOW! began its development in late 2008, synthesizing a variety of recommendations and techniques pioneered by some of the nation's leading experts. The result was a comprehensive best-of-breed approach that aims to create a strong feeling of buy-in and consensus from the 7,000+ individuals who work for the organization, including those at ETMC's 10 medical fitness centers.





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Service Theme and Standards

At the heart of ETMC WOW! is its service theme: "We treat guests with compassionate care and exceptional service. That's ETMC." Unlike formal mission statements, a service theme should use simple easy-to-remember language as the rallying cry for service. The service theme sets the tone, whereas service standards help elaborate on how each ETMC team member should contribute to upholding the standard and bringing it to life. The seven service standards of ETMC (outlined later in the Education Components section) are critical to ensuring that all staff understand shared objectives.

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Reward and Recognition

To create an incentive for repetition, great behavior must be recognized and rewarded. ETMC WOW! implemented a system in which anyone at ETMC can recognize outstanding service simply by filling in a form either online or by dropping a multipart paper copy in boxes throughout the facility. A copy is routed to the team member and another to his or her manager. To encourage use of this system, all those recognized are entered into a monthly drawing for $100 for the "team player of the month." Winners are posted on bulletin boards and on the hospital intranet.

In addition, four individuals are selected each year as "Service Hero" award winners. Recipients receive a plaque and special recognition at a dinner in their honor, at which a video is played to illustrate their personal commitment to caring. This video also is available on the hospital's intranet for the inspiration of other staff members.

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It's also important to periodically gather together and celebrate the shared commitment to service. ETMC WOW! was launched with a superhero-themed "Mission Launch Party" that featured food, prizes, and service-oriented games. All team members received an ETMC WOW! T-shirt, which is worn to the full-day training session and at other service celebrations. In addition, the organization hosts monthly events - such as bingo, rodeo trips, holiday activities, and so on - under the ETMC WOW! banner. The goal of these family-oriented activities is to create a sense of camaraderie and to reinforce that delivering service is not burdensome, but fun.



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Recovery Notebooks

An ETMC WOW! recovery notebook is located in each department for easy access by frontline staff needing extra incentives to aid in the service recovery of disappointed guests. These notebooks contain premiums, such as $5-off coupons in the pro shop, and are available for staff members to offer to disappointed members as a token of appreciation. The most important aspect of this initiative is that staff members use recovery notebook tools at their discretion without a manager's permission. This creates a sense of individual employee empowerment and helps make the recovery process fast and more effective.

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Other Aspects of the Program

  • Promotions include monthly comic book-themed posters to post in break areas.
  • Specialty items, such as ETMC WOW! pens and mugs, are offered as additional incentives for service that's above and beyond.
  • An ETMC WOW! intranet resources page provides customer service articles, quizzes, message boards, and staff feedback. Downloadable patient cards also are posted on the site for staff to recognize guests on special occasions.
  • Staff members are encouraged to submit customer service suggestions by email and a dedicated phone extension. A twice-yearly publication called You Said…We Listened fosters staff involvement by showcasing dozens of examples of improvements implemented because of staff suggestions.
  • Weekly walkthroughs by plant services, housekeeping, and members of the ETMC WOW! committee encourages the improvement of the facility to better meet customer needs by using a guest perspective.
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Education Components

Education is the centerpiece of ETMC WOW! Each team member participates in a full day of education (participants can preregister by phone or via the intranet). The training includes teaching, small group discussions, a follow-along comic book guide, and videos using ETMC staff members. ETMC WOW! also includes a supplemental half day of training specifically for managers in addition to the main team training.

The following sections list the seven service standards of ETMC WOW! and highlight a few of the training points that illustrate these important guidelines.

