I recently had gastric bypass surgery and everyone from the beginning of this process was wonderful-kind, caring, helpful, knowledgeable and always with a smile. This was my first experience at your facility and I have been passing the word and referring future patients there.

Letters of praise, like the excerpt above from a patient treated at Johns Hopkins Bayview, make everyone's day. Invariably, they prove that what patients and their families notice most is how they're treated as people. As the senior vice president of an out-of-state hospital wrote after visiting a family member in the Weinberg Building: "We were cared for by Greg, Sharon, Linda, Linrae, Kim, the gentleman who provides your cleaning services, Dr. Stephens and Dr. Lipsett. Each person introduced themselves, attempted to comfort us, made sure our questions were answered, and provided compassionate care to my brother."

Still, during the three years since Service Excellence has become a mantra throughout Johns Hopkins Medicine, overall patient satisfaction scores have remained relatively flat. Letters and patient survey comments noting stellar service are offset by blunt reminders that all is not always well:

• They talk to each other and on personal calls. I feel more like an intrusion than a patient.
• It seemed like I was on an assembly line.
• Whenever I call, I can only get voice mail.

"Most employees want to do the right thing," says Linde Ghere, senior human resources manager at Howard County General Hospital, "but often don't know how." Part of the solution, she says, lies in sharing patient satisfaction scores with staff and clearly defining what service behaviors are expected, such as smiling and making eye contact within seven seconds.

To remind everyone that Service Excellence remains a Hopkins Medicine priority, the First Impressions campaign now getting under way includes training sessions for managers as well as tips we can all use right away: