Committed to giving back to the community, Jennifer Grenier, MSN, RN-BC, created a program to encourage healthcare workers to help feed those who are food insecure in Chicago.
This article first appeared in the September 2016 issue of HealthLeadersmagazine.
Jennifer Grenier, MSN, RN-BC, director of nursing and inpatient rehab at Rush University Medical Center in Chicago, was undergoing a four-month community leadership development course when she was asked to create the framework for a program that would give back to her community. When brainstorming with another program participant, Grenier voiced her concerns over hunger in the Chicago area, and mentioned that as much as 40% of commercially prepared food goes uneaten and is disposed of.
The other participant turned out to be the executive director of the Oak Park River Forest Food Pantry, and together they developed a project that would redistribute excess commercially prepared food to local families in need.
The end result was The Surplus Project, a nonprofit organization that packages surplus food from local cafeterias and distributes it to people and families suffering from food insecurity. Currently, Rush Oak Park Hospital and Rush University Medical Center donate food, and the project won a $50,000 grant in February from the Oak Park-River Forest Community Foundation's Big Idea Contest Pitch Party held in Berwyn, Illinois.
On the link between food insecurity and poor health
If you are food insecure, then you don't have enough food for healthy living. What we see in food insecure people is that they often eat foods that are prepackaged and high in sodium. We see many of these patients coming in with congestive heart failure or uncontrolled diabetes, because they can't afford good, healthy food.
On healthcare workers and hunger
As healthcare workers, we have a special responsibility to relieve hunger, and one simple thing for us to do is to package food that is already in our hospital. We focus so much on helping patients to stay out of the hospital with medication and other treatments, but what we don't always do a good job of is asking the patient, "Do you have enough food at home?"
On why finding volunteers isn't difficult
At Rush, nurses are required to volunteer somewhere. Why not at their own hospital? With our in-hospital program, nurses and other staff leave their area for a half hour, package food, and boom! Volunteer time is done. No coming in on their day off. It's so easy for them, so convenient, and it's a great way to get staff involved because it's so quick.
High patient volumes, an aging staff, and healthcare workers' growing demands for flexibility can be surmounted with a few strategic management moves.
Healthcare continues to grow to the tune of expected job growth of 2.3 million new jobs between 2014 and 2024, but there's a downside to that growth, says Susan Salka, CEO and president of AMN Healthcare, a healthcare staffing company based in San Diego, CA.
"Many organizations are at the highest vacancy and attrition rates ever seen," says Salka.
SSM Health, a St. Louis, Missouri-based health system with 20 hospitals in four states, is scrambling to meet these challenges, says Kathy Starnes, SSM Health's system manager of staffing.
"We've been pretty busy," she says.
Through careful recruitment, retention, training, and planning SSM Health has to not only remain competitive, but to continue growing.
These efforts have helped the health system avoid or minimize three causes of staffing gaps:
1. More Patients Seeking Care
"This all started about two years ago, with a surge in volume we thought was temporary," says Starnes.
The increase in patient volume came as a shock to Starnes and her colleagues.
What's causing it? First, unemployment is the lowest it's been since 2008. Patients who are covered by employer-based health plans may be receiving care they might otherwise have put off or gone without.
Also, the Affordable Care Act has reduced the number of uninsured Americans by 16 million. Not only can more Americans buy health insurance from the exchanges, but young people can now stay on their parents' health plans until age 26. And patients cannot be denied coverage due to preexisting conditions, which means more patients have the opportunity to seek care.
But the volume never dropped—it only continued to rise. It soon became apparent that higher patient volume was the new normal. SSM is not alone; most healthcare organizations are reporting an increase in patient volume.
Since high volume is apparently here to stay, SSM has started banking on it.
The health system is focusing on expanding community access through affiliated retail clinics and increased ambulatory staffing, which has helped keep hospital patient volume under control, says Starnes.
2. An Aging Workforce
In 2012, 43.1 million Americans were age 65 and older—that number is expected to more than double by 2050.
