There's a crisis today in the healthcare industry; a crisis of spirit. No matter what conclusions are drawn about the pros and cons of healthcare reform, it is having a psychological effect, as shown in a recent study in which 57 percent of all nurse leader participants acknowledged healthcare reform had already had a substantial impact on morale (see graph below)[1]
As healthcare reform begins in earnest and the extent of its impact becomes clear, healthcare organizations will need to place renewed focus on the morale of those individuals who are working so hard with so much less. Since labor costs represent nearly 60 percent of a hospital's overall expenses, [2] workforce management plays a major role in achieving the dual goals of cost reduction and improved productivity. As a proven, cost-effective way to attract and retain motivated workers and increase morale, efforts to increase employee engagement will become a lifeline for hospitals, especially as economic conditions improve and competition for top talent increases.
Among other employee engagement strategies, scheduling tools that give employees freedom to choose when and where they work are proving to be instrumental in raising quality of life and job satisfaction — both of which are critical to patient care and satisfaction, and ultimately, to improving the bottom line.
Becoming a world class employer
The challenge: Many people in today’s workforce are "disengaged." In one study from Gallup [3], only 30 percent of surveyed employees were considered to be "engaged," with 50 percent "disengaged." That’s a lot of people putting forth minimal effort, doing just enough to keep their jobs. Surprisingly, 20 percent of the employees in the same study were actively disengaged. According to the research, actively disengaged workers are the excuse-makers of the organization. They tend to stir things up and blame others for problems. Like disengaged employees, this group is a drain on the bottom line.
Gallup found a complete reversal in "world-class" organizations, where 63 percent of employees were engaged, 29 percent were disengaged and only 8 percent were actively disengaged. Not surprisingly, this pattern of disengagement is mirrored within the healthcare industry. According to many studies, nurses are three to four times more likely to be dissatisfied with their jobs than the average U.S. worker (with nurses age 44+ four times more dissatisfied than the national average). Several studies report that most of the variability in job satisfaction is explained by working conditions (see box), with salary/benefits contributing little. [4]
Putting quality of life first
Quality of care, safety and patient satisfaction are obvious priorities to the healthcare industry. Despite these imperatives, in troubled times, many hospitals opt to reduce the size of their workforce to save costs. According to an April 2009 study by the American Hospital Association nine out of every ten hospitals in the survey reported they had cut back on expenses to address economic concerns, and nearly 50% reduced staff. [5]
Though hospitals experienced unusually low staffing problems during the recent economic downturn, the improving economy and job market will likely increase voluntary turnover rates as the best and brightest nurses leave for greener pastures. Fewer nurses will be competing for the same number of jobs, and hospitals that cannot attract and retain top talent will lose out.
No matter what else healthcare reform has in store, one thing is clear: Top-performing hospitals will reap rewards and low performers will suffer penalties. Becoming a top performer in light of an aging workforce, a looming shortage of nurses and stronger competition for both employees and patients will not be easy, nor will traditional strategies be as successful as in the past.
Becoming a "destination workplace" is one way hospitals can survive in this rocky environment. Tools that simultaneously improve quality of life, employee engagement and productivity are one proven strategy for becoming a more profitable — and hospitable — hospital.
Satisfied staff leads to satisfied patients
Under new healthcare reform initiatives, reimbursements will be determined, in part, by patient satisfaction scores, which are clearly related to employee satisfaction.
Work/Life schedule flexibility trumps salary
Workgroup cohesion and equitable assignments make the work environment more productive and collaborative. Hospitals can foster greater staff satisfaction by providing choice, flexibility, and transparency in scheduling. This leads to better quality of life for staff, managers and patients. According to PricewaterhouseCoopers, organizations that pay attention to work/life balance for physicians and nurses will also have a competitive edge in recruiting and retaining the best and the brightest. The same report states that work/life balance is the biggest influencer of how medical students pick a specialty, and that working conditions and schedules are the greatest influences on
overall job satisfaction among nurses, with salary only third place. [8]
It's clear that physicians and nurses want to drive the terms of their employment, and hospitals that provide scheduling options and integration of flexible work arrangements into their staffing models will thrive. Many hospitals in this brave new world of healthcare are stepping up to the challenge and are experimenting with new ways of engaging their workforce by implementing practices that heighten job autonomy and ownership. One workforce management practice that improves quality of life (and the bottom line) is open shift management, which can be used as a standalone tool or integrated with scheduling solutions.
