Ask any CEO, in healthcare or elsewhere, about the secret to success, and not a few will fall back on the tired platitude that “our people are our greatest asset.”
That phrase sets Tom Davenport’s teeth on edge. “That is utterly wrong. People are not assets. People own a very important asset called human capital,” says Davenport, the author of Human Capital: What It Is and Why People Invest It, and the coauthor of Manager Redefined: the Competitive Advantage in the Middle of Your Organization. “The ‘asset’ is an intangible that resides in the heads of employees, not in the bank account or the building of the company,” he says.
This is not just semantics for Davenport, who is a senior consultant at Towers Watson. To him the people-are-assets mindset is indicative of an antiquated management style that views people like office furniture – something to be arranged, inventoried, and occasionally sat on.
“You don’t manage people. You manage assets,” Davenport says.
If you understand that your employees own their own assets, however, you can create the work environment and incentives to get those employees to invest their human capital in your hospital.
Davenport spoke with HealthLeaders Media this month at the 47th Annual Convention & Exposition of the American Society for Healthcare Human Resources Administration (ASHHRA), in Phoenix, AZ, where he led a discussion on transforming the healthcare workforce.
“The question HR folks should be asking is ‘How can I get people to invest more of their human capital in their job here in this organization?” he says.
If employees like their job, if they like their bosses, if they are engaged in their work, if they are properly compensated, if their concerns are addressed, if they are treated respectfully, if there are opportunities for development, then they will invest more of their time, talents, and commitment – their capital – in your hospital. If not, they’ll leave, or dial back their efforts.
“An effective 21st-century manager manages the environment for success more than the people,” Davenport says. “At the end of your project or your year or your career, you’re saying ‘I did a really good job. I am responsible for my success.’ And [the manager is] offstage saying ‘You bet you are because I created the environment that allowed you to be successful.’”
To create that productive work environment, Davenport says supervisors must give their workers the resources they need, understanding that different workers have different needs and expectations. Those supervisors also must be immediately available to address workers’ concerns.
“A good supervisor has to have some empathy, and the resources to do something about it. I have to connect you with other parts of the organization to help you do your job,” Davenport says.
For that to happen, senior management must allow immediate supervisors sufficient time and support to create the effective work environment. That means acknowledging that the supervisor’s productivity might suffer as he or she concentrates on improving the environment for the people they lead.
In other words, don’t pile it on!
“There is this emotional element of empathy and a rational element of navigation that have to come together. You can’t do that effectively if the first thing a supervisor has to do Monday morning is three days of code writing,” Davenport says.
“So, the investment is less production from managers. The ROI for the hospital is lower manager and employee turnover, higher productivity, and higher engagement.”
For too long organizations have relied on player-coach models, Davenport says. “They think, ‘I can combine that production and leadership.’ But even for the people who are talented enough to do it, you have constructed a job where they can’t do both well.”
Fortunately, organizational attitudes are evolving. Executives across the business spectrum are starting to understand the importance of those immediate supervisors in sustained workforce retention, development, and productivity.
“We are just coming out the era of executive leader worship – that ‘if we just had Jack Welch or Steve Jobs at the top of the organization, then we will have an engaging vision, a direction, and people will come to work ready to work toward that,’” Davenport says.
Executive leader worship leads HR to prioritize things such as succession planning. “They’re thinking ‘I can find the next Jack Welch, or I can deal with the 500 middle managers that are not performing very well. Which seems easier? Well, the managers seem intractable. I’ll deal with succession planning,’” Davenport says.
The problem with this mindset is that most employees are far more impacted by day-to-day contact with their immediate supervisors than by the occasional company-wide email or mass-distributed Christmas card from the CEO.
Employees today are better educated, more sophisticated, and more demanding of their work experience. “They won’t tolerate micromanagers or leadership abuse or favoritism or all the stuff our parents’ generation had to put up with in the corporate world,” Davenport says. “Organizations will have to respond.”
