executive dialogue - healthcaresource · the new hire, and the monthly check-ins. the managers must...

ExecutiveDialogue

SPONSORED BY:

Leadership Strategies to Increase Employee Engagement

Sponsored by HealthcareSource

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The topic of engagement is important to every health care provider — urban or rural, independent or part of a large system. Engagement and development can have a positive impact on staff and physician retention, and reduce turnover. The American Hospital Association

and HealthcareSource convened a group of human resource executives in November in conjunction with the Talent Symposium 2017. This executive dialogue focuses on what hospitals and health systems are doing to support, develop and engage the existing workforce to enable the delivery of the best possible care.


MICHELE TALKA (Central Maine Health-care): We survey everybody, every two years. We want as many people as we can get. I’ve worked in organizations that surveyed more frequently and we discovered that most of the issues are longer-term issues. Having at least a year, if not two, gives managers an opportu-nity to actually put some things in place and then see the results.

GARY PASTORE (HonorHealth): We found that our employees were suffering from sur-vey fatigue. During our journey of surveying people who know a lot, we found that they were becoming survey weary. We had the

safety survey, the engagement survey and the National Database of Nursing Quality Indicators, for example. We found a way to bundle questions geared toward nursing staff, so they don’t have to complete mul-tiple surveys. As a result, we’ve captured a greater breadth of employees. We did add a different component this year — a cultural component — and we’re waiting to dissem-inate the reasults. One of the telling signs of engagement is how many people did not participate.

BEVERLY FEIN (Holyoke Medical Center): We’ve used a variety of different surveys over my career. We’re going to be doing an employee engagement survey next spring, but in between we conduct pulse surveys. The amount of time we invest in the commu-nication of the results and the action plan-ning really dictate future survey participation.


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MODERATOR (Felicia Bloom, American Hospital Association): A highly engaged workforce is essential to the provision of high-quality, patient-centered care. How do you assess employee engagement? What are your key metrics?

{ employee assessment }




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The communication of the results has to be quick and meaningful and the survey itself an organizational initiative driven by the CEO.

TRACY BRAMAN (Lakeland Health): If we have buy-in from the C-suite, it helps with our employee participation. Our CEO sends out an announcement that the survey is ready to go out. We conduct an annual survey at this time, and we haven’t been able to respond and build a comprehensive plan before the next survey goes. The idea of going to every two years may be better for us going forward.

CHENISE HAMILTON (Access Health Lou-isiana): We also conduct an annual survey, but we are looking to move away from that to encompass a culture of safety and engage-ment survey. We’re taking a close look at how we measure patient satisfaction on an ongoing basis to determine how we can mirror what we do with our patients with our team members. It shouldn’t be a snapshot of how our employees are feeling once a year, but rather to get a pulse of employee engagement every six weeks.

{ cultural fit }

MODERATOR: What techniques do you use in the hiring process to ensure that your organization selects people who have the potential to be highly engaged with your culture and your organization’s structure as well as its commitment to your mission and values?

JOE DUNN (HCA Healthcare): We integrate peer interviewing, involving our high-perform-ing staff to help select new hires as a way of getting them into the culture of the organiza-tion. It also helps to set up an informal buddy system so the new hires know to whom they can turn when they need help.

MODERATOR: What types of success have you seen with that?

DUNN: It’s been very successful. We have a

KORINNE CARPINO (Adventist Health system): Adventist Health System conducts an annual employee engagement survey and additional pulse surveys. Engagement is rated in the 99th percentile from our vendor. We are currently assessing our employee engagement assessment process.

NICK WATTS (SCL Health): We conduct a full survey every other year and in the off years, we conduct a condensed pulse survey. We’ve also struggled with survey fatigue, so we’ve combined our patient safety and cultural surveys with our engagement survey, as well as some of the critical nursing surveys that we have to do.

KATHY FAHY (GrapeTree Medical Staff-ing LLC): We typically do an annual survey comprising just 10 questions. Of those, usually six or seven of them are the same every year so we can follow trends. Then we do specific, more relevant topics to sense engagement or what’s keeping them with our agency versus another.

number of facilities that have been doing peer interviewing for a long time and other organizations are beginning to integrate this into their hiring process. We’re seeing payoff in terms of higher retention rates.

WATTS: All candidates are screened through HR first. They’re not routed to the hiring man-ager until they have a prescreened interview with the recruiter. We’re not only focused on the job for which they’re interviewing, but we’re also visiting with them and discussing organiza-tional culture and what it means to work for SCL Health. We call our recruiters ‘mission extend-ers.’ They’re the gateway to the organization to make sure that we’re hiring for fit.

