It's up to managers to clear the way for employees so they can do their job: caring for patients.
 |
| Wendy Leebov |
In these days of disturbingly high turnover, many health care organizations devote substantial resources to employee recruitment. In the short run, it's a must, but it's often conducted at the expense of retention--like running water into the sink with the drain open.
High turnover is incredibly costly and stressful. It thrusts managers and staff into a frenzied cycle of recruitment, hiring, orientation, vacancies, recruitment, hiring, orientation, vacancies, recruitment.
High turnover is also devastating to service quality. The great people you have on staff overwork to fill gaps caused by vacancies. They run ragged and resent it. New people, once you find them, take time to develop collegial relationships with their teammates, the ease of communication that comes only with time, and organizational savvy about how to get things done. Vacancies cause jagged, inconsistent service.
What to do? Get serious about making your organization a great place to work for the people you already have and the new people you're about to get. Your success in serving patients depends on having a critical mass of high-performing people who are focused on their patients and their work, not on finding the escape hatch to their next job.
Creating a Great Place to Work
While you can't under pay people if you want their satisfaction and loyalty, satisfaction is not about money. To be satisfied in their careers, employees:
- want to be involved.
- need to be in the know.
- want to do a good job--to make a difference.
- itch for opportunities to learn and grow.
- expect to belong--to work in a supportive group.
- like to be treated as individuals with unique strengths and a life outside of work.
Here is a five-step plan managers can use to keep their employees happy:
| Five-Point Tactical Plan #1: Remove barriers to providing top-notch care. #2: Keep your finger on your employees' pulse. #3: Sculpt the job; cater the job to the individual. #4: Hold yourself accountable for retention. #5: Communicate your regard with appreciation and thanks. |
Tactic #1: Remove barriers to providing top-notch care. When there are resource constraints, employees feel like they're pushing boulders up mountains. When staff are met with "no, no, no" or "we're trying, but can't seem to move the system," they get demoralized and question whether the mission of the organization is really about patient care.
Adopt barrier removal as your No. 1 great-place-to-work tactic and tackle it with a sense of urgency. Become an advocate. Out of respect and support for your staff, make running interference your key role--be an indefatigable advocate with higher-ups and other departments for your staff so they can serve their patients/customers.
Invite staff to tell you the barriers they encounter and how they can be removed. Here's a meeting format managers can use to engage their teams in eliminating barriers within their control:
|
Meetings like these engage everyone in easing job frustrations. But while teams can achieve some quick fixes themselves, many barriers to doing a good job extend beyond department walls. What do you do when nurses don't have enough linen delivered on time, or when no patient education materials are available to support the nurse's predischarge discussion with the patient and family, or when the food warming system is inadequate and hostesses hear daily complaints about hot food arriving cold?
Rather than giving up as so many managers do, you can use rapid cycle improvement approaches or bring in operational experts to redesign the workflow. These steps will help make it possible to serve patients efficiently and in ways that are manageable for staff. Employees want the conditions and resources to do a good job with patients. It's our job to shrink the obstacles that block their desire to help.
Tactic #2: Keep your finger on your employees' pulse. We have great people in health care--people with altruistic motives. So why do some managers appear surprised or start pointing a finger when employees adopt a routine approach to their job or, worse yet, head out the door? I think a large part of it has to do with a failure of managers to ask questions of and listen well to staff. In these hectic times, staff are running ragged, as are managers. With an out-of-touch manager, disillusioned staff members become more disillusioned, and their concerns escalate.