A five-year collaborative to eradicate central line-associated bloodstream infections in pediatric intensive care units across the nation has saved 355 lives, prevented nearly 3,000 infections, and generated more than $100 million in savings, the National Association of Children's Hospitals and Related Institutions' Quality Transformation Network has announced.
Now the challenge is sustaining that success, says QTN member Matthew Niedner, MD.
"Our inspirational goal is to get to a rate of zero, but the devil is in the details. Zero for how long: a quarter; a year; a decade?" said Niedner, director of patient safety and quality improvement at the C.S. Mott Children's Hospital Pediatric ICU at the University of Michigan, in Ann Arbor.
"The pragmatist in me recognizes that there will always be central-line infections because there will always be lapses in ideal healthcare delivery. The goal is to minimize that to the greatest extent possible," he said.
Ironically, success creates its own problems for pediatric ICUs that improve CLABSI infection rates. "The nature of trying to understand and remediate relatively uncommon occurrences in any one hospital, these are things that happened before the collaborative about once a month and now we have them down to just a few each year," Niedner explained. "And the more success you have the harder it is to learn from the event because by your improvement you are making them rarer and harder to learn from."
The QTN estimates that CLABSIs cost between $25,000 and $45,000 per event and increase the risk of mortality for children by 10% to 20%. The 88 pediatric ICUs that participated in the five-year collaborative focused on using rigorous, standardized, evidence-based guidelines for catheter injection coupled with daily maintenance for the central lines.
"One critical advance was the increasing statistical rigor that we have tried to bring to these enterprises," Niedner says. "Window dressings are no longer enough to say 'we made things better.' You want outcome and process measures that are collected in a way that you can attack the signals amidst the noise."
The QTN accelerated the learning curve at Mott, which -- like many hospitals -- had been working on infection controls on its own before it joined the collaborative. "We demonstrated a statistically significant reduction in central line infection within the institution just looking at our own data, but it took us two-and-a-half years of intervention and collecting data to detect that signal at our site," he said.
"We knew that we were doing the right thing within four months of joining the collaborative because of we were able to pool our data. The statistical power that a collaborative has that can determine whether or not you are barking up the right tree is much greater than when you are trying to do it alone."
In addition, Niedner explained, Mott's participation provided an outside perspective that they otherwise would not have had. "There is that old saying that fish don't see the water they are swimming in. You have that institutional blindness to your own set of processes that you just take for granted or you assume this is how it is or how it has to be," he said. "We had the opportunity to look at top performers and try to understand what is different in their system or approach. We can always build a better system ourselves, but it is much more pragmatic and efficient to look at other example systems."
Returning to the sustainability question, Niedner says it's understandable that when a particular threat like CLABSI is significantly reduced other concerns that will lay claim to hospitals' stretched resources.
"There does create a trade-off where you have to potentially invest increasing levels of resources into countermeasures to stop ever-diminishing threats," he said. "Those same resources might be allocated a little more deliberately across the unit -- perhaps as other nosocomial infections or other patient safety issues related to medication or blood product transfusion becomes the new, largest threat and it would be prudent to shift some attention there. That's not because you have gotten to zero in CLABSI, but in deploying your resources you want to do that in the most intelligent want to maximize safety and quality in the care environment."
Medical practices cut operating expenses 2.2% in 2010, a survey from the Medical Group Management Association shows.
The report -- Cost Survey for Multispecialty Practices: 2011 Report Based on 2010 Data -- also found that since 2001 general operating costs have increased nearly 53% to $252,629, exceeding revenue gains in the decade.
Total medical revenue in multispecialty practices not owned by hospitals or integrated delivery systems grew nearly 46% since 2001 and 8.5% since 2009, likely as a result of monitoring expenses closer than ever.
Spending on furniture and equipment fell more than 23% since 2010, and drug supply costs fell 8.5%. Medical practices reported rising expenditures for total support staff increased 4.8%, and medical/surgical supplies increased 7.4% for the period.