Older patients often require more care, both preventative and urgent, which drives volume up, but clinicians are retiring faster than medical schools can turn them out.
"I've been in healthcare for many years," says Starnes. "Over the past two years, I've seen more of a gap, with clinicians moving out of the workforce as the baby boomers are exiting." The need for more OR workers is especially acute: "[OR] is not a [skillset] you come in to the workforce with," she says.
SSM has started offering training to workers with strong track records and an interest in OR work in a "grow-you- own" program, and has used staffing agencies to provide workers as needed.
Nurses are particularly difficult to replace, Salka says. "Every nurse counts. We need to do everything we can to optimize our nursing staff… [while] ensuring that they're appropriately scheduled," she says.
3. Workers' Demands for Flexibility
As younger clinicians and workers replace those who are retiring, they are demanding more flexibility in both responsibilities and hours than their predecessors.
"The newer generation wants a variety of work and new opportunities," says Starnes.
"I think, with multiple generations in the workforce, there are different perspectives on work and life balance. We're looking at how we will adapt to newer generations coming into the workforce."
And it's not just millennials demanding increased flexibility. Some older workers aren't ready to retire, but can't work 12-hour shifts anymore, says Starnes.
SSM Health's in-house training program has helped the system retain employees who crave more opportunity. The organization has also started allowing workers to self-schedule using workforce management software.
Managers retain the ability to adjust employee schedules as needed the ensure proper coverage. "Flexibility is important," says Starnes.
Collaborative medical education could bring more doctors to hospitals in underserved rural areas.
Private osteopathic medical schools are bringing physicians to areas where they're needed most. The osteopathic medical colleges are collaborating with public universities to open hybrid schools, which are branches on public university campuses.
Hospital HR leaders should be aware of this new education option as they recruit clinicians.
Barbara Ross-Lee, DO, is vice president of health sciences and medical affairs at the New York Institute of Technology (NYIT)'s College of Osteopathic Medicine, based in Old Westbury, New York. Ross-Lee is also site dean of NYIT's first hybrid school, which opened earlier this month on the campus of Arkansas State University, in Jonesboro.
"It's kind of a win-win concept for medical education," says Ross-Lee. "It's our goal that these students will graduate medical school, will take a residency training position in the region, and when they complete their residency they will stay and serve the community," she says.
Ross-Lee took some time to answer a few questions about hybrid campuses for osteopathic medical schools and alternatives for other kinds of clinicians. This transcript has been edited for length and clarity.
HLM: Why are NYIT and other osteopathic medical colleges opening hybrid schools?
Ross-Lee: We are facing a shortage of physicians around the country, and medical schools, both MD and DO, are using different strategies to expand. MD schools are increasing their class sizes, for example.
Osteopathic healthcare has an accreditation process where schools can establish a different campus or an additional site. The additional site is a very cost-effective way in which to expand class sizes by establishing an educational program at a different location.
This option allows us to align with other institutions as partners. In this instance, the College of Osteopathic Medicine at NYIT is partnering with Arkansas State University.
We chose Arkansas because the state ranks number 48 out of 50 states for healthcare. It has a severe physician shortage, and only has one medical school. The ability to open a second or even expand existing schools has been hindered by the economics of the state.
So this was an opportunity to bring more education to Arkansas, and also [hopefully] increase the number of physicians practicing in the state.
HLM: What should healthcare HR leaders know about hybrid medical schools?
Ross-Lee: Hybrid medical schools are emerging, and represent a pipeline for healthcare leadership, particularly in areas of the country that are struggling to recruit the kinds of physicians or specialists they need.
We have critical workforce needs in many areas of healthcare, including nursing. And this type of model might be a way to make it happen.
HLM: The DO and MD accreditation models are different. Have medical schools followed the lead of osteopathic medical colleges?
Ross-Lee: The MD schools can open branch campuses. I know of examples in the MD world where they have done something similar to this, but have not aligned themselves with another institution.
