By: Carolyn Hardy, Regional Manager, Catalyst Learning
What's the point? That's what you're wondering if you're anything like me - a skimmer. Well, I'll give you the gist; this is not about a quick fix to turn around your engagement scores or a miracle new process that promises to be the magic bullet for retention or patient satisfaction. This post is about a multi-year journey with an organization that placed a premium on culture and used accountability to take their place as employer of choice in the community. This is about the hard work and the metrics that prove the link between employee retention, investment and operational efficiency.
Rhonda is already talking as I enter the room, on this last day at the ASHHRA 2013 Conference. I begin to tune in to Rhonda's clear, strong voice.
"The focus is here: to make every employee feel that they are part of what we do, no matter if they are a nurse, a doctor, a housekeeper, a parking valet. Connecting is what we need to do, regardless of our industry."
We're listening to Rhonda Larimore, Vice President of Human Resources and Support Services at Children's Hospital of Pittsburgh (UPMC). She's an excellent speaker and we're all here to see what we can learn about "The Business Case for Employee Investment". Much of Rhonda's message can be summed up by what must be an easily recognizable state to us all; regarding the role of HR, she says, "There's two kinds of HR departments - ones that do the paperwork and ones that do the vision work."
Listeners are introduced to a series of areas that Children's Hospital of Pittsburgh identified for improvement in 2006 when Rhonda came on board. From annual turnover to patient satisfaction, from a lack of vision in learning and OD to a need to focus on values in daily practice, we got a pretty clear picture - Rhonda wanted to take it back to the drawing board.
So how did they do it? She shared CHP's strategic plan:
Of this plan Rhonda tells us, "It's about packaging it so that people see not just the ones-ies and twos-ies of what we do but the whole picture." She is speaking of the leadership in the organization as well as the employees who report to them. Getting an organization of that size on board with this kind of change can't have been easy and she relied on support from other leadership and a values-based approach on which everyone could agree.
As this story winds up, I'll highlight a couple of stories from items 1 and 3 in the strategic plan.
CHP wanted to hire talent whose values closely matched that of the organization. Enter Ted Kinney, Ph.D. and Director of Research and Development for Select International. These two formed a partnership and implemented a standardized hiring process and assessment. Hands flew up as Rhonda spoke of their success, their measures and their processes. In the end, everyone was quiet and you knew they'd been impressed by the staggering lack of complications or issues with the new process. Ted was present to answer questions and he had rapt attention from the audience; this guy was about to become very popular.
Since Catalyst Learning is a workforce development organization, I promised to address workforce development and here it is.
Learning & OD - 'How can I focus on MY career?'
Again our speaker describes a dichotomy positing that there are two types of employees:
1) those who want to grow their career,
2) those who want to be the best at who they are in their current role.
Either way, Children's of Pittsburgh focused on the growth of their employees by providing a continuing education fund for those that want to attend a conference or other learning opportunity. For loyal employees who want to stay in same position, the organization still challenges them to improve in that role every year.
CHP provides online learning opportunities, leverages leadership and mentorship programs in which over 1000 people participate each year.
Ted brought this all home by stating that, "Hospitals need highly skilled employees and Patient Satisfaction is still relatively new to the industry." He spoke of combining "top-down" and "bottom-up" approaches, identifying specific behaviors that drive outcomes, and building accountability through better staff communication which correlates with patient safety.
So, here is your challenge - where are you as an HR or OD professional doing "The Vision Work"? We're all being targeted for improvement these days. I hope this post has inspired you in some way to take things to the next level, whatever your role in your organization.
Waves of learning credentials
One of the most disrupted industries is education, with more 3rd parties offering courses, credentials and certifications than ever before. So many young workforce entrants will avoid costly traditional secondary education/college and pursue low cost online courses to get skills. Groups like LinkedIn Learning, Coursera, edX, Udemy, Udacity, and The Khan Academy are leading the charge. Self-directed learning is driving the need for new credentialing.
Focus on upskilling and retraining current workers
There is political discussion around bringing manufacturing jobs back to America, while the media continues to publish alarmist articles on how technology advancements will eliminate jobs. But this may be smoke in mirrors; the biggest issue is finding ways to grow the U.S. worker skills gap! There are currently 6.2M job openings in the U.S. that are unfilled. Companies can’t find the right workers with the right skills, at the right time. Employers will be investing more into their training and development programs in 2018 to fill their skills gaps and reach full capacity.
Artificial Intelligence (Chatbots) become part of the workplace – but for hospitals too?
