Recent evidence from several sources seems to suggest that happy nurses — or happy healthcare staff at any level — play a significant part in creating a safe and high-quality care environment. While it's impossible to have perfect environmental harmony all of the time, achieving majority staff happiness and job satisfaction is well within the reach of any hospital willing to put in the effort. Many hospitals and health systems are giving themselves head starts by overhauling their hiring processes to select employees who are better cultural fits for their institutions.
According to Michael DiPietro, Chief Marketing Officer at HealthcareSource, a software company for hospital talent management solutions, ensuring job candidates are good cultural and behavioral fits is very important for maintaining and improving patient satisfaction.
It's an intuitive connection, he says. When hospitals employ people who show behavioral traits associated with good communication skills, overall morale from resulting positive relationships improves the workplace. "There's a place for both technical fit and cultural fit in job candidates," he says. "But when technical fit is not an issue, it's good to be able to assess comparable cultural fit to maximize patient satisfaction and patient safety."
Why selective hiring is key
At rural Tomah (Wis.) Memorial Hospital, the human resources department is fully aware of the importance of hiring. Brenda Reinert, Tomah Memorial's HR director, notes that better candidates deliver better care, which creates other quality efficiencies within the care system, particularly vital to smaller hospitals in which employees take on a wider variety of tasks. "Customer service is very important to us," she says. "We want the outgoing, warm, caring person who wants to work in healthcare."
They implemented technology to see if they could make Tomah Memorial's hiring process better and more efficient. "We started out not having a lot of tools at our fingertips. Using the technology we have now, we can more easily identify weaknesses and strengths in an individual, which is helpful for our managers, who have gotten very in tune with the type of people they want on their teams," says Ms. Reinert.
An added advantage of automating parts of the hiring process, says Ms. Reinert, is that she and her co-worker, HR generalist Britnie Rewey, have more time to spend addressing employee needs. "When employees see that human resources cares about them, it increases their satisfaction with the organization, and happy employees are happy with patients," she says.
As for the employees themselves? Updating the way that Tomah hires makes the hospital as a whole run more smoothly. "I always say hire people that make you look good, people you don't have to manage or babysit; that way, you'll be able to entrust them with added responsibilities and special projects. They'll be in it with you," says Ms. Reinert. Ms. Rewey agrees. "If you pick the first person that walks in the door, that's no good, but you also can't wait forever. You have to have a happy medium: Take your time, but work efficiently to find that right person."
Preserving post-hire momentum
According to Mr. DiPietro, the first thing to do post-hire is to identify employee behaviors critical to patient satisfaction, and then set performance goals based on these behaviors to incorporate into evaluations. Mr. DiPietro says that behavior should be a constant focus in performance evaluations. "You can use feedback to reward and reinforce desired behaviors. You can't just put personality traits in the job description and expect performance to last. You must give feedback to reinforce and reward desired behaviors," he says.
Michelle Gross, manager of staff training and development at the physician group University of Minnesota Physicians in Minneapolis has built a career advancement program for patient representatives based on this very principle. Ms. Gross knows that patients encounter obstacles to care even before they enter the clinic. "They have to battle Big Ten campus issues like traffic, parking and navigation," she says. "For people to want to come see us, we have to do something to make the experience special."
Ms. Gross says that because patients' primary relationships in a healthcare setting are with staff, University of Minnesota Physicians prioritizes keeping its new hires alert and engaged through career development.
Frustrated by patient satisfaction scores under where UMP wanted them to be, the system put together a focus group of patients, staff, supervisors and physicians. The group came up with an important revelation: Front desk staff were reaching the top of their pay scale, and then had nowhere to grow. "It was a huge disincentive to performance," says Ms. Gross, "so we created a career track that allows patient representatives to apply for senior patient representative status." Almost immediately the percentage of patients that would refer family and friends to the clinic began to climb.
Being a senior patient representative is no token promotion. The jump in pay grade requires a concomitant jump in effort. Successful candidates for the position have role-model conduct and are fully proficient in both everyday and unusual circumstances. In addition, candidates must complete courses in medical terminology, precepting, organizational structure and customer service. And they must receive a performance appraisal rating from a manager of at least four out of five. But patient representatives seem to be enjoying the opportunity for career growth, if improved patient satisfaction scores and reduced turnover are any indication.
This change has inspired some other structural changes at UMP, including humanizing the front desk area by putting call centers behind the scenes and establishing regular staff firestarter training and a robust manager training program for high-performing senior patient representatives.
Ms. Gross highly recommends investing in career development for staff. "We give them all the tools they need to be successful," she says, "because when they're satisfied they're better able to meet patient expectations and improve the patient experience."
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