HLM: Is attending school at the Arkansas campus different than attending in New York?
Ross-Lee: One of the requirements is that at least 50% of the curriculum must be identical. Each community has its culture, and there may be opportunities and experiences in the community that differ from each site. You build the curriculum around that.
In Arkansas, population health is a really important concept that students need to understand if they are going to stay and practice in Arkansas. We're adding additional curriculum that is focused on population health for students on our Arkansas campus.
Also, because the population is much more rural than in New York, we're also providing much more education around telemedicine. Our students need to be prepared to understand the methodologies and delivery of it.
HLM: What do hybrid school partnerships mean for the future of medical education?
Ross-Lee: The hybrid school concept can be applied to any other discipline. For rural schools that are suffering and don't have resources to compete with urban public schools, this may be a way to share information. The schools could share resources by using technology, doing it in a way that helps to maintain quality at the same time.
The hybrid approach is a cost-effective way to expand medical education into areas that are suffering from a shortage of physicians, as medical students tend to stay in and practice in areas where they trained. Your best shot at populating these underserved states with clinicians is to educate them in those states.
The Department of Labor's new overtime regulations don't go into effect until December, so there is time to prepare. But they come with a side of unintended consequences.
It's official: The long-awaited Department of Labor overtime regulations go into effect on December 1, 2016, leaving HR executives just over three months to prepare.
The changes needed to accommodate the new regulations may not be simple.
"This is too much, too soon," says Tim Garrett, an attorney specializing in employment law with the Bass, Berry and Sims law firm in Nashville. Garrett doesn't necessarily disagree with increasing overtime pay or workers' wages, but the abrupt implementation of these regulations will create hardships for many employers, he says.
Garrett gives the DOL credit for allowing some transition period—the agency "could have implemented this [in] as quickly as 60 days," he says—but even with the December deadline, Garrett predicts that many employers, including some hospitals and health systems, will have difficulty adjusting.
"I'm not saying overtime pay shouldn't be increased, but this should be done in more responsible manner… The regulations currently don't recognize some unintended consequences," he says, naming three:
1. Less Flexibility
Most healthcare leaders can remember putting in a day lasting longer than eight hours fairly early in their careers, whether to put some extra time in on a project, to help out a new coworker, or to organize a social activity at work.
Under the new rules, employers will have to tally time worked more rigorously and pay for any work performed outside regular business hours. Work-related activities include checking email or voicemail, doing work-related research, and making work-related travel arrangements.
If your instinct is to shrug this concern off as an overreaction, think about this: how many of the hospital's employees have access to work email on their smartphones?
"We have organizations realizing they can't let their employees synch their smartphones. Checking email might count as work off the clock… Stuff people used to do at home on their own time can't be done anymore," says Garrett.
2. Less Room for Advancement
Another unintended consequence of the new regulations is that it will become harder for young workers to make the leap into management, says Garrett.
As organizations tighten up on tracking hours worked, healthcare leaders may find they have less room for trial and error in hiring and promoting workers to the managerial level.
"With folks in entry level management roles, it used to be that you could hire two [candidates]," Garrett says. But no more. He says that rules around exemptions will force organizations to instead hire one experienced manager who is more likely to accomplish their job in the allotted eight hours.
"We'll be losing the chance for younger people to get started," Garrett says.
3. Lower Morale
Diminished opportunities for advancement come with a price: decreased morale.
"I don't think our sense of meaning comes from our pay," says Garrett. "For the most part, our sense of meaning comes from being valued within our organization. And that meaning is so much more than pay."
Workers might first feel excited to see a couple extra dollars in their paychecks for working extra hours, but that joy will be short-lived as they realize they are now required to painstakingly track every moment dedicated to work-related activity, that their options for advancement are limited, and that employers' budgets are tighter, Garrett says.
Some workers will inevitably be reclassified—a few workers that might have preferred non-exempt status might become exempt, but some workers that were previously classified as exempt will become non-exempt—which can be disheartening enough to kill the even the most passionate worker's morale.