This has big HR buzz right now, with both excitement and fear. The large digital companies are concentrating on smarter products using AI. There are over 1,000 AI vendors, supporting all types of businesses and people. Companies are using Chatbots as personal assistants, on-demand customer support, data mining, streamlining processes, recovering information, and answering employee questions.
Healthcare is so hands-on and people-centric that you may think Chatbots won’t make a divot in the workforce. But the top roles it replaces are: Information clerks/help desk staff, phone receptionists, assistants, security guards, and cooks/food. Because these roles are often a first step into a healthcare career, it could throw off traditional career pipelines for large hospitals.
EAP programs get prioritized – financial acuity, plus mental health and wellness
With 78% of Americans living paycheck to paycheck and high student loan debts, workers are struggling and it affects their health. Financial struggles affect productivity and job satisfaction. Many companies are helping with loan assistance, financial planning, counseling and mental health. In 2018, mental health issues are slowly carrying less of a stigma in the workplace.
Talent professionals can’t always just give $400 to every employee to spend on health activities, but they can encourage a company culture where health and wellness are promoted day to day. Put up a walking track around the hospital, encourage a charity walk, arrange games and activities, encourage onsite flu shots, or bring in a nutritionist to speak in the break room.
Employee burnout causes turnover
Employees are burning out from working longer hours with no additional compensation, because technology has expanded the work day. A study by Kronos cites that half of HR leaders say employee burnout is responsible for 50%+ of their annual workforce turnover.
Workforce decisions sway consumer behavior
Big data and research is showing a connection between a positive employee/candidate experience and actual revenue. A major study shows that 58% of employees are less likely to buy from a company to which they’ve applied if they don’t get a response to their application. HR will focus more on candidate communications when not hired, shorten hiring process, provide more clear application instructions, and giving notice when positions are filled or no longer considered. Most hospital entry-level employees live in the neighborhoods where they apply for positions, these are future patients. So treat them well when they interact with your health brand.
Companies take diversity more seriously
This subject has been in the conversation for years, but it is reaching a tipping point where companies are investing money in improving the composition of their workforce. Many companies are creating employee resource groups to support all types of diversity, including gender, ethnicity and age. Hospitals will aim to get their staff to mirror populations of their community. Building diversity at the top of the leadership apex may take grooming employees while at lower levels.
3 in 4 Americans plan to work past retirement age. As Baby boomers maintain their leadership positions, it will be harder for younger workers to advance to new positions, which could lead to high turnover, frustration and stress. Older workers may need tech training to keep skills current, so have a plan for your facility so you can hold on to long tenured employees.
An aging workforce is especially applicable to nursing staff. According to a Fall 2017 study by AMN Healthcare, 54% of bedside nurses are at least thinking about retiring or switching to part-time employment in the next 3 years. Prepare your younger nurses to lead, and encourage them to apply for leadership positions. NCharge: “Nurses Learning to Lead” is a nurse leadership development product that may be a good fit to prepare young nurses to lead.
Leaders encourage more human interaction, soft-skill development
Living in a Tech world has led to a breakdown in basic communication skills. Employers will begin to re-emphasize soft skills like emotional intelligence, collaboration, and negotiation. Ensure that soft skills are on the agenda for employee development.
More Applicant Assessments
HR will give more assessments to a potential new hire before hiring candidates, or transitioning associates to new roles. Employers can test for technical skills or culture fit. Use it sparingly though, applicants hate long rambling, transparent assessments. Only ask questions that have direct relevance to what you want to know.
“Diversifying perks” may sound like Millennial code for “silly work place nonsense.” Obviously hospitals are not going to start looking like Silicon Valley work spaces any time soon, but don’t fear benefits and perks that seem weird, or offbeat. Employees aren’t looking for NERF guns or bean bag chairs, its more what they represent. Don’t shut down perk ideas just because they seem odd. Reclining chairs, music, and an Espresso machine in the break room may be the sweet spot, and will show your employees that you want them to be comfortable at work, and socialize at appropriate times.
Leveraging Training as an Employee Benefit
Training is becoming a differentiator when companies compete for talent. Personal and professional development is an important focus area for modern employees when seeking employment, as well as when deciding to stay with their current employer. Provide accessible training to refine and grow employee skills. Developed employees are more motivated and successful in their roles. Training should be leveraged as an employee incentive and added to existing benefits packages, alongside retirement and health options. Predictions are for a 2-5% global training spend increase in 2018.
What are the fastest growing roles in the U.S. in 2018?
