by Sabrina Rodak
The challenges of the healthcare industry today require hospitals and health systems to apply all available resources to a strategy toward reducing cost and improving quality. One of healthcare organizations' greatest resources — and often the key to the success of new initiatives — is their employees. Attracting and retaining skilled employees necessitates a nurturing environment that encourages and rewards innovation through both material and nonmaterial benefits.
While tangible benefits, such as health insurance and compensation, are important to employee satisfaction, what may be more important are intangible benefits, such as respect and recognition. "It's not about the money," says Paul Spiegelman, founder and CEO of BerylHealth, a company focused on the patient experience. "People want to feel valued." In fact, most of the following pillars of success involve abstract concepts that, while difficult to define, may ultimately separate a "good" workplace from a "great" one.
1. Culture. Hospitals and health systems identified by employees as great places to work have developed a culture that reflects the values of the workers and organization. "An overarching cultural tenet of the health system is transparency, inclusiveness and stewardship toward our employees. It's the overarching cultural component that drives everything else," says Stephen L. Mansfield, PhD, president and CEO of Dallas-based Methodist Health System.
Similarly West Orange, N.J.-based Barnabas Health focuses on creating a friendly environment to make employees feel welcome and happy. To create this environment, the recently retired Barnabas Health president and CEO Ronald J. Del Mauro encouraged people to always say hello to each other, according to current health system president and CEO Barry H. Ostrowsky.
Just as something simple like saying hello can improve an environment, building a healthy workplace culture generally depends on many small factors rather than one expensive program, according to Mr. Spiegelman. "[It's about] very small things that simply show people that you care about them and not about doing expensive events," he says. Sending a note of recognition, for instance, can affect a patient as much as or more than a large, costly party. Dr. Mansfield attributes Methodist Health System's eight consecutive Dallas Business Journal Best Places to Work awards to a myriad of elements that "become embedded in the culture."
Creating a culture focused on the organization's employees is important not only for employee satisfaction, but also for patient engagement. Mr. Spiegelman says healthcare organizations are beginning to realize that "the only way to be patient-focused is to be employee-focused and to start first with developing an environment in which employees enjoy what they do every day." The organization's leadership is essential for developing an enduring employee-focused culture.
2. Transparency. Being transparent with employees is critical to gaining their trust and engaging them in their work. Dr. Mansfield says Methodist Health System makes it a priority to notify employees of any major initiatives before they are publicly announced. "The basic premise is let's not surprise our employees," he says. "Let them hear what we're going to do from us. And if possible, before a final decision is made." Communicating directly with employees instead of indirectly through other sources, such as the media, indicates the system considers its employees key stakeholders in the organization. "We want them to feel like insiders — they are insiders. You should treat them like you treat your board from the standpoint of how you communicate with them," Dr. Mansfield says. "If you want employees to act like owners, you have to treat them like owners."
When employees are informed about the hospital or health system, they become more invested in the organization. In addition, keeping employees up-to-date on changes within the organization ensures they are aware of its goals and can work to meet them. "People want to feel engaged in their work, so they want to understand the mission, vision and values of the organization," Mr. Spiegelman says. "They want to understand what they stand for, what their part is in helping the organization achieve [its] goals."
3. Communication. In addition to being transparent with employees, hospitals and health systems should communicate openly with employees on other aspects of healthcare that affect them. For instance, Barnabas Health educates employees on healthcare reform through multiple communication channels. Mr. Ostrowsky says hospital employees get little relief from the topic of healthcare because of its prominence outside the hospital in the media and even among friends and family. The system thus began discussing healthcare with employees to provide them with tools to use when faced with the topic outside of the workplace.
Employees have responded positively to this initiative. "Our employees have become more intellectually inquisitive about the topic — more interested in where we're going as a society in terms of healthcare. They have the interest and we should be able to capitalize on that by providing effective information and education," says Mr. Ostrowsky. In addition, Barnabas Health keeps employees updated on the system's involvement in policy discussions with elected officials and other policymakers "so our employees know we're advocating on behalf of our enterprise and by extension on their behalf."
4. Listening. As important as providing information to employees is soliciting information from them through surveys or other discussions. Dr. Mansfield and one or two other senior Methodist Health System leaders meet with all the system's directors and managers each year. These meetings give employees an opportunity to share their successes and improvements as well as barriers to success. Dr. Mansfield then compiles the responses and assigns a member of the executive team to address any issues frequently cited as a barrier. The progress on addressing those issues is reported to the front-line staff throughout the year.
