Executive summary
In today’s competitive hiring environment, hospitals must do all they can to attract, retain, and develop their workforce. This white paper outlines measures for improving operational efficiency in a way that drives productivity as well as employee satisfaction. It also addresses how to build the kind of institutional climate that makes a hospital a desirable place to work.
Introduction
As the world’s patient populations grow and age, hospitals worldwide are competing to attract and retain enough qualified staff to meet the demand. Asking an insufficient number of employees to simply work longer and harder isn’t an option, as it leads to employee burnout and makes a hospital unattractive to potential new hires.
This white paper explores the strategies that thought leaders recommend to help hospitals instead utilize their employees more efficiently, reducing time spent on tedious administrative tasks in order to focus on patient care. It also examines the factors that contribute to employee satisfaction – including ongoing onsite training, a smarter hiring process, more capable management, and HR policies that support the increasingly female proportion of the healthcare workforce.
Healthcare facilities
around the world face a huge staffing dilemma.
As patient populations and their associated healthcare needs grow, developed and developing countries alike are struggling to source, attract, and retain adequate numbers of trained, qualified healthcare professionals, especially physicians and nurses. Additionally, hospitals and health systems need employees with a new balance of skills – such as advanced nurse practitioners, physician assistants, medical technology specialists, and IT experts for integrating and standardizing data from multiple sources.1
Generally speaking, hospital executives can approach this workforce problem from two different directions: by increasing labor efficiency, and by maximizing their efforts to attract and retain employees. And in fact, the two directions support one another, as a hospital that makes more efficient use of its employees’ time is more likely to attract and retain staff, and a hospital that is well and capably staffed tends to run more efficiently. This white paper examines some strategies for accomplishing both of these goals.
Increasing labor
efficiency
Achieving more with less: this goal of manufacturing also applies to hospitals struggling to optimally care for patients in the face of staffing shortages.
In the past, hospitals have often made the mistake of attempting to increase productivity by simply requiring their employees to do more in less time. The consequence of such an approach is high staff churn, increased absenteeism, and diminished overall employee satisfaction – not to mention poorer patient outcomes, decreased patient satisfaction, and higher readmission rates.2
The aim of effective hospital management must therefore be to use staff more efficiently instead of burdening them with overtime. By streamlining employee workflow, hospitals can reduce the amount of time spent on administrative tasks so that each staff member experiences less stress and has more time to focus on patient care. A decisive factor in achieving this is the optimization of all processes, improved management of individual competencies, and investment in appropriate technologies that are safe to operate and that reduce employee workload, rather than increasing it.
“Most digital information and processes in hospitals reside in disparate systems or devices that must be interconnected and integrated to truly improve workflow and quality care,” writes Brendan Ziolo, head of large enterprise strategy at Alcatel-Lucent, an IP networking and cloud technology company. “Often you can find staff doing double data entry or pulling information from different systems and jumping through hoops to pull together the knowledge required for the best patient care. There are many tasks throughout the hospital that staff spend time on every day just to get their jobs done. The goal in a digital hospital is to automate as many of these tasks as possible to improve staff efficiency, information accuracy, and overall cost savings.”
Ziolo adds, “By standardizing procedures and breaking down processes into their component parts, digitizing, connecting and analyzing them, hospitals can realize unprecedented efficiency. Once processes are well understood, technology solutions can be leveraged to streamline these processes and integrate disparate elements. Essential to this integration is the information and communications technology (ICT) infrastructure that interconnects all aspects of care delivery and hospital administration.”3
The systematic and consistent use of operating protocols for devices and IT, as well as targeted training, enables a more flexible use of staff, a key aspect of business management. Put simply, technology that is easy to use reduces training costs, promotes increased staff rotation, and reduces the pressure of hiring overspecialized experts to manage individual silos in the care delivery chain.