Heads up! 10 out of the 30 are in healthcare, and 6 of the 10 are entry-level or mid-level frontline employees. With the economy at Full-Employment levels and an aging American workforce, HR will be developing plans to fill and hang onto their employees, especially in these 6 positions. Occupational Therapist Assistants/Aides, Physical Therapists Assistants/Aides, Pharmacy Techs, Medical Assistants, Skin Care Specialists, and Personal Aides/Home Health Aides.
"10 Workplace Trends You'll See in 2018", Forbes Nov 1 2017, Dan Schawbel
2018 HR Trends - Candidate Experience - What You Need to Know, Rezoomo in Human Resources Today, Nov 2 2017
"5 Major Talent Trends for 2018", Capterra Talent Management, Nov 7 2017, Halden Ingwersen
5 workplace trends you'll see in 2018"... Workforce Institute
Top 5 Workplace Trends for 2018, Laura Handrick, Nov 6 2017, Fit Small Business
Trends 2018: Speed is the heart of the learner experience" Doug Harward and Ken Taylor, Nov 2017, Training Industry
Top 30 fastest-growing jobs, 2018, Boston.com, Bureau of Labor Statistics, Forbes
Society for Human Resource Management - HR Magazine: "How to Accommodate Employees with Mental Illness"
Situation: Like many other healthcare organizations, Cincinnati Children’s Hospital Medical Center (CCHMC) faced a skills gap among its administrative staff. This large group of almost 850 employees includes admin assistants, customer service representatives, program coordinators, schedulers and access service representatives. The requirements and skills necessary to be a successful in an administrative role had changed over the last several years, while the talent and career development for these staff lagged behind.
At the same time, the hospital faced a shortage of external candidates resulting in constant vacancies. Adding to the challenge, on a more global scale in the healthcare industry, was that the title administrative assistant no longer reflected the skills and abilities of the professional, nor did it necessarily match the requirements of individual units within a healthcare system.
CCHMC, recognized not only as one of the “Best Places to Work” in Cincinnati for many years, but as the third in the nation for Pediatric Hospitals by US News and World Report, was facing a talent shortage— one that if not addressed, could have a significant impact on operations, employee engagement and patient satisfaction. CCHMC made a strategic decision to implement a career ladder program to improve employee versatility, and ultimately patient care.
Solution: In order to assess the career development needs among its administrative staff, CCHMC conducted a Morehead Employee Survey in 2012. The survey found that a significant number of administrative assistants wanted more support with career development and advancement opportunities.
This feedback further supported CCHMC’s overall staffing needs, prompting management to offer a tool and career coaching resource to assist administrative staff with career development and advancement. CCHMC was already successfully partnering with Catalyst Learning on School at Work® and so they decided to integrate CareerCare® to meet the Admin staff’s career management needs.
“Career development within a healthcare setting requires a variety of tools available to fit the unique needs of the various employees including their work schedules, family situations and educational goals,” said Beth Smith, BSN, employment support specialist for CCHMC. “School at Work and CareerCare provide the flexibility and scope to be able to identify the specific needs of the employee and select the appropriate tool which best meet the needs.”
CareerCare quickly became one of CCHMC’s primary tools for career development of its administrative staff, using the program in conjunction with personal career coaching and academic advising.To publicize the new service, management met with the leadership of the Administrative Assistant professional organization (C-CAP) within CCHMC to explain the new career development focus. In turn, that organization invited senior leadership and the career coach to present at their monthly membership meeting to recruit candidates to participate in the self-directed CareerCare project with career coaching.
Management continues to value CareerCare’s web-based approach because it provides flexibility for employees with different schedules, goals and educational backgrounds. Moreover, CareerCare allows employees to have a structured tool to use at their own pace to assess current skills, explore educational options, realize obstacles to achieving goals, and develop a realistic plan.
Results: Based on the reviews from the program’s participants, providing career development tools like CareerCare is essential to driving employment engagement. Elizabeth, an Administrative Assistant at CCHMC said, “I was able to complete the tool, and I found it very useful to help me identify my goals and then set my SMART goals. I have been successful in achieving a new position (one of my top goals) in Sponsored Programs-Accounting and will begin my new job as a grant accountant.”
Melinda, also an administrative assistant, voiced her support for the program as well. “I am thankful for the opportunity to be a part of CareerCare,” she said. “From my experience, it helps a lot when you are looking for direction in your career and you’re not exactly sure which way you should go.”
Cincinnati Children’s Hospital Medical Center is the third best children’s hospital in the U.S., according to Parents magazine. CCHMC was also inducted into the Cincinnati Business Courier’s “Best Places to Work Hall of Fame” after making the annual list for several consecutive years.
For more information on CareerCare, please email Brittany Gearhart at firstname.lastname@example.org or visit the CareerCare product page.