HAMILTON: We do the same. The recruiters assess from a cultural angle, and then we work with the hiring managers who assess



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BRAMAN: We use the skills assessment and the process works rather well. The issue is getting the hiring managers to actually use it. We can tell when they don’t, so this has been a focus of mine for the past year. I share the turnover and success rates with the hiring managers so they can see how the process works. I point out the red flags so they can recognize them going forward.

CARPINO: We are instituting a new behavioral assessment for candidates to provide another tool, besides our 360 reference tool, to select candidates who are a fit for our culture. This resource will also provide hiring managers with additional tools to conduct effective behav-ioral event interviews.

MODERATOR: How do you help those hiring managers learn how to be on stage?

CARPINO: I agree that more training is needed. We should also observe hiring man-agers during the interview process so we can

with their team for actual fit. Everyone has a role. We’re moving to video interviewing, and the interviews become part of an introduction to the unit.

MODERATOR: What are you doing in your organization when it comes to hiring for culture?

HAMILTON: Behavioral-based interviewing is tried-and-true. It’s something that we need to do. In my opinion, the part that we don’t do enough is just sitting and having a conversa-tion with the person. I’ve always heard, ‘You need to ask these specific questions.’ But I feel that I can learn more about a candidate by just having a conversation.

JIM GRAHAM (HonorHealth): We’re about to roll out a new career website that really focuses on our culture. We want to provide applicants a true sense of what it’s like to work at our organization.

FEIN: We have a video of our CEO on our career site, as well as standards and behavioral expectations. We also conduct behavioral assessments. In the past, I’ve had nurses work in our simulation lab so that we can see how they respond in different scenarios. We’ve used this to aid in the hiring decision, but also developmentally afterward. If we hire an indi-vidual and there are some gaps, training in the simulation lab is helpful.

CAROL KUBELDIS (Providence Health & Services): We’re using a skills survey from a reference perspective and we’ve pushed that forward in the process. When somebody is scheduled for an interview, we collect the survey at that point, so that we have those insights before we make an offer in regard to fit. Our recruiter prescreens candidates on mis-sion and cultural fit, those kinds of pieces.

FAHY: We mostly conduct phone interviews to prescreen, because we cover a wide geog-raphy for placements. We also conduct a skills survey. If a candidate makes it past those initial steps, we conduct a full interview. We ask a lot of deep questions trying to learn about past behaviors and whether they are going to show up. In the staffing world, that’s huge.

We call our recruiters ‘mission extenders.’

They’re the gateway to the organization to make sure that we’re hiring for fit.

Nick Watts



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DUNN: We provide a registered nurse res-idency program that provides nurses an ongoing group to meet with from a co-worker perspective to make sure they’re getting the support and development they need through-out their first year of employment. For many of our new hires, this is their first job and it can be a shock. The residency program allows a new RN to connect with other nurses who are going through a similar experience.

FEIN: We’re focused on reducing the 90-day turnover. The week before the new hires start, we’ve asked our managers to call them to see if there are any questions they may have and to make sure they know where to go on Day 1. It’s a nice touch. We’ve expanded our orien-tation program so that we focus on organiza-tional priorities and look at the patient experi-ence and our culture.

We then focus on the 30-, 60- and 90-day check-in because a great deal of the turnover occurs in 90 days. Some of that has to do with what happens on the unit, so we’re focusing on the amount of time a manager spends with the new hire, and the monthly check-ins. The managers must have accountability as well. We conduct a new-hire survey at 60 days, and we do a new-hire breakfast with the CEO who speaks to the team of new employees about

provide feedback. We sometimes forget that it’s a candidate-driven world.

FAHY: Agreed. That will lead to less turnover.

MODERATOR: After you found your perfect candidate what happens next and how do you work to prevent turnover?

BOB LIVONIUS (GrapeTree Medical Staff-ing LLC): We really look at 90-day turnovers. It was pretty scary, so we’ve made some changes. We conduct stay interviews, where our talent acquisition specialists reach out to new hires at 30, 60 and 90 days. During the first 90 days, people are in their honeymoon period. The talent acquisition team owns the first 90 days of turnover. After that, it’s shared ownership through the first year.

CARPINO: Once on board, we focus on reten-tion. We have developed a retention tool kit for hiring managers. Recruiters stay connected, and in fact call any hire that does not complete 90 days to assess what they can learn from this to improve selection in the future. We are in the process of deploying a robust performance management and develop program and tools throughout all of our facilities.

J.P. FINGADO (HealthcareSource): It’s important to connect the individual with other parts of the organization, whether it’s having lunch with an executive or constantly reaching out and engaging them. We want to onboard them so they really feel a sense of ownership.

