|
Send this issue to a friend
PDF
You will need to install Adobe® Acrobat® Reader™ on your computer if you do not have it already.
Download Adobe® Acrobat® Reader™
|
|
|
Vol.2 . No. 5
|
November/December 2000 |
|
|
|
Tips for Improving the Healthcare Work Environment
by David Buchmueller
The workforce paradox in today's economy also applies to the healthcare industry.
On one hand, the labor market is tight with unemployment around 4 %. Nurses, info tech staff, physical therapists and others are in short supply. And companies, like those in Fortune's "100 Best Companies to Work For in America," (www.fortune.com/fortune/bestcompanies/) are going all out to attract and retain employees with benefits and perks, from stock options to concierge services to free trips to Hawaii.
On the other, with downward pressure on prices and the need to do more with less, corporate downsizings continue, eroding what might be left of employee loyalty, and some healthcare managers seem to throw fuel on the fire of employee discontent through the ill-advised things they say and do.
Given the above industry conundrum, how can healthcare managers increase employee loyalty and improve the workplace environment? Here are 13 guidelines for healthcare managers. These strategies are not really new. And this is not rocket science. But most of us need the discipline and courage to practice these behaviors and to do them consistently.
1. Hire Right
It pays to take the time and expend the resources to be very clear about what kind of person you're looking for. It's more than matching experience to a job description. The value systems have to align - and much more. The point of hiring is the time to set the high standards that you want to characterize every element of your organization. For example, if prospective employees can't buy into the clearly enunciated patient and customer focus of a hospital's mission and philosophy, they should go no further. Similarly, managers who regard doctors as money hungry prima donnas have no place in a health care organization.
2. Tell Them What You Expect
One definition of quality is "adherence to specifications." Employees have both internal and external customers whose expectations must be met. In addition to the job description that describes what is to be done, you also need to specify how much is to be done and how well.
3. Give Them the Tools
To do their best, employees need the right equipment, materials and information to do the job. It is wrong to cut corners where the staff-patient interface is concerned. And if you expect people to go out and play hard for the team, you have to let them see the scoreboard - - in terms of financial, productivity, quality and other reports. |
|
4. Help Them Feel Proud
The CEO must personally communicate the importance of the mission and how important that individual employee is in carrying it out. (Listen to a Southwest Airlines flight attendant or baggage handler tell you how they feel about working for Chairman Herb.) This is not something you can do with buttons, badges, billboards and balloons. The bottom line may not be the only measure; however, shares of the 58 publicly traded companies in Fortune's "100 Best Companies ..." rose 37% annualized over the past three years compared with 25% for the S&P 500.
5. Treat Them Fairly
The lofty vision and values of the CEO notwithstanding, "management" in the eyes of the typical employee is his/her immediate supervisor. There is, of course, no room for discrimination or harassment. Moreover, each person is entitled to timely and objective performance reviews, aimed at helping him/her become a more productive member of the team. The review should be tied back to the expectations and to mutually determined goals. However obvious, this often doesn't happen. Conversely, if a person's performance is so consistently weak as to raise the prospect of termination, the personnel files need to contain the necessary documentation.
6. Learn the Rules and Play by Them
From the Employee Retirement Income Security Act (ERISA) to the National Labor Relations Act (NLRA) to the Americans with Disabilities Act (ADA) to the Occupational Safety and Health Administration (OSHA) - -you need someone who can give you answers and guidance. With the federal government harvesting huge returns for each dollar spent in the Operation Restore Trust fraud and abuse campaign, you must be sure that billing, coding, contracting and other practices are fully compliant. According to Richard P. Kusserow, former Inspector General, Health and Human Services, the person who becomes a "whistle blower" is often a long service, erstwhile loyal employee who "drops a dime" only when it appears that management will not act to clean up questionable (or worse) practices. Kusserow's company, National Hotline Services (www.hotlines.com) offers a comprehensive hotline service that is used by many healthcare organizations to give employees a positive, confidential outlet for such concerns.