Saint Anthony Hospital staff worked hard to improve its Leapfrog Hospital Safety Grade from a D in 2014 to an A in October 2016. The nonprofit, community teaching hospital in Chicago found one key to success came in providing front-line nurse leadership with increased confidence and management tools that would help improve hospital standards and quality of care.
Finding the Right Curriculum
Saint Anthony’s development team was searching for a structured, in-depth learning program that would empower their nurses to take leadership to the next level. What they found was Catalyst Learning Company’s NCharge® Nurses Learning to Lead program. NCharge provided the detailed content and knowledge assessments they were looking for, with results that are measurable. By focusing on relevant leadership scenarios within the hospital, participants were able to easily relate and apply techniques to their everyday environment.
“Like most healthcare organizations, we are growing and changing. We were also in the process of reorganization. It was about sweeping clean on old ideas and looking for ways to be more efficient. Illinois is also tightening on funds and as a nonprofit hospital, we had to look at ways to be more efficient in how we were working and make our staff feel as if they have a way to advancement,” stated Jaqueline Napier, Manager of Talent and Development at Saint Anthony.
Leading with More Confidence
One important outcome noted by Saint Anthony management is the overall improved confidence among nursing leadership. Creating a more autonomous team has positively impacted the hospital environment and proven an effective influence regarding quality of care.
Sonia Haro, an ICU Staff Nurse and NCharge participant, committed her time to the NCharge series with specific objectives in mind. “I was looking for ways to communicate more effectively, especially when setting expectations for the team. Sometimes, not everyone feels like being a team player. I wanted to find a way to encourage my team but stay firm and reach expectations,” explained Haro. This was the type of leadership training that most staff nurses don't get with shadowing or clinical training. Haro was pleased with NCharge, which provided her with a better understanding of communication styles and techniques to handle a variety of situations confidently in the unit.
Haro wasn’t the only person who noticed a need for better communication and confidence from front-line nursing leaders. When Catalyst Learning surveyed nurse managers at Saint Anthony before the NCharge courses were implemented, less than 20% strongly agreed that the Charge Nurses in their departments displayed confidence when leading their teams. In addition, less than 30% agreed that Charge Nurses were cognizant of the key drivers of a positive patient experience. A few months after the training was held, the same nurse managers were surveyed and reported dramatic improvement with over 65% saying Charge Nurses were more confident and over 70% recognized key drivers in positive patient experience.
Cultivating Team Dynamics
A more efficient, collaborative environment was formed as a result of the NCharge leadership training. The team who completed training worked stronger and smarter together when handling obstacles. “I really wanted to work with others in the hospital in the same position. It’s nice to have others to lean on and run questions by, and share experiences with. Networking with my own colleagues was a great bonus,” stated Haro.
Elizabeth Negrete, Director of Perinatal and Pediatric Services, had staff who completed NCharge training. Staffing in OB, having the right number of staff and the right combination, had been a continuous issue. NCharge class participants looked at staffing and created plans to put the right skills and experience in the best combinations. “Now the staff are the ones doing the schedule, entering it in to the system and balancing. When the census goes down, they adjust appropriately based on the patient grid. This shows how they have been working more autonomously and are able to make important decisions with less guidance,” explained Negrete. “The Charge Nurses are working more in collaboration with the house managers. Before, staff managers were just telling them what the need was, but now the Charge Nurses are more empowered to speak up about needs.”
Haro reported that the rounding process has also gone through changes, giving the NCharge participants an opportunity to observe with fresh eyes what happens within the unit when everyone is not on board with a change. “It takes some buy-in from everyone, and there were days when we were just being run ragged. You could easily see that on days when the new process wasn’t being used, feelings and tensions were high,” conveyed Haro.
By equipping front-line leaders with the skills to embrace change, NCharge prepares staff for reaction from team members and how to move forward as a unit. This can be vitally important and impactful when trying to deal with the constant updates within hospitals. “There is always more trust from staff when changes come from Charge Nurses. There is more peer influence and impact. The staff has more of a buy-in because they know the Charge Nurses truly understand what the impact will be since they are on the frontline with them,” described Negrete.
Made evident in the impressive move of their Leapfrog Safety grade from a D in 2014 to an A in October 2016, the hospital seems to have found the key to success in increasing quality standards. Napier credits the NCharge series with being a factor in that improvement after implementation in early 2016.
