Attractive to Patients and Staff Alike
more than 800 years, the Saint-Jean Clinic has provided care at the heart of
Brussels, where it was the first
private hospital. In our long history, we have prided ourselves in the
‘Saint-Jean Philosophy’ which characterises us; an all encompassing philosophy
which is probably impossible to define precisely, but most importantly puts the
human experience at its centre.
This approach requires constant effort and attention at all levels of our organisation, but is also a fascinating and rewarding process. In addition to the satisfaction of providing the highest standard of care to our patients, we recently had the pleasure of being awarded the ‘Magnet Hospital’ Award by the FPS – Public Health (SPF Santé Publique). This prize recognises the efforts made to improve the welfare of patients and staff members within the hospital, and rewards the organisations demonstrating an ability to attract and retain their staff. In this article, I propose to reflect on this ‘Saint-Jean philosophy’ which, translated into a number of HR initiatives and firm principles, has helped us to achieve the Magnet Hospital status and, by doing so, to serve our patients to the best of our abilities.
The Saint-Jean Clinic: Overview
Our clinic is a general private hospital spread over two locations at the centre of Brussels: the Méridien and the Botanique sites. With 503 beds, we have the capacity for 12,000 standard hospital stays, 9,000 hospital daycare stays, 10,000 surgical operations, 110,000 consultations, 1,100 births, and 21,000 emergency cases each year.
A full spectrum of care is covered by Saint-Jean, including critical care such as cardiac surgery, neurosurgery, oncology, specialised emergency care, intensive care, paediatrics and dialysis. In this perspective, we have a fully comprehensive infrastructure, and we also partner with other healthcare organisations in Brussels and the surrounding area when they need to transfer patients to some of our services that they do not have a structure for.
On a demographic level, we could be considered as a truly Belgian hospital: we treat French-speaking and Dutch-speaking patients from Brussels and beyond, as well as foreign residents and tourists, due to our central location in the capital. This position brings us a real mix of cultures and languages, which we consider to be our strength, whether in our relationship with our patients or with our staff members.
How to Foster Diversity in Human Resources
In a total of 1,300 employees working at the clinic, 760 are nursing staff, of which 570 are in full-time employment. Their minimum level of qualification is a BA, as we have set high criteria for our nurses. Our turnover is at 10.5%, which is well within the national average. In the ambient shortage of nursing staff, especially in Brussels, Saint-Jean is happy to be able to maintain the excellent level of its staff, and frequently receives unsolicited applications from both graduates and more experienced nurses. We have never had to resort to temporary staff, and our balance sheets are positive, which is quite rare for healthcare organisations.
Our staff members reflect the cultural diversity of our patients, and show the result of a clear and structured objective: in each team, we ensure that there is a balance of French-speaking, Dutch-speaking, and foreign employees. They have all obtained their degree in Belgium, and thus have a similar level of training and skills. Through the independent survey of our patients, we have also been happy to see that they consider the social climate in our clinic to be very good.
We want to provide the opportunity for our employees from both communities to work in their own language while being able to learn either Dutch or French. Each member of staff is entitled to 60 hours of ndividual language classes, half of which are considered work time. These 60 hours can then be followed by group conversation classes where staff members can learn medical jargon or practical vocabulary they will need to use in their work.
This focus on cultural diversity, the convivial atmosphere of the clinic and its many practical advantages such as easy access and flexible work times among others, make Saint-Jean an attractive workplace. Furthermore, our hospital prides itself on its constantly evolving approach to HR and on taking a number of measures to improve its staff welfare, which can all be found in the attributes of Magnet Hospitals.
The Federal Public Service – Public Health’s recent award to Saint-Jean in the form of its designation as a ‘Magnet Hospital’ was a wonderful recognition of our commitment to quality, safety and welfare in our hospital. The designation is part of a project of the Ministry of Health, and lists fifteen recommendations.
These recommendations include, for example, that the hospital must respect their staff’s choice of department and work schedule. It must provide security to its employees by offering them permanent employment contracts, as well as give a face to management. We work tirelessly to ensure that each employee works in his or her choice of unit or department. This also stems from a purely managerial point of view: a satisfied worker will deliver excellent results. Furthermore, our ‘Open Door’ policy, implying that there is no barrier in the hierarchy, makes it possible for any member of staff to talk to management on the day they request a meeting.
Other requirements for a Magnet Hospital consist in sharing our vision with staff at all levels, both as a mission statement (our ‘Saint-Jean philosophy’) and as an operational document, such as our ‘Patient Charter’.