"The tenor of these findings speaks to an environment of conservatism," William F. Jessee, MD, MGMA president/CEO, said in a media release.
"In an effort to reinforce themselves against a draconian proposed cut to Medicare payments, as well as other factors, they have worked to reduce operating expenses, and renegotiate rates with vendors, supply companies and insurance carriers," Jessee said. "This means medical practices are not spending as much money as they were last year, which isn't necessarily a good thing. There is only so much more practices can do to cut expenditures without inhibiting their ability to run a successful, innovative practice."
MGMA's Cost Survey includes data from more than 44,000 providers and 1,994 physician groups.
The federal government will grant $109 million to 28 States and the District of Columbia to help them "fight unreasonable premium increases and protect consumers."
The Department of Health and Human Services released a report Tuesday entitled Rate Review Works that HHS Secretary Kathleen Sebelius said details how previous rate review grants are fighting premium hikes and helping make the health insurance marketplace more transparent.
"We're committed to fighting unreasonable premium increases and we know rate review works," Sebelius said in prepared remarks. "States continue to have the primary responsibility for reviewing insurance rates and these grants give them more resources to hold insurance companies accountable."
As of Sept. 1, the Affordable Care Act requires health insurers seeking rate hikes of 10% or more in the individual and small group market to submit their request to experts to determine whether the rates are unreasonable.
ACA also requires insurance companies to publicly justify unreasonable premium rate increases. The Obama administration has said the provisions will bring greater transparency, accountability, and, in many cases, lower costs for families and small business owners who struggle to afford coverage.
The review program has been fiercely resisted by America's Health Insurance Plans, the lobbying arm of the health insurance industry. AHIP spokesman Robert Zirckelbach repeated earlier complaints that the federal government was holding health insurers accountable for costs that were beyond their control.
"The current focus on rate review ignores the soaring cost of medical care that is driving up the cost of coverage and taking up a greater and greater share of federal and state budgets," Zirckelbach said Tuesday in an email to media. "Now is the time to focus on the underlying cost of healthcare in order to make coverage more affordable for families and employers and finally put our safety net programs on sustainable and fiscally-responsible paths.
ACA provides states with $250 million in Health Insurance Rate Review Grants, $48 million of which has already been given to 42 States, the District of Columbia and five territories.
Sebelius said the grants and the review efforts they have generated are already having an impact on premium hike proposals. In July, Oregon forced an insurer to lower its request for a rate hike by nearly 10% that would have impacted about 60,000 consumers. Arkansas regulators recently negotiated a lower rate affecting approximately 90,000 policyholders.
In 2010, North Carolina regulators saved beneficiaries $4.5 million by reducing a rate increase request from the state's largest insurance company. The grants have also been used in nine states to help pass legislation to strengthen review and processes.
Sebelius said states are using the latest round of grants to improve filing requirements, transparency, and consumer interface, hire new staff, improve IT, expand the scope of review, and introduce legislation to strengthen oversight.
Another provision of ACA requires health insurers to spend at least 80% of premium dollars on healthcare and quality-improvement activities as opposed to overhead, advertising, and executive bonuses. If they don't they must reduce premiums or pay rebates to consumers and employers.
ACA also makes small businesses eligible for federal tax credits of up to 35% of the cost of coverage for their workers. That amount rises to 50% in 2014. Also in 2014, insurance exchanges created by ACA supposedly will use competition and transparency, including information on unjustified premium increases, to help make insurance more affordable, HHS said.
If one word encapsulates the focus of last week's American Society for Healthcare Human Resources Administration annual convention, that word is "engagement."
Employee engagement; physician engagement; patient engagement; leadership engagement: The four-day ASHHRA convention in Phoenix, AZ saw more talk of engagement than the Viva Las Vegas Chapel on Valentine's Day.