The best way to communicate these changes to workers? Sensitively.
"I would suggest HR people be very transparent," Garrett says. And don't grouse about the changes too much, he cautions. "You may be planting the seeds of the very weeds you are trying to uproot."
An international presence carries value beyond branding. HR stands to benefit in at least three important ways.
Healthcare used to be a locally sourced service, but no more. Not only are telemedicine services bringing healthcare into the homes of patients all over the world, but some health systems are exporting their own brand of world-class patient care to all corners of the world.
A pioneer in international health system partnerships is University of Pittsburgh Medical Center (UPMC), which has since 1997 partnered with overseas healthcare organizations to share best practices and to help those organizations create their own world-class institutions.
With projects in places as diverse as Italy, Singapore, and Qatar, UPMC's leadership takes a different approach with every project, says Eric McIntosh, director of human resources at UPMC International."There's no single model that we follow. This is done on a case-by-case basis," he says. Details such as ownership and management arrangements vary based on need, partnership type, and local laws.
In many cases, such as that of its soon-to-open cancer center in Colombia, UPMC doesn't directly employ the staff. Instead, clinicians and other workers are employed by the foreign partner. UPMC's HR department takes on a consulting and recruiting role.
"We were more like headhunters," McIntosh says of UPMC's role on the Colombian project with local partners FCV (Fundación Cardiovascular de Colombia), where UPMC's main role was primarily driving applicant flow and finding the right candidates for that campus, in addition to hiring a local workforce and training them.
Having an international presence can be helpful to HR in many ways, says McIntosh:
1. Recruitment and Retention
"[Having an international program] is great for recruitment, both foreign and domestic," McIntosh says. "When trying to set up international projects, many foreign healthcare workers are excited to work for western institutions," he says.
Large healthcare systems may have an advantage, but US healthcare institutions of all sizes are respected worldwide.
International projects can also be an excellent retention tool, says McIntosh. Many US healthcare workers are excited by the idea of living and working abroad, even if only for a few weeks or months.
And having an internationally recognized brand can help to expand an organization's presence, says McIntosh. While some might think that keeping a brand top-of-mind would be a greater asset to finding new patients than anything else, they would be overlooking the benefits of brand awareness as they relate to recruiting new employees.
Extending a healthcare provider's brand abroad is a good way to show the organization's influence, which can help hang onto veteran employees.
2. Growing Skills
Inviting foreign colleagues to the US for a training or sending staff to a foreign institution are great opportunities for organizations to learn something from their foreign partners, says McIntosh—and some foreign partners have specialized knowledge they are happy to share with the US staff.
"Some locations are very good at this," says McIntosh, mentioning that healthcare professionals in Singapore are very advanced in patient care were happy to share new techniques and different ideas with visiting US staff during a recent UPMC partnership project there.
3. Increasing Cultural Competency
Cultural competency is swiftly becoming a required skill for all employees in healthcare, and there are few better ways to enrich cultural competence than time spent abroad or helping international colleagues adjust to American culture.
Even working with a team that is familiar with English language and American business etiquette can yield surprising challenges.
McIntosh recalls an incident during a UPMC project in Qatar, where some American workers began eating at their desks, having failed to take into account that they were eating in front of their colleagues during the holy month of Ramadan, when eating is forbidden for Muslims from sunrise until sunset.
The locals politely asked their American counterparts to be considerate of their customs. "It was a learning experience," for the American staff, McIntosh says.
International experiences can teach hospital workers of all levels to be culturally sensitive, conscientious, and adaptable, while adding value to an organization's HR department and beyond.
HealthLeaders Media Council members discuss how their organizations engage the patient/consumer.
This article first appeared in the July/August 2016 issue of HealthLeaders magazine.
Richard Polheber CEO Benson Hospital Benson, Arizona
On the link between outreach and consumerism: When we started to focus on outreach, we realized that despite Benson Hospital having been around for 50 years, there were people in our community who didn't even know we existed.