In this document, we outline our care philosophy, which is made visible to all our patients: we strive to give them an individual, holistic, interactive and informed level of care. The patients know that we aim to respect their language, their religion, their dignity and their privacy, and know what they are entitled to expect from their stay in our clinic.
In addition, we focus a great deal of attention on our young interns and recruits, by designating a ‘mentor’, a more senior member of staff who will help them to settle in their new roles. This could be represented by the Magnet Hospital recommendation to encourage solidarity and autonomy in staff members. We try to put our employees at the helm of as many decisions and initiatives as possible, and support their continuing education financially and morally. I found that this approach was key to discover and foster some ‘hidden talents’ in our hospital’s teams. One of our employees, Mrs Vass, for instance, was a nurse at Saint-Jean before going on to obtain a degree in Hospital Financial Management and so was perfectly suited to become the Head of our Purchasing Department, where she can draw on her experience as a nurse to make the most informed and thoughtful purchasing decisions. Another one of our employees had studied architecture at the La Cambre school before graduating as a nurse, and we were extremely advantaged by her insights on the design of the new wing of patient rooms she helped us to create. She could ensure that all the practical elements of patient care were taken into account in the plans, which even the best architect could not have known, lacking the point of view of a nurse. This versatility in our staff is a privilege I am most proud of, and I encourage all the nurses to take on roles in other departments of the clinic, such as administration and logistics, as I feel that their experience is always a crucial addition to the running of Saint-Jean.
To summarise, we operate a ‘Hospital-centred management’, instead of the financial or medical management approaches usually seen in other hospitals. A hospital-centred management gives every member of staff the possibility of becoming involved, and thus engaged, in the management’s decisions. For us this is only logical, as nurses make up the majority of Saint-Jean’s personnel, far more than doctors or managers.
Safety Brings Quality
This focus on our nursing staff also applies to ensuring they can work in the safest environment possible. Once again, this is part of the fifteen requirements of the Magnet Hospital Award. These recommendations are in line with the new EU Directive on Healthcare Worker Safety and sharps injuries prevention, published in June 2010 and to be implemented as national law by all EU member countries by May 2013, and state that the hospital management must provide a safe environment to both patients and workers, by using the best, most advanced and safest equipment, but also by preventing risks. I am proud of the fact that we were among the first healthcare organisations in Belgium to introduce ‘mobile teams’ who could stand in for an absent nurse without it affecting another nurse’s schedule and work patterns, and to use safety-engineered medical devices, for example, long before they became the norm. Measures such as monitoring hand hygiene, reporting needlestick injuries or using safety-engineered blood collection devices, infusion devices, injection needles, for example, are all practical adaptations of the risk prevention recommended by the European and Belgian legislations.
However, we are adamant that safety must not be considered as a nurse’s concern only. Everyone at the hospital is exposed to risks, accidents and infections, and in order to address this issue, we have recently enrolled in the FPS’s ‘Patient Safety’ project and received funding to appoint a Safety Manager. Mrs Peeters, one of our nurses, received training from the FPS in order to take on the role. Her primary task is to assess the safety culture within the clinic - among doctors, nurses and nurse’s assistants, and to report any risk or near-accident she witnesses. As we encourage an atmosphere of communication and exchange in our departments, this assessment is by no means a way of pointing fingers at possible shortcomings, but a determining tool in preventing risks. The results of Mrs Peeters’s survey will be the basis for the new safety plan she will propose to implement at the level of the organisation, as opposed to the nurses’ level only, which I am very much looking forward to.
By insisting on safety and welfare at all levels of our organisation, we make our philosophy, the ‘Saint-Jean philosophy’ visible to our patients who can reap the benefits of our general positive approach to our employees. Indeed, through our internal benchmarking tools as well as the patients survey processed externally, we have observed that the staff reflect the quality of their working conditions and the consideration they enjoy in their team, in their care of our patients.
High standards are Saint-Jean’s objective in all respects, be they the regular refurbishment of our premises and rooms, the safety visible on every floor of the clinic, the interaction between patients and their carers, or the level of comfort patients can enjoy in their rooms. The effort and money we invest in this quality are, in our view, a long-term commitment to distinguishing ourselves in our patients’ opinion. Reputation and image are no longer a secondary concern for healthcare organisations, as I am convinced that only the hospitals with ‘added value’ will be able to survive the current saturation of beds.
In a way, quality in care has become our selling point. It would be just as naive as it would be vain to imagine that our hospital is providing better medical care than any other healthcare organisation in Belgium. All our doctors and nurses have had the same standard of training for giving injections or inserting catheters. In this context, there remains only the approach to care, the human experience at the heart of our commitment to patients. This philosophy is a work in constant progress, but would certainly be a fitting definition of the ‘Saint-