"Engagement is critical because it helps you utilize your best resource," says Ann M. Torkelson, Human Resources Director at Mayo Clinic, and an ASHHRA seminar leader. "An engaged workforce is going to produce. You are going to have better patient satisfaction, better outcomes, even with less," she says.
For years, progressive healthcare organizations, like Mayo, have prided themselves on employee engagement and mission "buy-in" as the right thing to do.
Practically speaking, however, the bottom-line case for engagement clearly has been bolstered by two big-dollar issues: First, engaged employees are less likely to quit, and that greatly reduces budget-busting turnover costs associated with recruiting and training new workers.
Secondly, there is an understanding that patient satisfaction scores under the healthcare reform law will soon be linked to reimbursements. Engaged employees care about patient satisfaction, and that empathy will be reflected in higher reimbursements.
"All those soft pieces of your customers' experiences come from that engagement. If your staff is willing to go above and beyond, whether it is an internal customer, a patient, a physician, whoever, you are going to get a lot more value," Torkelson says.
ASHHRA 2011 President Bob Walters says healthcare HR executives understand their critical role as financially challenged healthcare organizations grapple with issues such as engagement, recruiting and retention, and the linkage to bottom line issues like patient satisfaction.
"With disengaged leaders, you are going to have disengaged workers. So we have really focused on engagement," Walters says. "We have tried to look at productivity measures on engagement, and even with things like workers' comp, if you have engaged employees you aren't going to have bad workers comp experiences."
Tom Davenport, a talent management and organizational alignment consultant with Towers Watson, says many healthcare organizations have come to understand that engaged and energized staff really can make a difference.
"We have invested in technology. We have invested in facilities, structure, processes, any number of things. All of that can help. But ultimately – and I don't know why it took so long to figure it out – if you have energy and engagement then that stuff is a catalyst to outcomes you want," Davenport says. "And if you don't have energy and engagement all the other assets don't matter."
Davenport, who led an ASHHRA seminar on transforming the healthcare workforce, says senior leadership has often tried to downplay the HR factor.
"In some ways it is easier to conceptualize 'Well, what if I found a cool new way to treat or diagnose things? Then I'd be able to take the humans out of the equation,'" he says. "Humans are the hard-to-predict and hard-to-control part of the equation, whether its patients, executives, physicians, or employees. But we have finally come to the realization that you can't take them out of the equation."
As if things weren't complicated enough, the new thinking on employee engagement in healthcare is occurring in the midst of enormous change. Nobody knows for certain what healthcare will look like in five years.
"I can't think of an industry that has more vectors of force hitting it simultaneously than healthcare," Davenport says. "You have legislative issues, financial issues, science issues, technical issues, cultural and morality issues. The things that are smashing into healthcare are if not unprecedented then at least unusual.
Healthcare has had to run so fast to catch up because for generations it was a pretty simple deal. It's not so simple anymore."
Walter says his son was writing a college paper recently on strategic HR management. "He said, 'Dad what is the difference between now and the days when it was 'personnel?'' I said 'the difference is now we are a major player at the table and we are there to drive the organization in a lot of things like engagement, sometimes kicking and screaming,'" Walters says. "A lot of people aren't interested in engagement, but once they see the results it makes all the difference in the world."
Bloomsburg (PA) Health System and its affiliates will merge into Geisinger Health System, the two systems announced jointly Friday.
“This affiliation is good news for Bloomsburg Health System, our patients, and the community,” Bloomsburg Health System President/CEO Regis P. Cabonor said in prepared remarks. “It is very difficult in today’s environment for small, independent hospitals to invest in the facilities, technology and staff necessary to maintain services.”
Bloomsburg Health System includes Bloomsburg Hospital, Bloomsburg Health Care Center, Columbia Montour Home Health & Hospice, and Bloomsburg Physicians Services.
Danville, PA-based Geisinger and Bloomsburg already collaborate in other areas. Eight Geisinger doctors have full privileges at Bloomsburg Hospital, and 19 others are on the consulting or courtesy staffs. A Geisinger physician serves as medical director of the psychiatry unit. Geisinger provides clinical engineering services at Bloomsburg.