To raise awareness of the hospital, we've tried to pursue various wellness initiatives that aren't necessarily paid practices that generate revenue, but that get our name out and make consumers and community members aware of our organization. We have support programs for patients with diabetes and respiratory problems, and we invite guest speakers for them to learn about how to manage their conditions. Our nutritionist visits senior living complexes and offers nutrition counseling. Recently, we did some outreach with fifth graders about what it means to eat healthfully.
We have an annual health fair. Last year, we had about 55 vendors offering educational material and information on anything from simple things like diet and exercise to buying special insurance for helicopter transportation in a medical emergency.
We have become very much involved in our community. At every parade, at every event in the community, we maintain an educational booth. We get involved with schools, make an effort to donate school supplies, and organize toy drives around the holidays for local kids.
The goal, I believe, is to be viewed as a value-added business leader in the community, and to make life better for everyone who lives in the region.
Leonard Grossman, MD
President and CEO
Princeton Medical Group
Princeton, New Jersey
I do agree to some extent that focusing on patients as consumers can be useful to our organization. We're looking to improve access, both in ease of making appointments and also in expanding our appointment times. We have three offices, and offering those three locations improves access. Two of our locations have infusion capabilities.
Our organizational philosophy values patient outreach. We now have a portal that sends out appointment reminders. We are encouraging patients to come in for routine visits, including physicals, pap smears, colonoscopies, and mammograms. We participate in a patient-centered medical home, and we employ a care coordinator. With the help of one of our payers, we're able to detect what we call "gaps in care," when patients have been diagnosed with a condition but have not been following up at regular intervals. We've started reaching out to them to follow up and make sure they're getting routine care and follow-up visits for conditions like hypertension and diabetes.
To ensure that our staff is getting the message right, patients take a survey immediately after each visit using an iPad. We tally the feedback from patients and give feedback to our staff. I think that we could be a lot stronger in emphasizing better patient experience—it's an area we can work harder on.
Eric Franz
Vice President of Finance and CFO
Graham Hospital
Canton, Illinois
In looking at how to engage our patients, I believe we need to define what they want. We need to ensure that we're able to focus on their expectations and outcomes.
I'm not a clinical person, but I can tell when good customer service is provided, and I think most patients are in the same boat. The patient-consumer and his or herfamily can tell when we do a good job from a customer service perspective.
It's not only the clinical side of care that is important. From the moment the patient starts the process of his or her encounter, from the moment he or she is greeted by a volunteer or receptionist at the front door, that's what kicks off the whole engagement process—a process that doesn't end until the patient is completely free and clear of anything that encumbers him or her, such as a bill that we may have sent, or another responsibility that he or she may have from a financial perspective. Throughout that encounter, we need to make sure that the patient has an experience that reaches his or her expectations or better.
However, we have not created a formal program to do patient engagement training. We do have regular discussions internally about the importance of that kind of activity.
Kathy Landreth President and CEO
Bath Community Hospital
Hot Springs, Virginia
We are a small, rural critical access hospital located in a part of the country where the population is somewhat dwindling, although to either side of us are larger hospital systems. So for the small hospitals like us, it gives us an opportunity because consumers are able to shop around.
Being small—we have about 160 employees, both full- and part-time—I think it's easier for us to make changes, such as deciding that we're going to focus on patient engagement scores, than for a larger organization where it has layers of employees and management to go through.
I think that in the age of consumerism, patients choose a facility because of the service that is delivered and the experience they have there. So the opportunity lies in improved patient experience, improved quality of service, and then the overall health of the population that we serve.
On providing convenient care: We really put a lot of focus on our rural health clinic. The focus of being able to fit patients in and see them when they call is really not an easy task, but we were able to get our providers on board. We saw 1,200 more patients in our rural health clinic in 2015 than we did in 2014. In a community that only houses about 4,500 people, that is huge. And I believe this success goes back to our focus on patient experience
The ranks of physician assistants are expected to grow by 30% between 2014 and 2024. They can practice and prescribe medicine in all 50 states at almost half the median cost of an MD.
