Managing a Generationally Diverse Workforce

During the next decade, the health care industry will face an influx of patients. Baby boomers will live longer than previous generations due to new medical treatments and technologies. At the same time, the retirement of boomers from the workforce will exacerbate current shortages, especially among physicians and nurses. This shift in patient and workforce demographics will create a generational gap between older patients and younger health care providers, ultimately affecting the care delivered in hospitals.

The challenge for the health care industry is to develop a workforce that can adapt to these changing patient demographics. Currently, there are four generations in the workforce — traditionalists, baby boomers, Gen Xers and millennials — and each generation has different life experiences, values, communication styles and perceptions of work that influence organizational culture and performance.

Generational differences are only one factor of workforce diversity, which includes ethnicity, gender, educational level, socioeconomic status, religion and political orientation. If hospitals and health care systems do not properly manage diversity, they may experience high employee dissatisfaction and turnover; pay higher costs for recruitment, training and retention; and see lower patient satisfaction scores and worse clinical outcomes. Health care organizations that effectively manage generational differences of employees will thrive with a steady and able labor force, realize better clinical outcomes and provide a better patient experience.

Strategies for Managing an Intergenerational Workforce

In 2013, the AHA Committee on Performance Improvement focused on issues related to generational differences in the health care field and developed the report "Managing an Intergenerational Workforce: Strategies for Health Care Transformation." The report provides hospital leaders with workforce management strategies to help achieve Triple Aim outcomes — better care, better health and lower costs. There are three major strategies outlined in the report:

• building a strong generational foundation;
• establishing effective generational management practices;
• developing generational competence.

To create high-performing teams that are flexible and adaptable to the evolving health care environment, the workforce management strategies must operate synergistically. Hospital leaders need to understand their organization's workforce profile and develop programs and policies to acquire and retain generationally diverse employees. Once programs and policies are established, hospital leaders need to tailor their management styles to the strengths of each generation and relieve any generational tensions in the workplace. Then leaders can spread generational understanding and sensitivity among the entire workforce.

The chart lists different methods to deploy the individual strategies.

Deploying Strategies to Manage an Intergenerational Workforce

Examples from Innovative Organizations

Several health care delivery organizations, applying a combination of methods, have made significant strides in managing a generationally diverse workforce.

Atlantic Health System, headquartered in Morristown, N.J., is recruiting baby boomer employees. The health system's human resources department reached out to placement agencies, events and clubs geared toward the 50 and older population. The health system also provided support services catered to each generation. For example, it installed track-ceiling lifts in patient rooms to reduce the stress and strain on staff, especially traditionalists and baby boomers. Because of its progressive workplace policies and practices, the health system since 2006 has been honored by AARP annually as one of the best employers for individuals 50 and older.

Baptist Health Lexington (Ky.) established a shared governance model that provides opportunities for generationally diverse employees to collaborate with colleagues and organizational leaders to shape their work environment. For example, the nursing leadership council — comprising eight baby boomers, six Gen Xers and four millennials — sets standards and policy, which help to shape nursing practices at the health system.

Baptist Health also created the Evolving Leaders Program to cultivate current and emerging leaders of the organization. The program consists of three levels. In the first two levels, participants complete a series of courses, and in the third, they work with mentors. Participating in the program is one criterion used when considering internal candidates for promotions. Over a three-year period, 75 percent of nurses who participated in the program were promoted to nurse managers or positions that were extended.

The AHA Committee on Performance Improvement report, "Managing an Intergenerational Workforce: Strategies for Health Care Transformation," provides additional examples of successful approaches used in health care organizations today. The exemplary efforts of different hospitals and health care systems demonstrate that intergenerational management strategies are critical to redesigning care delivery that will help to achieve Triple Aim outcomes. The projected patient and workforce demographic shifts necessitate innovation, and success will elude organizations that fail to adapt to the new health care environment.

James A. Diegel, F.A.C.H.E., is the president and chief executive officer of St. Charles Health System based in Bend, Ore. He served as chair of the AHA Committee on Performance Improvement. Rhoby Tio, M.P.P.A., is a program manager for the Health Research & Educational Trust.