“Our focus is on further developing community-based programs designed to improve patients’ health and well-being, and enhancing the ability to provide superior care and service for all the residents of the region,” Geisinger President/CEO Glenn Steele, Jr., MD, said in prepared remarks.
After the deal clears regulatory hurdles, Bloomsburg Health System’s approximately 800 employees will keep their jobs and the Bloomsburg Hospital Board of Directors will become an advisory council for the new Geisinger-Bloomsburg Hospital campus.
“We expect approvals by the Pennsylvania Department of Health and Attorney General’s office could take approximately six months,” said Cabonor. “Moving forward, we will be looking to grow programs that best provide services for patients in the most efficient and appropriate setting.”
A fake doctor who treated more than 1,000 people in two states, collected about $1.2 million for the "care" he provided, and then tried to sell their health information, pleaded guilty in federal court in Atlanta this week to charges related to the scheme, the Department of Justice said.
Federal prosecutors said that Matthew Paul Brown, 30, formerly of Atlanta, GA, and Nashville, TN, worked with licensed physicians in both states from November 2009 to April 2011 and used their provider numbers to collect about $1.2 million in false claims with Medicare/Medicaid and private insurance companies.
Brown, who has never held a license to practice medicine, would administer the care in the physicians' offices and at health fairs, with the physicians agreeing to pay Brown between 50% and 85% of the take. There is no indication that the physicians who worked with Brown were aware that he was a fraud, prosecutors said.
Brown was indicted in April. He pleaded guilty Tuesday in U.S. District Court in Atlanta to charges that include 17 counts of healthcare fraud, each of which carries a maximum sentence of 10 years in prison and a fine of up to $250,000.
Brown also pleaded guilty to wrongful disclosure of individually identifiable health information, a violation of the Health Insurance Portability and Accountability Act. Prosecutors said Brown tried to sell a spreadsheet containing healthcare information on the people he had treated to an undercover FBI agent, who Brown thought was a potential investor in a business Brown was starting. The HIPAA charge also carries a maximum sentence of 10 years in prison and a fine of up to $250,000, prosecutors said.
Sentencing is scheduled for Nov. 22.
The U.S. Attorney's Office in Atlanta has tried to notify the people treated by Brown, but federal prosecutors said they don't believe that any of them were harmed. Brown bought the needles and allergy shots he used from a retail pharmacy. There is no evidence that he ever used unsterile needles.
"The reckless conduct displayed by the defendant not only displayed a total disregard for the patients that he was improperly and illegally treating, but also for those individuals who could have legitimately benefitted from the federal Medicaid/Medicare funds," Brian D. Lamkin, special agent in charge, FBI Atlanta Field Office, said in a media release.
Hospitals and health systems that hope to survive in the era of healthcare reform will have to learn to live with lower Medicare reimbursements, says healthcare consultant and futurist Ian Morrison.
"Do as every other industry has done and change how you deliver services," Morrison said Tuesday as the keynote speaker at the closing ceremony for the 47th Annual Convention & Exhibition of the American Society for Healthcare Human Resources Administration, in Phoenix, AZ.
"That is what we have to confront very rapidly and I don't see enough evidence that we are doing that," he urged.
Morrison says many healthcare executives operate under two flawed assumptions: That reimbursement should cover the cost of care, and that "the way we are doing it now is the right way."
He said he was recently confronted by a hospital CFO who complained that Medicare doesn't cover the cost of care. "I said 'Dude, let me rephrase that. Medicare doesn't pay the income aspirations of you and your people for doing things exactly the same way you've been doing them for 25 years. Change the way you do the things you do, like every other industry has had to do over the last 25 years,'" he recalled.
That acceptance of lower reimbursements will require "new math," Morrison says. For example, a shift towards population-based payments will encourage healthcare providers to change the way they conceive of integrated care. "People say that sounds like capitation. It is capitation," Morrison said.