Managers need to create a routine way to take the employees' vital signs. While some organizations conduct employee satisfaction surveys, these surveys merely supplement; they don't replace the need for managers to take the pulse of their teams frequently and in a personal way. Here's a short report card managers can use:
|
|
|
||||
| A | B | C | D | E | |
| 1. Has made an effort to get to know me and show respect for who I am. | |||||
| 2. Makes job expectations clear to me. | |||||
| 3. Communicates thoroughly and often so I feel in the loop. | |||||
| 4. Gives me honest, regular feedback about my performance. | |||||
| 5. Shows respect for my life outside of work. | |||||
| 6. Shows flexibility to help me manage the many facets of my life. | |||||
| 7. Encourages me to express my concerns and shows responsiveness. | |||||
| 8. Helps coworkers get along, so we have harmony within our team. | |||||
| 9. Helps me feel appreciated. | |||||
| 10. Advocates for what we need; removes barriers. | |||||
| 11. Finds ways to help us lighten up and have fun. | |||||
| 12. Provides learning opportunities; helps me grow. | |||||
| My suggestions: | |||||
You can circulate this report card at least once per quarter to find out how employees are feeling. Share the results openly in a meeting with the staff who took the survey. Thank people for their feedback. Show responsiveness to their perceptions by telling them what course corrections you plan (not want) to make. Invite their suggestions. Tell them you'll be asking them to fill this out again in three months so you can see how they're doing and you're doing. By using a short homegrown survey like this, managers can gain valuable information about how their team members feel and can then take steps to enhance their work experience and relationships.
There are also powerful ways to obtain feedback using focus groups and individual interviews. Both help create customized employee satisfaction and retention initiatives that have greater power than generic solutions.
Tactic #3: Sculpt the job; cater the job to the individual. Job sculpting involves using what we know about each employee to customize the job to the individual, building on their particular strengths, making their work schedules doable and their lives manageable. The age of generic solutions to people management is gone.
Some organizations are making individual work arrangements with caregivers. For instance, recruitment and retention "swat teams" work with one patient care unit at a time to address the issues that different individuals within that unit identify as interfering with their job satisfaction. These highly creative swat teams dig deep, creating unique contractual relationships with employees. For example, some employees have arranged to take on an ambitious 10-month schedule with 12-month pay so they can take summers off with their kids and still get paid. Some negotiate for conference attendance and additional learning opportunities instead of certain other benefits. Some negotiate for tuition support for their children instead of themselves. Some negotiate for physical help for all patient lifting, so they can work despite back problems. While it is complicated to do job sculpting to this degree, and it requires human resource guidance to stay within the law, imagine the talent and energy it unleashes for patient care and service!
Tactic #4: Hold yourself accountable for retention. Employees quit their managers more often than they quit their jobs or the organization. Embrace your responsibility for enhancing and sustaining employee satisfaction. Consider employee retention a key leadership competency in your job description and performance review, and develop your retention strategy and skills as part of your personal learning plan. Set a goal for reducing turnover.
Tactic #5: Communicate your regard with appreciation and thanks. This strategy is nothing new, but it's too critical to avoid mention. Managers need to generously give each employee individualized appreciation and thanks. If we want our employees to feel precious, we will call them by name. We will inquire about how they're doing. We will notice and appreciate them. We will compliment them about specific things that they do well and specific ways they contribute. We will acknowledge big life events. We will take the time to write occasional thank-you notes and send them to home addresses so they're more likely to share them with their families. We will give this positive regard whether we're getting it from our bosses or not. Active, regular, specific, genuine employee recognition must become a job requirement of every manager.
Dare We Put Employees on a Pedestal?
Health care really is about valuable human beings caring for vulnerable human beings. It is the work of the soul. Health care employees have always deserved to be admired and supported in their caring work. It is our job to create caring communities that help them flourish. They will feel gratified in their lives. Our patients will benefit by receiving the care and service they deserve. And your organization will be able to maintain a more experienced, harmonious and stable team.
Wendy Leebov, Ed.D., is president of Wendy Leebov Inc. in Philadelphia. She is also a regular contributor to H&HN OnLine.
GIVE US YOUR COMMENTS!
Hospitals & Health Networks welcomes your comment on this article. E-mail your comments to hhn@healthforum.com, fax them to H&HN Editor at (312) 422-4500, or mail them to Editor, Hospitals & Health Networks, Health Forum, One North Franklin, Chicago, IL 60606.
If you would like a FREE Subscription to H&HN OnLine, please click here to register.
This article 1st appeared on October 18, 2005 in HHN Magazine online site.
To respond to this article, please click here.