Best practice: Open shift management
Main Line Health, a five-facility healthcare system in suburban Philadelphia, is one of many healthcare institutions that have implemented an open shift workforce management solution to improve employee engagement and quality of life.
Using an online "Software as a Service" solution, nurses can view a complete listing of available shifts that match their qualifications and synch them up with their own availability dates and the preferences of their families. If they want to pick up extra shifts in other Main Line facilities in nearby communities, that's possible too, with manager pre-approval. Staff members are categorized by competencies to ensure the most qualified clinician with the most appropriate expertise is assigned to a given shift. By heightening awareness of staffing needs, nurses are given the opportunity to work on new units where they are qualified, which helps them gain valuable experience and encourages them to expand their education and accreditation to further their careers. Providing career development support and opportunities to advance their skill sets through unit cross-training increases quality of life, boosts retention, and maximizes human resource management for the hospital. Open shift management has vastly changed the nursing landscape at Mainline Health from a mindnumbing exercise of phone calls and manual scheduling to a process that encourages a closer partnership with nurses and gives them freedom to manage their own time and the flexibility to schedule work around family and personal life. When management can more intelligently and more appropriately schedule a nurse or technician to be in the right place at the right time, they’re setting themselves up for greater success and ensuring that all standards of care are appropriately maintained.
These new processes have produced financial benefits as well. Conservative estimates indicate that each of Main Line's 85 nursing and medical staff managers individually save an average of five to six hours a week on scheduling minutia, which roughly translates into an annual savings of more than 22,900 hours of nurse manager time or approximately $1.97 million per year in reduced management labor and outbound scheduling calls that don’t have to be made.
Strategic benefits of open shift management
Concerro offers healthcare management systems and services that improve both quality of life and your bottom line. With online scheduling, open shift management, and emergency preparedness solutions, you can effectively manage and communicate with your staff. Join more than 500 hospitals that rely on Concerro’s award-winning solutions and services. Learn more at www.concerro.com.
Footnotes:
________________________
1 Results from HealthLeaders Media Industry Survey 2011, Nurse Leaders.
2 American Hospital Association, Cost of Caring, 2010 report.
3 Gallup Consulting, “Employee Engagement: What’s Your Engagement Ratio,” 2010.
4 Robert wood Johnson Foundation. “Multiple Factors Affect Job Satisfaction of Hospital RNs.” Feb 2007.
5 American Hospital Association, “The Economic Crisis: The Toll on the Patients and Communities Hospitals
Serve,” 2009.
6 John Commins, “When Average Isn’t Good Enough,” HealthLeaders, April 2011.
7 Purdue University at www.incentivecentral.org/pdf/employee_engagement_study.pdf
8 PricewaterhouseCoopers Health Research Institute report, “What works: Healing the healthcare staffing
shortage,” 2007.
As healthcare reform begins in earnest and the extent of its impact becomes clear, healthcare organizations will need to place renewed focus on the morale of those individuals who are working so hard with so much less. Since labor costs represent nearly 60 percent of a hospital's overall expenses, [2] workforce management plays a major role in achieving the dual goals of cost reduction and improved productivity. As a proven, cost-effective way to attract and retain motivated workers and increase morale, efforts to increase employee engagement will become a lifeline for hospitals, especially as economic conditions improve and competition for top talent increases.
Among other employee engagement strategies, scheduling tools that give employees freedom to choose when and where they work are proving to be instrumental in raising quality of life and job satisfaction — both of which are critical to patient care and satisfaction, and ultimately, to improving the bottom line.