In addition, if individual employees fall ill, their work can more easily be delegated to other employees, thanks to the greater versatility of the staff. The flexible deployment of staff not only allows hospitals to function more efficiently; it also increases employee satisfaction, as team members’ tasks become more varied. “To accommodate the preferences of the multiple workforce generations, hospitals need to replace traditional human resources policies that were applied uniformly to all workers with policies and programs that include flexibility and choices,” reports a study by the American Hospital Association.4
In conclusion, increasing productivity is by no means incompatible with boosting employee satisfaction. Properly designed efficiency measures that are focused on freeing up working time and reducing hours contribute to employee satisfaction. According to research by Dutch psychologist Arnold B. Bakker, work engagement depends on job resources that include social support, feedback, and opportunities for autonomy, variety, and growth. Such resources are good for both the employee and the workplace, because when job resources are rich, work is accomplished faster and with better results.5
Attracting and
retaining excellent staff
Employee turnover in healthcare is 30 percent higher than in other industries. When it comes to nursing staff, involuntary terminations, excessive workload, and relationships with supervisors and colleagues are the most commonly cited causes of turnover. The most successful organizations have tackled this problem by doing a better job of selecting nursing employees in the first place – by defining important behavioral competencies, becoming better at interviewing candidates, and using proven behavioral assessments to examine behavioral competencies.6
Select International recommends these additional strategies for minimizing turnover among front-line and nursing staff: Clarify work expectations during recruiting and on boarding; encourage staff input on critical issues; support career development; optimize schedule flexibility; place and train managers who value, engage, and develop front-line staff; build teamwork; and do not tolerate lateral violence.7 These measures are equally relevant to other members of the hospital workforce.
Among doctors and other qualified medical personnel, there is also a great desire and need for continuous workplace training. Team training has been shown to reduce patient mortality by 15 percent and medical errors by 19 percent.8 Ongoing in-service trainings can not only improve outcomes, but can also promote increased job satisfaction. Staff must also be continuously trained in the operation and range of application of medical equipment. Besides preventing errors with potentially high costs, such training promotes personal development, a more needs-based use of equipment, and the greatest possible flexibility in deploying staff.
Implementing policies that promote wise hiring, efficient use of employees, effective management, ongoing staff training, and improved clinical outcomes can do more than simply help hospitals retain staff; they can help build a reputation that makes the hospitals attractive to prospective new employees. When a hospital’s reputation improves, its costs for attracting and retaining qualified personnel fall. In the United Kingdom, for instance, the reputation of an NHS trust as an employer is the first consideration for one in five nurses when they look for a new job.
Other important reputation factors include a healthy work-life balance, good career prospects, and salary. Three-quarters of the 1,600 U.K. nurses surveyed by the consulting firm TMP Worldwide said they would actively avoid working for a trust with poor employee engagement.
“The message for healthcare service providers and NHS trusts is a simple one. Reputational risk and effective communications – and in particular positive employee engagement – now need to be top of the agenda for any board that hopes to attract and retain the best staff,” said study author Nicola Bullen.9
A good working relationship with colleagues proves also a prerequisite for high employee satisfaction. In the healthcare sector, this especially includes communicative aspects. Even more so than in other industries, health workers rely on handovers and databases to keep each other up to date.10 Effective communication and appropriate information are an essential component of the job. Thus, modern, user-friendly IT solutions that help employees to efficiently share information across departments are all the more important for job satisfaction.
Job satisfaction is also based on making informed decisions based on one’s own knowledge and a solid information situation. This information comes from complex clinical applications, and therefore requires high-performance technologies for accurate diagnosis and effective treatment – both in routine clinical practice and for scientific work in research and teaching.
Meeting the needs of female employees
Female employees comprise a continually increasing proportion of the healthcare workforce, and this trend is expected to continue. In 2011, an average of 44 percent of doctors across countries belonging to the Organisation for Economic Co-operation and Development (OECD) were women. Since 2000, the proportion of female physicians has increased in all OECD countries for which data is available.11
This increasingly prominent demographic gives hospital managers a powerful incentive to specifically address the needs of the growing number of female doctors and nurses.