The combination of increased confidence, more efficient staffing and adaptability to change have helped Saint Anthony become a more progressive, efficient hospital when it comes to patient care and standards. “The nurses are more cohesive as a team and moving towards a group environment where the charge nurses really stand out as leaders. They are really keeping their team members engaged. All of that correlates to the patient experience and how everyone is measured,” stated Napier. “Our people were skilled but now they have more confidence in those skills and their ability to engage the nurses on their team. They now understand how this all comes together to enhance the patient experience.” By giving front-line leaders new techniques to handle their day-to-day situations and changes, an environment of new ideas and proactive enthusiasm has been cultivated.
By investing in the front-line nursing leadership at Saint Anthony, stronger teams were built and the confidence instilled in the newly trained charge nurses was of great value. The return on investment for the Chicago hospital is shown through the recognition of receiving its first A rating from Leapfrog Hospital Safety Grade and becoming a top-rated hospital.
With inpatient, outpatient, home health and palliative care services, Mercy Health Youngstown is the largest employer in the Mahoning Valley region of Ohio. Investments in employee development, therefore, have a positive impact on both the health system and on the community at large, making this a top priority for senior leadership.
Mercy Health Youngstown has expanded access to skills and leadership training for entry-level workers with education programs, college tuition reimbursement and opportunities for career advancement. Entry-level employees with leadership potential, for example, are encouraged to enroll in School At Work (SAW), a training and career development program created by Catalyst Learning Company.
SAW participants complete a series of modules led by a Learning Coach in the Culture and Learning Department at Mercy Health Youngstown. The Principles of Patient Satisfaction and Safety module has proved to be especially valuable.
“We found the Patient Satisfaction course very useful because entry-level employees didn’t realize how the little things they do affect patients and patient satisfaction. Sometimes patients arrive at the hospital frustrated and hard to please, so this particular course made a big difference,” said Learning Coach Georgette Peters. “This course also showed entry-level employees the importance of their work and its impact on HCAHPS reimbursements.”
To demonstrate program value and return on investment, Mercy Health measures impact and tracks aggregate success among SAW participants. Of the 35 students who graduated from SAW last year (20 from Mercy Health Youngstown and 15 from Mercy Health Cincinnati), nine are now enrolled in higher education and pursuing further training to move up within the organization.
SAW graduate Janet Johnson found similar success. She started in an entry-level position at a Mercy affiliate hospital in 2009. With a grant from the Robert Woods Johnson Foundation, she trained to be an entry-level healthcare associate. This resulted in a promotion to Environmental Services, where managers recognized her leadership potential and recommended Janet for SAW. She completed SAW and is now enrolled at Penn State, pursuing a career as an occupational medicine assistant at Mercy Health Youngstown.
Mercy Health is proud to see employees like Janet advance.
“When speaking with our employees who complete the SAW program, I always thank them for bringing me along on their journey. I hope to assist in lighting the flame, and I hope the students keep it burning,” said Peters.
Mercy Health Youngstown plans to continue offering SAW courses and hopes to expand the curriculum to smaller regional partner facilities. Additionally, senior leaders hope that by offering upfront college tuition reimbursement, they can help employees overcome barriers to advancing their education, particularly those who earn the lowest wages.
The health system aims to enroll up to 45 percent of their employees in skills training programs and help more employees pursue advanced educational opportunities. As employees succeed and move up within the organization, senior leaders are seeing morale and retention rates improve, resulting in better patient care. Mercy Health Youngstown believes that employees are their most valuable resource, and by investing in them they hope to make lives better and the community stronger.
“Service support is increasingly important. There is a tremendous need for high customer service skills: think hospitality-minded members. We are trying to work with workforce boards and schools to prepare for a better fit for health care for our future.” Amy Barry, SVP and CHRO, Lakeland Regional Health
With service support positions taking an increasingly important role in healthcare, employee engagement and retention is top of mind for HR leaders. Most organizations understand the importance of employee engagement as it relates to morale and turnover, but what let’s take a moment to define an engaged employee.
Employee engagement is the emotional commitment the employee has to the organization and its goals. This emotional commitment means engaged employees actually care about their work and their company. (Forbes, 2012)
The definition of an engaged employee has been confused in recent years. It’s up to administrators and managers to identify the characteristics of an engaged employee according to the organization’s mission and goals. Quite as important, leadership must effectively communicate these characteristics to all departments and units to ensure alignment.
Once you’ve defined the traits and behaviors of an engaged employee, you can develop a strategy to encourage those qualities. While rewards and incentives are important, strive to go beyond the norm and create a positive environment that is unique to your organization. There are a number of ways to build loyalty with frontline employees.
Frontline employees with high morale perform their best and have a desire to advance within the organization. When it comes to turnover, investing in talent yields much greater returns than dedicating valuable resources to a reactive approach.