Becoming a world class employer
The challenge: Many people in today’s workforce are "disengaged." In one study from Gallup [3], only 30 percent of surveyed employees were considered to be "engaged," with 50 percent "disengaged." That’s a lot of people putting forth minimal effort, doing just enough to keep their jobs. Surprisingly, 20 percent of the employees in the same study were actively disengaged. According to the research, actively disengaged workers are the excuse-makers of the organization. They tend to stir things up and blame others for problems. Like disengaged employees, this group is a drain on the bottom line.
Gallup found a complete reversal in "world-class" organizations, where 63 percent of employees were engaged, 29 percent were disengaged and only 8 percent were actively disengaged. Not surprisingly, this pattern of disengagement is mirrored within the healthcare industry. According to many studies, nurses are three to four times more likely to be dissatisfied with their jobs than the average U.S. worker (with nurses age 44+ four times more dissatisfied than the national average). Several studies report that most of the variability in job satisfaction is explained by working conditions (see box), with salary/benefits contributing little. [4]
Putting quality of life first
Quality of care, safety and patient satisfaction are obvious priorities to the healthcare industry. Despite these imperatives, in troubled times, many hospitals opt to reduce the size of their workforce to save costs. According to an April 2009 study by the American Hospital Association nine out of every ten hospitals in the survey reported they had cut back on expenses to address economic concerns, and nearly 50% reduced staff. [5]
Though hospitals experienced unusually low staffing problems during the recent economic downturn, the improving economy and job market will likely increase voluntary turnover rates as the best and brightest nurses leave for greener pastures. Fewer nurses will be competing for the same number of jobs, and hospitals that cannot attract and retain top talent will lose out.
No matter what else healthcare reform has in store, one thing is clear: Top-performing hospitals will reap rewards and low performers will suffer penalties. Becoming a top performer in light of an aging workforce, a looming shortage of nurses and stronger competition for both employees and patients will not be easy, nor will traditional strategies be as successful as in the past.
Becoming a "destination workplace" is one way hospitals can survive in this rocky environment. Tools that simultaneously improve quality of life, employee engagement and productivity are one proven strategy for becoming a more profitable — and hospitable — hospital.
Satisfied staff leads to satisfied patients
Under new healthcare reform initiatives, reimbursements will be determined, in part, by patient satisfaction scores, which are clearly related to employee satisfaction.
- Gallup reports a strong link between employee engagement and patient satisfaction: "As organizations improve their engagement levels, there is a positive linear relationship with growth in patient satisfaction and loyalty." [6]
- Purdue University researchers found a direct link between worker satisfaction and customer satisfaction and between customer satisfaction and financial performance. [7]
- A March 2011 study by Elizabeth H. Bradley, MD, published in The Annals of Internal Medicine, concurs. Bradley and other researchers visited 11 hospitals, half ranked in the top 5 percent and half in the bottom 5 percent based on mortality rates for heart attacks. After conducting more than 150 comprehensive interviews from all areas and job categories of each hospital, they discovered the culture of the hospital had more impact on mortality rates, including communication and support of staff, than more traditional factors such as patients' income levels, affiliation with a university, number of beds or location.
Work/Life schedule flexibility trumps salary
Workgroup cohesion and equitable assignments make the work environment more productive and collaborative. Hospitals can foster greater staff satisfaction by providing choice, flexibility, and transparency in scheduling. This leads to better quality of life for staff, managers and patients. According to PricewaterhouseCoopers, organizations that pay attention to work/life balance for physicians and nurses will also have a competitive edge in recruiting and retaining the best and the brightest. The same report states that work/life balance is the biggest influencer of how medical students pick a specialty, and that working conditions and schedules are the greatest influences on
overall job satisfaction among nurses, with salary only third place. [8]
It's clear that physicians and nurses want to drive the terms of their employment, and hospitals that provide scheduling options and integration of flexible work arrangements into their staffing models will thrive. Many hospitals in this brave new world of healthcare are stepping up to the challenge and are experimenting with new ways of engaging their workforce by implementing practices that heighten job autonomy and ownership. One workforce management practice that improves quality of life (and the bottom line) is open shift management, which can be used as a standalone tool or integrated with scheduling solutions.