  • I anticipate needs and exceed expectations by focusing on details! It's helpful to realize that guest impressions are made up of hundreds of small details. Going above and beyond with attention to the little things is critical to creating a great impression. For example, when a fitness center customer asks what type of equipment works the abdomen, this is a perfect opportunity to recognize that the guest is really asking, "What type of exercise should I do to lose weight?" A quick-thinking staff member can then use this as an opportunity to engage the guest in a discussion of comprehensive nutrition, exercise, and lifestyle improvement.
  • I am consistently positive and engaging! Being aggressively and honestly friendly is about making the first move. That's why it's important to overcome shyness and engage our guests in a genuine and friendly manner. Staff must recognize that they are always onstage when in front of a guest. The importance of using guest names is critical, as well as using proper telephone etiquette. The harmful effects of forbidden phrases such as "that's not my job" also are discussed and illustrated at length.
  • I display kindness, sensitivity, and respect to everyone! Training covers a range of communication techniques to handle difficult situations and foster empathy. For example, a guest upset about an incorrect exercise class listing should receive an apology, quickly followed by refocusing on how the mistake will be corrected, along with the delivery of appropriate recovery techniques.
  • I reach out to my guests using "GREAT" communication! GREAT™ is an acronym for a structured system to help staff remember how to create an overall impression of competence and caring. The acronym stands for Greet (use the guest's name and make appropriate introductions), Reassure (provide encouragement that instills guest confidence), Explain (cover both time and process), Ask (if there's anything else needed or if there are other questions), and close with Thanks.
  • I practice "FAST" and effective service recovery! FAST™ is another acronym that is helpful in the recovery process: Focus, Apologize, Solve the problem, and Thank the guest. The importance of flexibility, as well as open and honest communication, is stressed in this section of training.
  • I support and encourage my team members! Teamwork is vital to foster a customer-focused culture. In addition to a range of teamwork tips, the importance of recognizing unique behavioral styles and flexing to accommodate different coworker personalities is covered.
  • I maintain a clean and welcoming environment and personal appearance! It's important to understand that members look at the physical environment of a medical fitness center and make inferences about the quality of services based on the setting. They also make the same association based on the grooming and clothing of the staff.
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Management must provide approval and support to allow for the creation of a service excellence program and realize the benefits to come - improved loyalty, improved retention, and increased member volume. To make the case for a structured customer service approach, every customer service program must have a champion - someone who is committed, passionate, and a strong communicator. This champion should educate himself or herself about all aspects of service and become the resident expert on guest relations by attending seminars, reading books, and learning.

Next, it's important to form a customer service committee. Make sure that representatives from all areas and levels are involved and that the committee is composed of individuals who themselves exemplify good customer service. Meet with them regularly. Teach them about service and let them help create a program to meet the needs of the organization. It also can be helpful to hold focus group meetings and invite interested members of the team to help create greater consensus and involvement.

The next step is to create a program name, a service theme, and a graphic look. Make them fun, inspirational, and pertinent to the organization. Then develop general customer service standards to bring the theme to life. Limit standards to seven in number, and ensure that they are easy to understand and internalize.

Each area also must develop more specific tactics to bring the standards to life in your organization. For example, the fitness center front desk might call members on the day after they begin an exercise program to see how they feel.

Communicate the plan to the staff through training. Have ongoing meetings and talk about service. Cover service issues and education in newsletters and emails. Do whatever it takes to make them understand.

Make a pledge to customers. Let them know the organization is upping its service commitment with signs, flyers, bulletin boards, and newsletters. This helps keep the team accountable for great service.

Celebrate service. Reward and recognize high achievers. Make them role models. Start a formal recognition program, and stick with it. Don't forget the importance of periodically getting the team together to have some good old-fashioned fun to bond and develop relationships.

Do whatever you can to improve the setting with a guest orientation. Try to experience the fitness center environment from the perspective of members.

Work to improve processes with a guest orientation. Don't say "that's the way we've always done it" or "it's the industry standard." See things with new eyes. Be unafraid of change.

Monitor results to ensure that the plan is working. Tweaks and modifications will be necessary. Periodically reassess all aspects of the program. Service delivery is a dynamic process. Be open to modifications.

And no matter what, keep striving together as a team to improve. Be relentless. The time and resources expended on this effort will be considerable, and the program is never-ending; it's a continual quest to improve, which is challenging and exciting at the same time. Developing a customer-focused culture is hard work, but it's also fun. The end result is an organization of engaged, motivated, and happy men and women, which equates to more satisfied and loyal customers.

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Customers expect fitness center staff not only to provide clinical expertise, but also to meet personal needs and create a caring atmosphere. Organizations can meet this need by developing a comprehensive program that educates staff and provides reward/recognition incentives, celebration events, recovery tools, and a host of employee empowerment and involvement tactics. By following a structured approach that engages the team in this process, fitness center members will enjoy an improved experience, and management will earn greater customer loyalty.

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Recommended References

Lee F. If Disney Ran Your Hospital. Bozeman (MT): Second River Healthcare Press; 2004.
    The Disney Institute, a business excellence program based at Walt Disney World. Available from:
      The Studer Group, an international outcomes-based health care consulting firm. Available from:

        Communication; Employee Education; Teamwork; Recovery; Compassion

        © 2010 American College of Sports Medicine.