WATTS: We’ve had luck using robust talent management strategies that help us to under-stand who the candidates are, where they are in their career and where they want to go. We are looking for people who want to have careers with us. We’re looking at how we can bring them in and grow them within our organiza-tions. That’s been successful for us. And every year we get a little bit better. When you have 18,000 people who work for you, it becomes a complex project. Our leaders are now having those performance conversations; they are ask-ing employees where they want to go and what we can do to help them get to the next level. Or if they’re fine with their current position, how do we make sure that we capture that and continue engaging them in that role?

If we have buy-in from the C-suite, it helps with our employee participation.

Tracy Braman



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financially. It may actually be closing its doors and we are helping to fill staff until the end. We need to set realistic expectations for our temporary staff. It goes a long way. And then remind them that they are there to care for patients and to make sure that the patient experience is exceptional regardless of what is going on at the facility at that time.

CARPINO: Span of control has generally been large on nursing units within AHS hospitals. The system is moving toward adjusting span of con-trol to allow managers to engage and develop staff on a more personal level. Team members now have easy access to a manager and can receive frequent feedback and recognition.

PASTORE: During exit interviews, we often found that the role didn’t meet the new hire’s expectations. The job didn’t match what they were told during the interview process. That’s one of the biggest drivers of turnover. We are working with our leaders to be more effective in setting expectations up front.

HAMILTON: I agree with that. It’s making sure that you give realistic job previews in the inter-view. A lot of times, we want to sell ourselves and sell the organization, which we have to do, but then you don’t allow the candidates to

who we are as an organization, where we want to go, how important their feedback is and what will make the organization successful.

HANK DRUMMOND, R.N. (Cross Coun-try Healthcare Inc.): We’ve started holding regional summits where we invite staff to join us for a cocktail reception. It gives us the opportu-nity to ask them questions and we have a con-versation with them about their experiences. As a staffing agency, we’re in a unique position because we need to be responsive to both the health professionals that we place, as well as our client organizations. So, the next day, we do the same thing with the clients. We bring them in, have a discussion and then give feed-back from the health care professionals. We’ve brought in speakers to discuss quality and care delivery, so it’s a good program.

LIVONIUS: We’ve engaged our new hires through our new-employee orientation by giving them each a purple ribbon that they wear for the first 90 days. There’s no signifi-cance in the color; it just helps their co-work-ers know that they’re in the training and orientation period. They may not know where everything is, and that person does not always have to be the one to reach out.

BRAMAM: We are trying to connect with our new hires outside of work as well. If they are new to the area, are they connecting to the community? We have a LinkUp Lakeland Face-book page to help connect them to our area of southwest Michigan. The more we can get our new hires grounded in the community, they more likely they’re going to stay. It’s connection to their work and connection to the community.

PASTORE: In my perspective, especially having gone through the transition of bringing on another organization, the key element is transparency. We need our best effort to be transparent. It goes a long way. If you don’t know an answer, be honest about it. There’s nothing wrong with saying, ‘I don’t know. I’ll find out.’ I found that transparency went miles during this whole transition.

FAHY: I agree. It’s important on the staffing side, too. They may not always be going into the best situations. Maybe the hospital or nursing home they are going to is struggling

We are working with our leaders to be more effective in setting expectations up front.

Gary Pastore

CARPINO: Under our Creation Health princi-pals, AHS encourages and provides resources for team members to consistently practice the eight principles of CREATION Health – Choice, Rest, Environment, Activity, Trust, Interpersonal Relationships, Outlook, and Nutrition. By doing this, team members can prevent burnout and disengagement.

WATTS: We are looking at all of our hospitals and the staffing models and matrices that we’re using. Historically, we didn’t necessarily hire people for a specific shift. Everyone was hired to work a variety of shifts. For one schedule period, they may work days and for the next, they may work nights. That doesn’t necessarily fit with people’s lifestyles, so we are looking at how we change those paradigms and schedule in a way that makes the most sense.

KUBELDIS: We need to ensure that we make an investment in fun. We want people to bring their best selves to work, but fun can also hap-pen inside our doors. It doesn’t have to wait until after they leave work.

DUNN: One thing that we’re doing is invest-ing in our employees and their desire to give back to the local community. We have match-

ing programs where the company matches employee donations to various nonprofits. We have several programs in which employees can volunteer for a certain number of hours at a nonprofit and then we give the nonprofit a gift card. It encourages the concept of giving back to your community, and that seems to be having a big impact on our employees.



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FEIN: I think the other thing that came out of the new-hires survey that we have done over the last several months is knowing who to see about what or how you get things done in the organization. It tends to be something that new hires really need and it can disen-gage them if they don’t have this knowledge. Another thing we learned was that visibility of their next-level leader is important. New hires need to know the organizational structure and that leadership does round and welcome them to the organization.

actually find out what the job is really about. They get the job description, the printed version, but what does that really entail? And once we started doing that, even with our directors, our nurse practitioners, midlevels and physicians, they were able to say, ‘OK, you really did tell me this before I got here,’ and they had to agree to the elements of the job, that it’s hard work, and it’s going to take a lot out of you, but you committed to it so we committed to help you. I think that’s key to keeping them there.

