Staff & Provider Engagement | Supporting the Workforce

Getting Back to Courtesy & Respect in Healthcare

Christie Zachman
Manager of Patient Experience
Unity Point Health Methodist

Courtesy and respect have been a common trend in patient feedback for several years and tend to rank high on the list of patient and family expectations.¹ One could argue that is because regardless of our background, education, or experience, being treated with kindness is something anyone can measure. The feedback comes in the form of compliments almost as often as it does in the form of complaints, emphasizing that this is a top priority for our patients and families.

Over the last three years, our volume of complaints and grievances on the topic of courtesy and respect has increased by nearly 33%. Like many other organizations, we have seen a drift away from best practices. The reality is that staffing shortages, increasing workplace violence and burnout were present before COVID. These are not new issues, although the added stress of the pandemic may have elevated them. 

When we dig into the root cause of the majority of these complaints, we see a level of burnout that has created a culture focused on transactions. The continued stressors day after day have left our team members feeling exhausted, both emotionally and physically, and we are missing important opportunities to connect with others. While getting back to the basics is important, it’s not enough to just talk about best practices. Instead, we need to focus on defining the behaviors that are part of AIDET that communicate courtesy and respect.² Our focus is now on showing team members how to make the most out of every interaction. 

By nature, healthcare workers are typically focused on caring for others and often neglect their own wellbeing. With this in mind, we have shifted our focus in 2023 to supporting wellbeing by encouraging self-care. We must understand that we have to take care of our team members before we can expect them to care for others. This meant we had to find new ways to connect, showing support and promoting the importance of self-care. One of the first steps we took last year was to create training focused on empathy. This became an open forum for staff to share their feelings and experiences. We heard loud and clear that despite everything that was happening behind the scenes, our team members didn’t feel supported. Our goal was to reconnect staff to their purpose by asking them to reflect on their own individual experiences where empathy was present, ultimately in hopes of reigniting their passion for caring for others. 

Further, in collaboration with our nurse leaders and Patient Experience department, our professional practice council has adopted the Duffy³ model of quality caring in nursing. Duffy’s theory is based on the concept of creating caring relationships, moving from transactional to relationship-based. Duffy also tells us that in caring for others, we must first care for ourselves.  

We are leaning into the feedback we have gotten from our team members, focusing on visibility and finding ways to communicate the importance of self-care through what we are calling “Duffy Rounds.” Leaders, including executives, are rounding regularly and checking in on our team members. Rounding and visibility are more important now than ever as we work together to find ways to connect with people in the “new normal” of healthcare.  

About the Author:
Christie Zachman started her career in healthcare as a Radiologic Technologist. Earning a designation as a Certified Patient Experience Professional (CPXP), she currently serves as Manager of Patient Experience at UnityPoint Health Central Illinois. In this role, Christie oversees the complaint and grievance process as well as patient experience surveys. Working in healthcare for over 25 years, she has had the opportunity to view experiences through many different lenses – from patient to caregiver – giving her a unique perspective and the ability to understand the importance of human connection.


  1. Mayfield, E., Highfield, M. E. F., & Mendelson, S. (2020). Meaning of Courtesy and Respect: Nurse and Patient Experiences. Journal of nursing care quality, 35(2), 177–181.
  2. Huron (2022). AIDET patient communication.
  3. Duffy, J. (2018). Quality caring in nursing and health systems: Implications for clinicians, educators and leaders. Springer Publishing Company, NY. 

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