Best practice: Open shift management
Main Line Health, a five-facility healthcare system in suburban Philadelphia, is one of many healthcare institutions that have implemented an open shift workforce management solution to improve employee engagement and quality of life.
Using an online "Software as a Service" solution, nurses can view a complete listing of available shifts that match their qualifications and synch them up with their own availability dates and the preferences of their families. If they want to pick up extra shifts in other Main Line facilities in nearby communities, that's possible too, with manager pre-approval. Staff members are categorized by competencies to ensure the most qualified clinician with the most appropriate expertise is assigned to a given shift. By heightening awareness of staffing needs, nurses are given the opportunity to work on new units where they are qualified, which helps them gain valuable experience and encourages them to expand their education and accreditation to further their careers. Providing career development support and opportunities to advance their skill sets through unit cross-training increases quality of life, boosts retention, and maximizes human resource management for the hospital. Open shift management has vastly changed the nursing landscape at Mainline Health from a mindnumbing exercise of phone calls and manual scheduling to a process that encourages a closer partnership with nurses and gives them freedom to manage their own time and the flexibility to schedule work around family and personal life. When management can more intelligently and more appropriately schedule a nurse or technician to be in the right place at the right time, they’re setting themselves up for greater success and ensuring that all standards of care are appropriately maintained.
These new processes have produced financial benefits as well. Conservative estimates indicate that each of Main Line's 85 nursing and medical staff managers individually save an average of five to six hours a week on scheduling minutia, which roughly translates into an annual savings of more than 22,900 hours of nurse manager time or approximately $1.97 million per year in reduced management labor and outbound scheduling calls that don’t have to be made.
Strategic benefits of open shift management
- Employees can view schedules, request desired shifts and monitor their hours from any Web browser at home, at work or on the go.
- Incentives and bonus pay are more cost-efficiently managed and focused on those areaswhere the greatest needs exist.
- The professional resource pool can be cross-trained and shared among multi-facility locations to meet the requirements of a variable patient census.
- Shift managers are easily able to balance and redeploy employees in nursing, respiratory, radiology, laboratory and therapies through a convenient, easy-to-use Internet-based dashboard.
- Required skills for specialized shifts are more readily available to improve and maintain safety and QI standards while reducing premium labor costs.
- Many of the outbound telephone calls for shift scheduling of employees, contractors and agencies are no longer necessary, since a majority of the open shifts are filled automatically.
- Managers save five to six hours per week on staffing and scheduling tasks, and this produces a potential savings of millions of dollars per year for a typical hospital in reduced management labor and lower outbound telephone costs.
- Premium labor expenses from overtime, contractors and outside staffing agencies can be cut significantly to save millions of dollars per year for the average hospital.
- With online open shift selection, a hospital can evolve into more of a world class "employer of choice" for nurses and clinicians, due in part to the flextime, work life freedom and greater variety of interesting assignments.
Concerro offers healthcare management systems and services that improve both quality of life and your bottom line. With online scheduling, open shift management, and emergency preparedness solutions, you can effectively manage and communicate with your staff. Join more than 500 hospitals that rely on Concerro’s award-winning solutions and services. Learn more at www.concerro.com.
Footnotes:
________________________
1 Results from HealthLeaders Media Industry Survey 2011, Nurse Leaders.
2 American Hospital Association, Cost of Caring, 2010 report.
3 Gallup Consulting, “Employee Engagement: What’s Your Engagement Ratio,” 2010.
4 Robert wood Johnson Foundation. “Multiple Factors Affect Job Satisfaction of Hospital RNs.” Feb 2007.
5 American Hospital Association, “The Economic Crisis: The Toll on the Patients and Communities Hospitals
Serve,” 2009.
6 John Commins, “When Average Isn’t Good Enough,” HealthLeaders, April 2011.
7 Purdue University at www.incentivecentral.org/pdf/employee_engagement_study.pdf
8 PricewaterhouseCoopers Health Research Institute report, “What works: Healing the healthcare staffing
shortage,” 2007.