Hospital HR departments often have two goals that can be very much at odds with one another: first, hire talented clinicians who can offer the best care; second, cut staffing costs.
But some are finding there's a way to do both.
Physician assistants can practice and prescribe medicine in all 50 states; they can examine, diagnose, and treat patients, interpret lab test results, assist in surgery, and take care of routine patient care.
And they cost less than physicians.
PAs have been certified since 1975, their ranks have doubled since the 1980s, and the number of PAs is expected to exceed 124,000 by 2025.
It's not hard to see why the profession is growing, says Dawn Morton-Rias, Ed. D, PA-C, president and CEO of the National Commission of the Certification of Physician Assistants (NCCPA).
According to the Bureau of Labor Statistics, the number of PAs is anticipated to grow by 30% between 2014 and 2024, adding 28,700 PAs to the US workforce.
As of December 31, 2015, there are 108,717 certified PAs in the United States
There are 103.9 PAs for every 1000 physicians
37.7% of PAs work in a hospital setting
PAs work a median of 40 hours weekly
The median income earned by a certified PA is $95,000 annually
And there are benefits unique to PAs, says Morton-Rias.
1. Cut Payroll Costs
The median physician's income of $187,200 is at least $90,000 more than that of a PA, who can perform many of the same duties a physician can.
2. Assist Specialists and Grow Departments
Like physicians, PAs can have specialties.
Until recently, most PAs specialized in family medicine or primary care, but that's changing, says Morton-Rias.
Data backs her up; while 28.3% of PAs still chose to specialize in primary care, a growing number (about 70%) are choosing to specialize in other subspecialties, such as surgical, emergency medicine, dermatology, and hospital medicine. The median annual salary for these specialties range from the low end of $85,000 for women's health and pediatrics to $115,000 for vascular surgery.
3. Facilitate Communication
PAs are a good fit for roles where sharp communication skills are vital, says Morton-Rias. Having gone through much of the same training as physicians, a PA will understand what other clinicians need, and may have more flexibility and time to spend with patients.
Counseling patients, transitional care, and care continuity are all areas where PAs shine, says Morton-Rias. "PA's training resides around good communication skills," and putting a PA in a role where their listening skills and ability to give clear instructions is an excellent way of putting that training to use.
Other roles PAs can bring their excellent communication skills to include assisting in the surgical theater, pediatrics, and geriatrics—any job where an ability to keep docs, nurses, and patients all on the same page is key.
Good PAs can "help empower patients, and are able to talk to patients in language [patients] understand and help them to care for themselves," says Morton-Rias.
They can also explain patient concerns to other clinicians in straightforward or clinical terms that get results and can make a high-quality, well-trained, and less expensive addition to patient care teams.
Data shows that women physicians make about $20,000 a year less than their male counterparts. But there's no data—yet—that shows how much of wage discrimination is intentional.
Women graduate from colleges and universities at higher rates than men. Three current supreme court judges are women. The presumptive Democratic presidential nominee is a woman.
But despite these chipper talking points, the evidence is clear: We still have a long journey ahead of us before we reach gender equality and income disparities are still very real.
And healthcare is no different than other fields, a recent study published in JAMA Internal Medicine illustrates.
Anupam B. Jena, MD, the study's lead author, spoke with me recently about the findings. He is associate professor of healthcare policy. The transcript below has been lightly edited.
HLM: Tell about your study and what you were trying to find out.
Jena: A number of studies both inside and outside of healthcare have found wage disparities between men and women for decades now. One of the questions that constantly comes up is whether or not the research is able to count all of the factors that we know impact income.
HLM: Tell about the data used in the study.
Jena: We had really unique data from two sources. We assembled data from 24 medical schools in 12 states.
These states have laws that require state employees' wages to be reported online, so we were able to create a database of physicians at state medical schools with their actual salaries.