According to the U.S. survey “Working Mother 100 Best Companies,” these needs include flexible working hours, compressed work schedules, fully paid maternity leave, child care, company-owned lactation (breastfeeding) rooms, and the provision of mentoring programs and career counseling by the employer.12 These criteria set top rated U.S. companies apart from others from a female-friendly perspective.
Naturally, such criteria differ from country to country. For example, fully paid maternity leave is mandated by law in countries such as Spain or Germany, so in these countries, maternity leave does not act as a differentiator in employer branding.
HR policies that are attractive to female employees can play an important role in recruiting and retaining qualified hospital staff and can help a hospital’s reputation as a desirable place to work.
References
1. Deloitte. (2015). 2015 Global Health Care Outlook: Common Goals, Competing Priorities. https://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/gx-lshc-2015-health-care-outlook-global.pdf. Accessed November 23, 2016.
2. (2016). Inadequate Staffing Harms Quality and the Bottom Line. AMN Healthcare. http://www.amnhealthcare.com/latest-healthcare-news/inadequate-staffingharms-quality/. July 13, 2016. Accessed November 23, 2016.
3. Brendan Ziolo. The Digital Hospital: Streamlining Workflow to Improve Care. Healthcare Business & Technology. August 25, 2015. http://wwwhealthcarebusinesstech.com/digital-hospital-workflow/. Accessed November 23, 2016.
4. American Hospital Association. (2010). Workforce 2015: Strategy Trumps Shortage. http://www.aha.org/content/00-10/workforce2015report.pdf. Accessed November 23, 2016.
5. Arnold B. Bakker. (2011). Work Engagement, Job Satisfaction, and Productivity – They’re a Virtuous Cycle. Association for Psychological Science. https://www.psychologicalscience.org. Accessed November 23, 2016.
6. Bryan Warren. (2016). Healthcare Turnover is 30% Worse than Other Industries: The Role of Selection Strategies. Healthcare Hiring Perspectives Blog. July 25, 2016. http://www.selectinternational.com/healthcare-hiring-blog/healthcare-turnover-is-30-worse-than-other-industries-the-role-of-selection-strategies/. Accessed November 23, 2016,
7. Bryan Warren. (2015). Turnover: The Cost, the Causes, and a Sustainable Solution. Select International. http://www.selectinternational.com/turnover-the-cost-thecauses-and-a-sustainable-solution. Accessed November 23, 2016.
8. Amy McCaig. (2016). 19% Fewer Medical Errors After Team Training. Rice University. July 15, 2016. http://www.futurity.org/health-care-team-training-1204252/. Accessed November 23, 2016.
9. Nicola Bullen. (2014). Employee Engagement Must be a Priority for NHS Trusts. The Guardian. March 19, 2014. https://www.theguardian.com/healthcare-network/2014/mar/19/employee-engagement-priority-nhs. Accessed November 23, 2016.
10. Claudia Goldin. (2014). A Grand Gender Convergence: Its Last Chapter. American Economic Review. https://scholar.harvard.edu/files/goldin/files/goldin_aeapress_2014_1.pdf. November 23, 2016.
11. OECD. (2013). Health at a Glance 2013. https://www.oecd.org/els/health-systems/Health-at-a-Glance-2013.pdf. Accessed November 23, 2016.
12. Claudia Goldin. (2014). A Grand Gender Convergence: Its Last Chapter. American Economic Review. https://scholar.harvard.edu/files/goldin/files/goldin_aeapress_2014_1.pdf. Accessed November 23, 2016.
13. Working Mother. (2014). 2014 Working Mother 100 Best Companies. August 18, 2014. http://www.workingmother.com/best-companies/2014-working-mother-100-bestcompanies. Accessed November 23, 2016.