The new math will also require consumers to become more engaged in their healthcare coverage and its limitations. "The high-cost fancy places are going to be called out in these high-performance networks as unaffordable and if you, the public, want to go there, you are going to have to sign up with some other plan," he explained.
Morrison says changes in the healthcare delivery model will be facilitated and accelerated by technology, and the compensation principle will shift from actions to outcomes. "Patients don't want health services, they want outcomes," he said. "We tend to give them health services rather than deliver what it is they want. We also tend not to persuade them to do less. We persuade them to do more."
He also sees – and supports – further consolidation of the healthcare industry, because larger integrated healthcare systems are simply more efficient. "A lot of these smaller institutions need to be swept up into larger networks of care," Morrison says.
"I see large hospital systems rapidly consolidating and integrating and expanding their base but they need a payment signal from CMS that that is a good thing to do," he continued. "If you are going from volume to value you are going from 'fill the hospital' to 'empty the hospital'. That is a different mindset."
Morrison says every hospital should be planning to integrate health services for accountable care – even if they have no plans to join the ACO pilot. "That means prepare to take financial risk for the patients, maybe not full capitation, but certainly bundled payment. Integrate with your medical staff and dedicate those staff to higher performance," he says. "The only way I know to be in the forefront 20 years from now is make it better, faster, cheaper. Make it cheaper care. Learn to live on Medicare. Make it better. Continuously improve performance and focus on outcome not just processes."
Even with the uncertainty and upheaval in the healthcare sector, Morrison reminded the ASHHRA crowd that it is an "exciting time in healthcare." He cited a recent Centers for Medicare & Medicaid Services estimate that healthcare spending could hit $4.6 trillion by 2020. "This is a great business to be in. Do not be depressed. Go home uplifted," he says. "You do not want to get a job in commodity textiles. This is the business you want to be in."
The best nurse recruiting and retention plans on the planet are no match for a "jerk boss."
"Jerk bosses have one common quality --people don't trust them," says Dick Finnegan, CEO of C-Suite Analytics, and the author of Retention Rethinking.
"If you can't close that gap, you are on an island trying to make these programs work. How many times have you heard an employee say 'I don't like it here, but if I can just hold on until employee appreciation week'?,'" Finnegan told a full room at the 47th annual convention of the American Society for Healthcare Human Resources Administration in Phoenix, AZ.
For recruiting and retention plans to succeed, Finnegan says, so-called jerk bosses must be identified and they must be held directly accountable for the turnover of people under them. He suggests that HR set specific retention goals for supervisors, and conduct exit interviews with those supervisors every time they lose an employee.
Job turnover is a tremendous cost driver in healthcare. There is a 27% turnover rate for first-year nurses. That can be reduced, Finnegan says, if employers understand what motivates workers to stay. It's not a fear of the recession or unemployment because the unemployment rate for college graduates is about 4.5%, and nurses are in particularly high demand.
What gets workers to stay, he says, is not more money but a belief that they are getting something "unique" from an organization, that they are well-matched with their jobs, and that their supervisors have built a trusting relationship that fosters retention."
Finnegan offered seven steps to improve retention.
1. Get the C-suite on your side by quantifying the cost of turnover in dollars, not percentages. Make sure that the CEO and the CFO understand the direct and indirect costs of turnover." Once you have a number they can back, they get it," Finnegan says.
2. Provide monthly reports on retention and name names. Identify the supervisors who are not making retention goals, and make sure they understand the costs of not meeting those goals.
3. Change the hiring process. Make sure that your supervisors conduct structured, competency-based interviews. "HR is highly structured but interviewing managers aren't," Finnegan says. "Teach them to probe based on the answers they get. Don't let lousy hiring managers make lousy hiring decisions."