We linked that data to information from a comprehensive physician database assembling data on a whole host of characteristics, including experience, specialty, where they trained, how many publications they've authored, how many grants they have, and how many clinical trials they've run.
We also obtained information that is publically available from Medicare on clinical reimbursements. So, we had detailed information on physician salaries and a lot of measures of research and clinical activity that we could merge together.
All told, we looked at about 10,000 physicians, and we found that women earn about 8% less than men.
HLM: Can you put that into perspective?
Jena: The difference in earnings comes out to about $20,000 annually, which is quite a bit of money.
HLM: Were you able to normalize the data to identify the factors that are creating the disparity?
Jena: Something commonly cited in similar studies is that women are more likely to work part time, and as a result, their annual salaries are expected to be lower.
But we accounted for that in two different ways; first, by looking at how much clinical revenue a person brings in from Medicare, which is a strong indicator of how active they are.
Second, we focused on physicians who have NIH grants. [Those physicians] are very unlikely to be part time. And we found the exact same results in that subgroup of men and women.
So, in my mind, these facts dispute any notion that the income gap is due to more women being part time workers.
HLM: How does discrimination happen? How much of it is intentional?
Jena: Our study didn't have any qualitative analysis, but I can speculate on why I think this is happening. The first conclusion is that women are less inclined toward negotiation or feel they have less negotiating power when it comes to salary setting.
The second is that women are less likely than men to solicit job offers and then use those offers as leverage with their employers to negotiate a higher wage.
Also, there is overt discrimination, which can be either conscious or subconscious.
A department chair might have a pot of money to allocate as raises, but if that's not done in a uniform way, there can be a subjective perception of a chair that one person is contributing more than another.
Worst case, it can be overt discrimination. I think that is less common than subjective-type discrimination, but it's hard to comment how often that actually happens. We don't have any data on it.
HLM: When hiring and giving out raises, what should HR leaders be mindful of?
Jena: I think that HR for any employer should have a solid understanding of the various ways an employee contributes to an institution.
If they can actually quantify their contributions, that's even better, because the quantification of those contributions is most likely to eliminate disparities.
There is no secret formula for improving efficiency and cutting costs, but using analytics tools to inform management decisions is vital.
Faced with the possibility of state budget cuts, one nurse manager knew she needed increased insight into the organization's personnel management and inefficiencies—and fast.
"Labor costs are among the highest costs… so we had to make sure we were paying very close attention to [them], and that we weren't using too much overtime," says Michelle Godin, manager of business operations in the nursing department at Saint Mary's Hospital, a not-for-profit community teaching hospital in Waterbury, CT.
The hospital had been using personnel productivity tools to track its 1,935 employees since 2012. But the installation of a new suite of analytics tools in mid-2015 has been generating savings.
These tools enabled Godin and her colleagues to gain staffing and productivity insights that have led to $650,000 in savings over a six-month period
The savings were driven by analytics, but "we did some other things to reduce waste, such as putting new punch clocks in specific locations to reduce travel time. It was an entire project, but it was all geared toward efficiency, and analytics gave us the data that said it was working," says Godin, who oversees a hospital-wide productivity project.
She recently discussed the project in a phone interview. This transcript below has been lightly edited.
HLM: How do you use analytics for personnel management?
Godin: The most straightforward way it's used is that we look at the performance of each department in terms of an established target and how well that department is performing.
Every manager, director, and vice president gets a copy of the productivity report to show whether the department is performing to target every week. We look at each department's finances, budget, satisfaction scores, and their productivity.
HLM: How was the new analytics tool an improvement over your old tool?
Godin: Our old tool was really a report; we would send the company data, and they would send us reports weekly. But with the new analytics program, the data belongs to us and is accessible any time, so I can go in there and drill down on some of the reports from analytics.
An example is that I can look at a department's overtime and figure out what's driving it. I can also run new reports and do trend analysis.
