By Jim Murphy and Beth Boynton
We recently started a series on what the ideal healthcare organization would look like. In our first installment we cited six characteristics, based on an article in the June Harvard Business Review (HBR). Then we added twelve more attributes from an earlier HBR blog post. In our third article, we listed ten more as given by a blogger for Examiner.com.
Now we suggest ten additional attributes of a great organization and how they would appear in healthcare, based on a list in the current newsletter “Improving the Workplace” by local guru Bruce Katcher. Bruce is an organizational/industrial psychologist and is founder of Discovery Surveys, Inc., and the Center for Independent Consulting. He wrote the book 30 Reasons Why Employees Hate Their Managers .
Bruce’s newsletter is one of the most useful in the business. In the September issue, he asks “Are You Proud of Your Organization?” He proposes ten factors that make employees proud and thus make for an ideal organization.
1. Giving back – organizations should give back to the community.
In healthcare, the core mission is to serve the community, though, alas, many hospitals now see themselves as working for a constituency, not the whole population. But one can find much giving back in healthcare, from summer youth programs to charitable donations. Certainly there is room to develop the idea that healthcare itself is integral to the health and well-being of the community and this may manifest differently than marketing efforts.
2. Optimism – in a good organization employees feel good about its and their own future.
In healthcare, the constant pressure to cut costs can work against optimism. Employees too often feel stressed out and fearful about their jobs. This last winter the Lucien Leape Institute-National Patient Safety Foundation released an important Roundtable report called, “Through the Eyes of the Workforce“. It raises serious concerns about the physical and psychological harm that healthcare workforce is experiencing. Strikingly different experiences than many professionals were expecting or seeking.
3. Quality products and services – in the ideal organization these should be first rate
In healthcare, there is a federal agency devoted to improving service quality and more than one journal covering this topic. But for all the attention the issues gets there is still dissatisfaction, as the existence of the patient engagement movement shows. Many consumers report positive experiences in healthcare and many do not. This gap between what healthcare professionals can and should do in terms of quality (and safe) care is reflective of unclear or inconsistent priorities, fragmentation, and understaffing.
4. How decisions are made – employee involvement in the decision making process helps
In healthcare, the complex and hierarchical nature of organizations is a barrier to employee participation, despite evidence linking it to patient satisfaction. Interventions that bring together the people in the various healthcare roles, such as medical improv, are thus very important. Leaders and managers including nurses and doctors must be fluid in their abilities to provide structure and empower staff and promote collaboration. In healthcare, a command and control element is key, but when employed all the time is oppressive and counterproductive.
5. Respect for employees – management needs to listen and people to trust one another
In healthcare, with all the pressure on healthcare leaders, it is all more imperative that they pay attention to employees and earn their trust. We posted a story of a leader who listened. One example trust building is the no-layoff policy of Scripps Hospital in San Diego. Employees who are listened to by leaders will be learning to listen to patients.
6. Employee development – learning opportunities and career growth are essential
In healthcare, continuous learning is imperative as new technology and new mandates are implemented. Employee development has been called “a prescription for better healthcare”. Ensuring that ongoing training is interesting, engaging, and meaningful to staff and the organizational mission should be a priority. Computerized, mandated training is often lacking in all of these.
7. Cost control – employees must believe that quality is not being sacrificed
In healthcare, no issue is more in the news than reducing costs, and it seems that everyone has their own list of ideas on the subject. How that can be done without sacrificing quality of care may be the number one question in healthcare. Further, when there is confusion about reducing costs versus making money, staff are pulled in different directions and care may become secondary. This chips away at the integrity of professionals and organizations and speaks to having a clear, honest, and consistent vision.
8. Personal accomplishment – employees must know about their performance and purpose
In healthcare, the key to good patient-centered care is employee engagement, which requires a sense of accomplishment. Employee engagement has even been linked to good HCAHPS scores! Personnel evaluations should be inspiring and supportive of growth. Too often, a punitive approach such as feedback about poor time management skills without acknowledging organizational accountability for staffing insufficiencies may push employees into a corner. Shortcuts, silos, defensive behaviors are counterproductive consequences.
9. Transparency – a good organization is clear about goals, pay and other matters
In healthcare, transparency is a difficult goal, with patients often being kept in the dark purportedly for their own benefit. Yet it has been said to be the “most powerful driver of healthcare improvement”. Leaders, staff, and consumers must all be active players in understanding and influencing statistics that arise from increased transparency in healthcare. Safe staffing, infection incidence, workplace injuries are complicated phenomenon.
10. Strong benefit program – a great organization provides great employee benefits
In healthcare, the cost cutting imperative again can adversely impact employee benefits. But the industry may actually have the ability to provide great benefits while still holding down cost; in fact, it has been suggested that hospitals could actually lower costs by providing employees with some of the benefits that they provide their patients! It is also imperative to have a longterm vision that includes the costs of staff turnover and injuries. Taking care of staff and supporting the work has to be part of any safe and cost-effective strategy.
Surely a healthcare organization scoring highly on Bruce’s list of attributes would be an ideal place to work. And we’ve seen some cases where such things actually are happening.
Can readers help provide more examples to aid our quest of creating the ideal healthcare organization? Do you know of any employer who does exceptionally well on any of the above characteristics? Or maybe you have thoughts about what the barriers are. We would love to hear from you.
–Jim Murphy has a solo consulting practice called Management 3000, focusing on organizational development and change management. Formerly he led the Massachusetts Bay Organizational Development Learning Group, was Human Resources Director for the City of Boston Assessing Department, and served as a consultant with the Boston Management Consortium. His consulting practice includes management coaching as well as research and writing on employee relationships, leadership, healthcare and collaborative practices. Having produced newsletters for several organizations and being a frequent content writer for the”Confident Voices in Healthcare” blog, he is interested in writing and research opportunities, as we all consulting and coaching.
Beth Boynton RN, MS is a national speaker, organizational development consultant, and the author of the award-winning book, “Confident Voices: The Nurses’ Guide to Improving Communication and Creating Positive Workplaces”. She specializes in communication, collaboration, & emotional intelligence for healthcare professionals and organizations and is trained in the Professor Watson Curriculum for Medical Improv through Northwestern University Feinberg School of Medicine. She offers medical improv training for communication, emotional intelligence, culture change, and teambuilding efforts. Her video, “Interruption Awareness: A Nursing Minute for Patient Safety” and blog, “Confident Voices in Healthcare” have drawn audiences from all over the world. She is currently writing a core text with F.A. Davis Publishing Co. tentatively titled Successful Nurse Communication: Safe Care, Positive Workplaces, & Rewarding Careers, practices as a Per Diem RN in a LTCF for folks with dementia, and a student of improv. Her complete CV is online.