For example, one year many directors identified IT communication and response times as a barrier. The IT executives then redefined their roles, acting as vendors to the hospitals, which became clients. This new framework spurred the IT team to work with the hospitals directly to meet their technology needs. The next year, the issue was not mentioned as a barrier and was even listed as a success by the directors and managers. "For me, it's a way to get unfettered dialogue from them to me and me to them," Dr. Mansfield says. "Making that overt effort to try to get frontline feedback at least once a year from across the enterprise and doing something with that feedback has contributed to our success as a culture."
In addition to formal discussions, informal interactions with employees can be valuable in gauging employees' needs. "Just as important as a formal survey and benchmarking year-over-year improvements are informal ways to get feedback during the course of the year," Mr. Spiegelman says. Rounding on the floors, for instance, can give hospital leaders a real-time view of the employee experience.
5. Caring. Showing employees their leaders and colleagues care for them is important in enhancing job satisfaction and employee retention. Methodist Health System has a program in which employees can voluntarily designate some of their payroll to a fund for employees in need. A committee of employees determines how to allocate the funds. For example, an employee whose home burned or who lacks the money necessary to pay for medical care may receive some of these funds. "We try to create a sense of family and mutual respect and caring for one another," Dr. Mansfield says. Barnabas Health has a similar program. Last year, nearly 20 percent of employees contributed a total of $130,000 for employee assistance.
Another way Barnabas Health shows employees it cares was by introducing a dry cleaning service, a full bank branch and an entertainment center into the hospital. "Employees could [order food], rent a movie and leave from work ready for an evening of relaxation," Mr. Ostrowsky says. "We didn't make any money renting movies and having a full bank branch, but employees understood that we were concerned [and wanted] to develop something that could make their lives easier and less stressful when they left the job."
6. Empathy. Empathy takes caring one step further by expressing an understanding of employees' situation. Making employees aware that their leaders understand the challenges of their job is critical in engaging employees in the workplace. "If you're going to dedicate your professional life to working in healthcare institutions and supporting families and the sick, you have a personality profile and character that is unique and admirable. What we need to do every day as the employer is to connect with that emotion, that inner spirit that drove a person to want to be employed in the industry," Mr. Ostrowsky says.
Barnabas Health supervisors, many of whom have been on the frontline before, are trained to support their staff emotionally by expressing an understanding of the difficulty of staff members' jobs. "You have to start with empathy," Mr. Ostrowsky says. "It's not enough to say 'Thank you for your great work.' You need to say 'Thank you and I understand how difficult it is.' Expounding on that will allow the employee to understand that we really do appreciate what is done on a daily basis." Supervisors who previously served on the frontline are also encouraged to ask their staff what has changed since they left to gain a sense of new challenges the workers face. "If you miss that connection on the emotional level, then you're not going to make the workplace attractive to incumbent staff or new staff," he says.
7. Recognition. Recognizing employees for their efforts significantly impacts employee job satisfaction. Dr. Mansfield believes one important thing CEOs can and should do is to personally acknowledge employee accomplishments and successes. One small thing he does is to drop a personal note to the home of employees who are featured in their weekly system newsletter for achieving a goal such as receiving a certification, award or other accomplishment. This small act creates great value for the employee at little cost to the health system. "That costs nothing, really — just a little time and a stamp, and I love doing it," he says.
Employee recognition should be timely and continuous, according to Mr. Ostrowsky. He suggests healthcare leaders recognize an employee — whether through a formal award or informal acknowledgment — as soon after the behavior they wish to reward as possible. Responding to employees' successes in a timely manner demonstrates the leaders' value of and commitment to employees.
8. Professional development. Professional development opportunities are also central to an attractive workplace because they show the organization's investment in employees and their desire for them to progress in their careers. Methodist Health System has an emerging leader program for frontline employees identified by a manger as potential leaders for the future. Similarly, Barnabas Health has a management institute that trains employees.
Training healthcare employees may become increasingly important as healthcare reform focuses more on the patient experience, which depends in large part on patients' interactions with the people in the organization. "In healthcare, people are highly trained in a specific skill set. But they're not generally trained on what it takes to run a business in terms of personal interaction and team development," Mr. Spiegelman says. "Providing an environment in which they can learn those skills is critical."
9. Organizational pride. Mr. Ostrowsky says hospitals and health systems identified by their employees as great places to work are those that make their employees proud of the organization, such as by getting involved in the community. "If the employee doesn't have a warm feeling about the accomplishments of the overall organization, or the employee doesn't acknowledge to him- or herself that the organization is trying to accomplish something that's important, you lose an opportunity to make the employee feel good," he says.
10. Fun. Becoming a great place to work in healthcare also requires opportunities for employees to have fun, according to Mr. Spiegelman. One way to have fun is encouraging employees to decorate their office space. He also cites the case of one hospital that shows funny videos to staff, schedules dress-up days and has social events outside the facility. "They realize that as serious an environment as a hospital is, they can still find the time to have fun with each other."