With the old system, I would have to call the company and do some work with them to get this information. Saint Mary's now has much more control over the database, and I have more control over the reports, and we can look at them daily.
HLM: How do these analytics relate to managing people? What do they help you see?
Godin: Our payroll system sends us a download daily with the names of all of our employees, the hours they're working, their schedules, and pay. So, I can get down to the individual level and see, for example, how much overtime someone has used, or how much benefit time someone has used.
I can look at a specific employee from a manager's perspective and ask wait, how many of this employees' grandmothers died last year? And I can run a report that can show us this information.
Also, when managers request new positions, HR is in the room with us saying, "OK, they want a new transporter. Well, how's transport been doing with their productivity?" We can see if the numbers show that they really are overworked and need new staff, or if they seem to manage with the staff that they have.
HLM: What were some other initiatives geared toward managing workers efficiently?
Godin: Moving punch clocks to more convenient locations near workers was a big one.
We were also able to give mobile devices to the managers. They have programs on their iPads or phones that enable them to correct problems, such as someone forgetting to clock out for lunch, immediately rather than waiting until the Monday morning time card report.
They get exception alerts when something is off, and they can also check and see who is on the schedule to come into work today.
With a little planning, seasonal issues such as dress codes or social events need not become a distraction.
Summer presents HR not only with unique staffing challenges, but also gives rise to the need for reminders about dress code policies and strategic planning for organization-wide social events.
Warm weather can tempt employees to eschew sensible shoes for flip flops, but in addition to being unprofessional, footwear can have a real impact on both worker and patient safety, says Owen Dahl, an independent consultant with the Englewood, Colorado-based Medical Group Management Association.
"It's becoming more of more of an issue as people become more casual," he says. Some employees, especially younger ones, might not see the value in professional attire.
But patients prefer seeing clinicians in professional attire. And summer is a good time to remind staff of dress code policies.
"Every time a patient comes in to the clinic or sees physicians on the wards, there's a certain expectation of how their physician will dress," says Christopher Petrilli, MD, an internal medicine resident at the University of Michigan Health System in Ann Arbor and lead author of a study on the role of physician attire in patient satisfaction.
In addition to possibly affecting patient satisfaction scores, safety can be compromised when workers wear inappropriate footwear.
Healthcare isn't the only industry that has to tell workers to rein in their personal style.
Dahl recalls seeing a barista at Starbucks a with a bandage on her arm. He asked her how she had injured herself, and she revealed that the bandage was covering a large tattoo management had deemed inappropriate for a client-facing worker to display.
If Starbucks can tell baristas that certain styles aren't workplace-appropriate, hospitals can do the same, concludes Dahl.
But keep in mind: 93% of Millennial workers say they want a job where they can be themselves at work, and 79% think they should be able to wear jeans at least some of the time.
As the world becomes a less formal place, experimenting with less formal dress codes might go a long way toward Millennial worker retention.
Summer Outing Strategies
Along with the office holiday party, summer outings are great opportunities for employees to get together and socialize outside of the normal work environment.
"I like the idea of those kinds of events—I believe building relationships has some side benefits," says Dahl, citing improved morale as one.
But organizations must ensure that these events are enjoyed safely. Drunk driving, inappropriate interactions between employees (including, but not limited to, sexual harassment), and other dangerous activities can turn summer events into an HR nightmare.
Hold these events at family-friendly venues and encourage employees to bring their families along for the day. Workers are less likely to misbehave when there are kids or spouses present, says Dahl.
Limit the amount of alcohol that is served or elect not to serve alcohol.
Arrange for transportation if necessary. Have access to a cab service or ride-sharing app in case anyone looks like they could use some help getting home for any reason, alcohol-induced or otherwise.
"A family-based situation, especially a picnic during the summertime, would be a good idea," says Dahl. Outdoor activates might include a barbeque or a company ball game, such as volleyball or softball.
He suggests avoiding risky activities such as hang gliding or ziplining. "I'd stay away from those. Keep yourself where the exposure to liability is less."