4. Use RJP -- Realistic Job Previews -- so potential new hires completely understand what they are getting into. Make sure they understand that they will probably be working most holidays, perhaps evenings, and that much of what they will encounter in their first year of nursing may not resemble what they anticipated when they were in nursing school. "It is why 27% of new hires don't last a year. They don't get it. What can you show them that smacks their senses," Finnegan says.
5. Implement tipping point interviews. Make sure that supervisors have regularly scheduled "tipping point" interviews with new hires to gauge progress and satisfaction. "You can't just say 'good luck.' You can't just walk down the hall and say 'How ya doing?' That's a greeting, not a meeting," Finnegan says.
6. Develop manager relationships that foster trust. "Think of the role that trust plays because it is in everything,"
7. Train managers to conduct "stay interviews" with staff at least once a year. Find out what makes them happy. What concerns they have. Try to address the issues they raise. If an issue can't be resolved, explain why. "The irony is that in marketing you are always asking the customer what they want, but we don't do that with employees," Finnegan says. "The fear is that they will want more money. No. They won't. But they will be thrilled that somebody has asked."
Violence against healthcare workers is not breaking news for people who work in healthcare. For many of them – particularly emergency department staff – threats, cursing, screaming, and sometimes even physical assaults are symptomatic of a healthcare delivery system stretched to the breaking point.
As I have noted before, data from the U.S. Bureau of Labor Statistics show that for every 10,000 hospital workers, eight workplace assaults resulted in missed work days. In the overall private sector, by contrast, only 1.7 workplace assaults resulted in missed work for every 10,000 workers.
These assaults on healthcare workers should never be considered routine, or “part of the job.” Nobody trying to make an honest living – especially a healer – should have to put up with abuse. And to their credit, growing numbers of hospitals and other healthcare organizations are adopting zero tolerance policies.
For the most part, however, the public does not understand the extent of the problem. It’s up to the healthcare sector to educate them. The word is getting out, slowly. The mainstream media is starting to pick up the issue, and every article or TV news segment dedicated to the topic will bring that much more public attention to the problem. With the public informed and on your side, good things will happen.
Smart hospital leaders are finding positive, proactive ways to generate publicity about violence against staff, and patients. It’s not difficult to do because hospital security is an important story that resonates with the public.
They are in dozens of hospitals already, and have been for years. However, the Vanderbilt program has generated a lot of news coverage for the hospital. TV and print media, supplied with a compelling angle (and most importantly for TV, a picture), wrote stories about the program, providing viewers and readers with a brief primer on the growing threat of violence in the healthcare setting.
For example, The Tennessean, one of the largest newspapers in the Volunteer State, described a patient who “jerks a metal vent out of a wall, pounds it into a crude shank and brandishes it threateningly. He’s not in a prison. He’s in a hospital emergency room.”
The Tennessean notes that the incident happened at Vanderbilt University Medical Center, but that the hospital “has no monopoly on ER violence. Workplace assaults and threats have risen to the point that Middle Tennessee hospitals are ramping up security measures and teaching ER workers de-escalation techniques. The increased focus on prevention comes after a national organization representing ER workers exposed the hidden scabs behind nurses’ uniforms.”
Of course, this is not good publicity in the traditional sense. Nobody wants their hospital to be described using words usually reserved for the crime blotter or a prison movie. It’s not the warm-and-fuzzy opening of a new maternity ward or a breakthrough, life-saving, high-tech gizmo. And be prepared for TV shots of scrubs-clad hospital employees practicing arm bars and headlocks. That is inevitable – TV needs pictures.
But here’s the rub: It works. By doing it this way, Vanderbilt has sent the message to the public that they are dealing with this undeniable and disturbing reality in a proactive and positive way. With an understanding of the problem, the public will sympathize and demand action to protect healthcare workers, who in every community are their friends and neighbors.
Sign up for a violence prevention program. There are several out there – just ask around. Find one that emphasizes risk assessment and de-escalation techniques. The cost of such a program will likely be made up in improved employee safety and morale, and by the free and positive publicity you will generate when you make public your proactive efforts.