Today’s healthcare human resources department has changed dramatically over the last decade. Rather than being consumed by the day-to-day necessities of benefits and paperwork, today’s leaders are active business partners of those they serve. Adept at both strategy and operations, HR leaders are invaluable organizational partners in improving employee, physician, and patient engagement as well as quality, operations, and financial performance. That’s why at Studer Group we feel it’s so important to partner with HR leaders to drive results.
Is Your First Year Turnover Like a Revolving Door?
Reducing employee turnover is one of the prime ways Studer Group can work with human resources executives for quick and dramatic improvements. High employee turnover is particularly expensive because it impacts all five Pillars: People, Service, Quality, Finance, and Growth. (In fact, our studies show that clinical quality dramatically improves when turnover is lower than 12 percent.)
One of the biggest costs? Turnover of first year employees! In some organizations, first year turnover in entry-level service positions—like nursing support, food service and housekeeping—is 40 to 50 percent. If it costs $5,970 to replace just one housekeeper (based on 25 percent of a $23,880 salaryi), consider the dramatic savings to the organization through higher retention.
How high is your first-year employee turnover? When turnover is 20 percent or greater, Studer Group recommends specific processes and tools for selection and retention in the first 90 days, which frequently reduces first year turnover by up to 50 percent. These include:
- Behavioral-based peer interviewing for new recruits— In our experience, identifying new employees that are the best job and skill fit for both the organization and the team occurs when high-performing peers are selected to interview and rank potential employees using structured behavioral-based competency questions. (Studer Group maintains a best practice database of questions that can be tailored to any position.)
- 30- and 90-day conversations with new employees— To retain employees beyond the “honeymoon” phase, direct leaders to meet with each new employee and ask specific, structured questions at both the 30- and 90-day marks of employment to strengthen the relationship. By learning about the employee’s perceptions of the new job, team members, and organization, supervisors can create dialogue for clarifying expectations and also understand what matters most to new employees to ensure retention.
Community Health Network (CHNw), a six-hospital health system with 500 employed physicians and 12,000 employees in Indianapolis, IN piloted these tools in 2012 with 52 new hires over six months and lost just one hire for an effective return on investment of $6 millionii. Today, after expanding these practices across the organization, CHNw new employee retention is 85.88 percent.
“We noticed that employees started to feel empowered because of the selection process,” explains CHNw Vice President of Human Resources Nancy Foster. “And to ensure it occurred with every new employee every time, we created accountability for peer interviewing. We require leaders to return the peer interviewing form to our department before we make an offer.”
Are Your Best Prospective Employees Choosing Your Closest Competition Over You?
In many cities, potential employees surf the web to see which employers sound best. They are searching for signs that employees and physicians are happy there…when an organization is recognized as the best place to work in the community, for example, or when they hear from existing employees who speak highly of an organization (a sign of engagement).
Are your employees highly engaged? While most organizations complete an annual employee survey—and sometimes express shock and concern over what employees say—those survey results often get buried in a binder until next year when it’s time to repeat the very same survey. And then, when the organization hosts a pre-survey cook out or pizza party—and they ask if a survey is coming up—we wonder “How did they know?”
Studer Group finds that the best way for Human Resources to help drive sustainable, high employee engagement is to actively coach leaders over the long-term, beginning with how to implement an effective 90-Day Plan post-survey. Leaders can become overwhelmed with the survey data—or discouraged by negative feedback—and miss the opportunity to make things right or harvest the wins that demonstrate progress on key issues. Then, when nothing changes, employees feel their input doesn’t make a difference and stop participating. An engagement death spiral!
Learn more about 90-Day Plans
To build a positive cycle of engagement in your organization, begin by reviewing key survey findings with department leaders. First, point out some positive findings and express your appreciation for what’s working well. Next, help them form a work group of their employees to identify the top two to three priorities for improvement in the department. Let employees become part of the solution.
At UW Medicine in Seattle, WA, Barbara Fromm, assistant administrator of Clinical Support Services and Planning shares how leaders collaborated to create a custom approach to internal customer surveying at each of UW’s four hospitals. One UW hospital prefers to survey departments quarterly and then follow up with quarterly rounds to report back on results from its action plan.
Another hospital is focused primarily on surveying and action planning for its number one priority: improving the ED patient experience. ED leaders worked with the support service directors for the ED (e.g. security, engineering, food services) to strategize together on how to impact the patient experience in the most meaningful way.
When the Security Department reviewed videos of security incidents and recognized the anxiety that an incident would create for a patient who was observing it, officers began using key words to reassure patients about their safety and, when appropriate, reinforce that patients would receive high quality care. It was one way Security could contribute to a positive patient experience and manage up caregivers. “Everyone in Security sees themselves as a caregiver now, but it takes time. You can’t just flip a switch so that employees are happy,” explains Foster at CHNw. “You only get traction over time.”
CHNw also uses communication to fuel transparency and alignment to organizational goals, which in turn, raises engagement. “Remember, employees will leave their leader, not their job. That’s why effective leadership development is the foundation for high employee engagement. It starts with leaders who understand what goals they are accountable for and the ‘why’ of what they do…so they can communicate that effectively to staff,” she adds.
At CHNw, the Human Resources Department is respected as an effective business partner with the departments they support. Their assistance in difficult situations is welcomed by department leaders. By serving on CHNw’s Leadership Development Institute Committee, HR representatives recommend curriculum to drive results that meet organizational goals and develop talking points that leaders can take back to their teams to ensure high engagement and organizational alignment. They also coach department leaders how to carry key messages back to employees after the employee survey using a stoplight report: “Here’s what you asked for; Here’s what we delivered.” (Download the Stoplight Template to learn more about stoplight reports.)
Change Is Hard. You Go First… with a Support Services Survey
To become a trusted ally of the departments you support, you’ll need “skin in the game,” as Quint Studer likes to say. If you want departments to boost high engagement by being more responsive to the needs of their employees, you’ll want to role model the process for them by demonstrating you are responsive to their needs. That’s where interdepartmental surveys and internal rounding can help.
Do they view you as responsive, capable, and thorough in your follow-up? Ask them to rate your performance on a support services survey. UW Medicine has continued to refine its support services surveys over six years to better meet the unique needs of its stakeholders. “We’re always working to ensure it’s the most meaningful, valid tool it can be by keeping things metric-driven and prescriptive to signal that it’s important,” explains Fromm.
She adds, “We started by asking about things like courtesy and accuracy, but over time we’ve worked to gain consensus on who to ask and what to ask. Questions evolved to better align with Pillar goals or the most important organizational goals…mirroring the CAHPS categories of questions, for example. When you ask people to march through questions that aren’t accurate or important, they become disengaged.”
Become an Effective Internal Coach
Do the departments you support see you as their partner in delivery of care or as a barrier to hiring or firing employees? Now is your opportunity to build influence and drive results organization-wide as you join the ranks of the progressive HR Departments we have the honor to serve.
View Examples of Support Services Surveys
i Assumes cost is equal to 25% of an average salary of a housekeeper in a privately owned hospital, Hospital Housekeeping Pay Scale, Chron.com, work.chron.com/hospital-house-keeping-pay-scale-3843.html
ii ROI based on reducing first year turnover from 820 to 410 at an average hiring cost of $15,000 per employee.