Holidays Welcomed Amid Economic Gloom

John Commins, for HealthLeaders Media, December 15, 2008

This has been a rough year for Boca Raton Community Hospital, but they've still found a way to celebrate the holidays.

The 394-bed, acute-care hospital reported losses of $110 million in fiscal 2007/08, with anticipated losses of $30 million for the current fiscal year. Some of the losses were owing to the bad economy; some were owing to bad business decisions that have forced the hospital to go through three CEOs in less than one year.

Last week, in the shadow of the holiday season, and after months of rumors and very public speculation in the media, 39 employees mostly in administrative and support areas were laid off, 20 vacant positions were eliminated, and 40 employees had their hours trimmed back to avoid more layoffs.

Brian Altschuler, executive director of Human Resource Operations at BRCH, says that though layoffs had been expected, the 1,900 employees who remain are still grappling with the loss of their friends and colleagues. "People tend to forget you have two different groups of grieving people, the severanced employees and the employees who remain," Altschuler says.

In this environment, senior leadership at the 41-year-old hospital tried to find an acceptable way to celebrate Christmas; a toned-down celebration that would reassure and express appreciation for the remaining employees without spending lavishly. "Just like in any other mourning, or any other loss, a lot of times you will see families continue a tradition because that is what the person would have wanted," he says.

After speaking with employees, the decision was made to cancel the hospital's traditional Christmas party, a hospitalwide annual gala for full- and part-time employees and their families that had been budgeted at around $100,000. "We surveyed our employees. We didn't just make that decision," Altschuler says. "We did focus groups because we felt like, while we may think we know as leaders what our employees want, we wanted to make sure we clearly understood through communication what they wanted."

Altschuler says the employees made it very clear that they did not want an annual Christmas party at the expense of more layoffs. "It was really heartfelt to me," he says. "There is a lot of longevity here and a lot of affiliation to the organization. People were looking at that as doing their part to save more jobs."

Working with the BRCH Employee Activities Committee, the hospital decided to go ahead with other holiday celebrations that have long been a tradition there. There was a festive decorating of the lobby to kick off the holidays. The Debbie-Rand Memorial Service League volunteers hosted their annual cookies-and-punch party. Employees held their annual door-decorating contest.

"We do the pieces that culturally send the message to our employees that this is still a great place to work and this is still the hospital you know, but we are going to respect that we need to do the things we need to do to be a smarter business as well," Altschuler says.

BRCH's physicians donated $50,000 to provide grocery gift cards to employees, saving another hospital tradition that would have otherwise been axed. "That doesn't sound like a lot, but our employees in environmental services, food and nutritional and other core functions of the organization really rely on that gift card," Altschuler says.

"Our physicians stepped up to the plate out of their own good will and are picking that piece up. Talk about a hospital culture! We aren't just saying we are a good hospital. We're trying to show everybody it's about all of us coming together and contributing to put us on a healing path."

Altschuler says communicating with employees about the status of the hospital and their job security has been a critical component for building trust. In the midst of the holiday celebrations last week, CEO Jerry Fedele held employee forums in the hospital auditorium to explain the hospital's financial state and its future plans. He took questions from employees in the hope of assuaging their anxieties.

Altschuler says BRCH plans no more job cuts and has made that clear to employees. "We have taken a strong stance that we don't want to be an organization that every six months has layoffs. Talk about morale! How can you as an executive in healthcare allow that to be a threat to your culture," he says. "You have to do things effectively and right so that employees know that, while you had to make a difficult last resort decision, that you've done it right and you've done it with the intention that no there will be no more layoffs."

Altschuler, who's been at BRCH for two years, says the layoffs and the employees' responses have provided lessons in resiliency and organizational pride. "In healthcare it starts with us caring about each other as an organization so we can deliver that excellent care that we pride ourselves on," he says. "I'm not surprised. This is a unique organization."

John Commins is the human resources and community and rural hospitals editor with HealthLeaders Media. He can be reached at
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