7. Deal in Facts
Given the sizeable amount that hospitals, health systems and health plans spend on salaries and benefits, it is imperative that they have:
- a Position Control Document that reconciles to the personnel budget;
- a staffing plan tied to workload and on which revenues and expenses are based; and
- a daily reporting system which assures that staffing matches workload and which facilitates prompt adjustments. This is basic blocking and tackling - - but few health service organizations have such reporting systems in place. A system meeting the above needs and more is offered by OnTrak Solutions (www.ontraksolutions.com) .
8. Look for Signs and Symptoms
A sick or suffering organization will often exhibit that malaise or weakness in the form of excessive absence due to illness or, perhaps, frequent tardiness. Each organizational setting is unique, but I've found that: (a) if absence due to illness is comfortably below 3%, this aspect of the organization is probably okay and (b) if it's well above 3%, there is probably a basis for investigation. Again, the analysis is not rocket science. Look for frequency of absence and when it occurs, e.g., Mondays, Fridays and before holidays. The positive actions are also pretty straightforward. Give a cash award for 12 (or maybe even 6) months perfect attendance. Let employees sell back, at a discount, a limited amount of sick leave. The same goes for being alert regarding workers comp use and cost. Benchmark your experience. Part of it is a mindset. Encourage employees to think of workers comp as "insurance for a contingency" not as "an employee benefit." Many healthcare organizations have successfully utilized the software programs and services of Health Management Technologies (www.hmtsales@ssigroup.com) not only to manage their cases, but also to carry that capability to their healthcare clients.
9. Measure
Many enlightened healthcare organizations regularly conduct employee satisfaction/attitude surveys -- an especially good idea for a new CEO or HR Director. However, management must be ready to act on valid concerns or the result will be worse than not asking at all. Management Science Associates (MSA) (www.mgmtscience.com) is one of several firms doing this work for healthcare organizations. MSA has a database that contains over 1,000,000 healthcare employee responses and they can also help with follow up, if needed.
10. Work as a Team
It is a leadership responsibility to:- get people working together in a unit;
- bring different units together as part of a system, e.g., Claims and Provider Relations in an HMO or Emergency Department and Admitting in a hospital;
- listen to ideas and inputs; and
- tie system performance and success to individual rewards.
11. Have Fun
If you are asking people to spend eight hours or more a day in pursuing the goals of the organization, you should work consciously to create a cheerful and positive atmosphere -- without losing sight of the overall goals to provide superior products and services and to be profitable. This can be a planned picnic or holiday party or it may be spontaneous. But it needs to happen.
12. Recognize and Reward
In today's environment, managers must explicitly set high standards and then positively reinforce those people who meet or exceed them. Everyone appreciates rewards and recognition when they are meaningfully linked to a superior effort. Sure, money is great! However, recognition and reward can take many forms. This is amply demonstrated in 1001 Ways to Reward Employees by Bob Nelson (Workman Publishing, New York).
5
13. Show Respect
In my judgment, nothing is more important. This can take many forms:- It starts with the Golden Rule and by simply saying "please" and "thank you."
- It involves the old adage of "praise in public and criticize in private."
- It welcomes diversity of people and opinions, so long as all are working as respectful colleagues, focused on common goals.
- It can entail taking the 90-120 seconds necessary to drop someone a handwritten note of thanks or praise. Yes, a handwritten note even in this era of e-mails.
This "baker's dozen" can be key to establishing a "working" organizational environment. And although the references cited herein represent companies I am familiar with and trust, there are other well-qualified firms out there that may serve as resources. The space available limits the number of items and the extent to which I can expound on any of them. What would you add? What would you delete? What do you think?
About the author: David Buchmueller's career spans over 30 years as a senior executive with or consultant to academic medical centers and hospitals and health systems. As CEO of hospitals and health systems, Mr. Buchmueller applied his expertise in managing operationally and financially challenged institutions, enhancing physician and interdisciplinary team efforts, developing new clinical programs and strengthening community relations. As Vice President of Scheur Management Group, Mr. Buchmueller is leading services in the areas of improving operations, building positive personnel and physician relationships, and developing strategic alliances. |
Back to The Insider Index
|
|
|
