SMITH: It is hard for me to imagine someone not wanting to be a mentor, but some are substantially better at it than others. We do it one-on-one and then we rotate those every eight to 10 months. We require our mentors to meet with their mentees once a month for an hour and a half and we give them guidance as far as what direction to take the conversation.
ZAMAN: We put a lot of responsibility on the mentee. We can assign mentors and we can partner you up, but unless both the mentor and the mentee are really committed to this, it doesn't work. So the responsibility of the mentor is to make sure they make the time and that they hit certain plateaus of what we want to take place in the program. The mentee must take on responsibility for ensuring that they are reaching out to schedule their meetings and they are completing the tasks. We invest a lot in those early days of getting that mentee and mentor both to know the expectations.
HEALTHLEADERS: What are mentee expectations about promotion and when that should happen? You have to manage that, right?
BRADFORD: You have to be bluntly honest with them: We're training you and developing you because you're showing potential, but we don't have a clear, defined role open for you. But when we do have a position, we're not going to hire it from the outside if we have a viable candidate inside. We'll take a risk on someone internally that we wouldn't take on an external person. But we're transparent that it may be two years, five years, seven years before something develops.
DEBORD: The message is that there will be opportunities but they are not necessarily going to get the first opportunity. That's part of setting those expectations. When I recently filled a position on my executive team, we had some great internal candidates. I probably could have hired any one of them and I think each one of them would have done a good job, but I couldn't hire each of them. It doesn't mean that any of them are not worthy of this position. There will be other opportunities.
ZAMAN: When you're hired at Scripps, one of the first things we do at our new employee orientation is an assessment. It's a process by which we talk about who you are, what your goals are, and where you see yourself going in the organization. We encourage each of them to participate in our Center for Learning and Innovation in a talent development counseling session. It helps set realistic expectations.
HEALTHLEADERS: Given the additional parts of the care continuum that hospitals are taking on these days, are you cross-training these talented people who you're trying to develop?
BRADFORD: We're teaching folks on the inpatient side how to operate in an ambulatory fashion. The new economic model is a customer service model, and we're struggling with it without a doubt. But the biggest risk is that we get entrenched in a certain methodology of doing things—particularly around skills—when the skills that are needed are going to change based on reform, the economic model, and the economy. We're learning, but we haven't yet cracked that nut.
DEBORD: We're trying to set an expectation that we're going to be doing cross-training, but initially it's just between our hospitals. But we have ambulatory centers now as well. We are in the process of building two freestanding emergency departments and there's imaging, infusion, there's radiation oncology, fast health clinics, and we're looking for people who will float through different areas. We haven't gotten there yet, but when you're struggling to get something staffed, I can see why people have to mandate this kind of training.
SMITH: Role change is going to be a retention issue for this next generation. We believe they thrive on change, and that's the way you're going to retain them.
ZAMAN: We do a lot of talking amongst ourselves or our leaders about this. I see patients now on a medical-surgical unit that 10 years ago I saw in an ICU. What is going to be happening as we shift the whole dynamic of how healthcare reform is going to impact us resides in the outpatient arena.
HEALTHLEADERS: This kind of cross-training seems to offer a real opportunity to break down the silos in healthcare. Would you agree?
DEBORD: You won't survive healthcare reform unless you break down those silos. There's a lot that we don't know, but we know it's going to be different. We know it's going to be harder. We know there's going to be less money there. And so we have to be more efficient. We have to be more fluid. We have to be more flexible or we're not going to survive.