We integrate peer interviewing, involving our

high-performing staff to help select new hires as a way of getting them into the culture

of the organization.

Joe Dunn

{ recruitment }

MODERATOR: What recruiting investments are you making to ensure that you have enough staff to prevent burnout and disengagement?


{ staffing }

level of education as every other full-time employee. They have to get the same creden-tials. And, as mentioned before, the agencies still have to receive Joint Commission certifi-cation. Even though the expense of agency costs is a concern to the hospital, I think what our agencies find is that hospitals will turn toward quality over expense in every situation.

LIVONIUS: There are studies that show that the average contingent labor nurse has about four to six years’ greater experience than the average nurse and they typically have more advanced degrees. Because professional liability is a big part of agency cost, agencies know they cannot risk hiring even one bad nurse. We do extensive checks to ensure that we only hire good nurses.


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MODERATOR: For the staffing executives, what types of partner-ships are you looking for with your health care provider clients?

{ leadership development }

MODERATOR: What investments are you making in learning and development or succession and leadership planning?

FINGADO: This year, we are launching a tuition-reimbursement program, which our staff has been requesting. We also have a mentoring program that connects rising leaders with somebody in a different group to foster professional development.

BRAMAN: Lakeland Health offers a Lead-ing Toward the Future Program, an intensive 18-month program for aspiring or current leaders within the organization. And we have one for clinicians that is held at night so it fits their schedule. We’ve seen success. Between 60 and 70 percent of individuals who partic-ipate in the program have advanced within the organization. We also have a leadership endowment fund that goes toward advanced degrees in areas where we may not need it now, but we know we’ll need it in the future.

FAHY: We take our Joint Commission certifica-tion just as seriously as our provider clients. When the Joint Commission visits, they look at all of our records and we want to make sure that they’re up to standard. We take that seriously because we want to make sure that we’re not compromising the facility that we are there to serve.

MICHAEL WEJROWSKI (Healthcare-Source): There is a common misperception that if you go to an agency you’re getting lesser quality individuals and that’s simply not true. The agency staff receive the same

DRUMMOND: Some of the feedback from our nurses is that they feel stuck in their career field. We partnered with a local nursing school to help nurses advance their careers. But it also helps us to meet the needs of the organi-zations that we serve.

DUNN: We are rolling out a charge nurse development program that includes both charge nurses, as well as nurses who aspire to be charge nurses. The curriculum helps to develop leadership skills. It’s important. We often hire nurses for competency but, in reality, they don’t have the necessary leadership skills to help them in their roles.

CARPINO: We have a robust succession plan at the executive level. We offer residencies and have both a chief nursing officer and a chief financial officer fellowship program to identify individuals who are ready for next-level leader-ship. We also have a new program called Talent-Care that gives managers the tools they need to create development plans for each individual employee to help reach their goals.



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MODERATOR: What is your biggest roadblock in workforce recruiting and engagement? What keeps you awake at night?

PASTORE: One roadblock that we success-fully overcame is hesitation among staff to report errors. We’ve placed emphasis on the Just Culture program and combined it with

{ solutions }

PANELISTS

Tracy BramanExecutive Director, Human ResourcesLakeland Health; St. Joseph, Mich.

Korinne CarpinoExecutive Director, Talent Management Adventist Health System; Orlando, Fla.

Hank Drummond, R.N.Chief Clinical OfficerCross Country Healthcare Inc.; Boca

Raton, Fla.

Joe DunnDirector, Assessments and EngagementHCA Healthcare; Nashville, Tenn.

Kathy FahyVice President of Sales and Marketing GrapeTree Medical Staffing LLC;

Milford, Iowa

Beverly FeinVice President of Human ResourcesHolyoke (Mass.) Medical Center

J.P. FingadoPresident and CEOHealthcareSource; Woburn, Mass.

Jim GrahamAssociate Vice President of Talent

Acquisition HonorHealth; Scottsdale, Ariz.

Chenise HamiltonVice President of Human ResourcesAccess Health Louisiana; New Orleans

Carol Kubeldis, R.N.Director of Talent AcquisitionProvidence Health & Services; Seattle

Bob LivoniusBoard MemberGrapeTree Medical Staffing LLC; Dallas

Gary PastoreDirector of Human Resources2017 ASHHRA President HonorHealth; Scottsdale, Ariz.

Michele TalkaChief Human Resources OfficerCentral Maine Healthcare; Lewiston

Nick WattsSystem Vice President, Talent &

Workforce OptimizationSCL Health; Denver

Michael WejkowskiVice President and General Manager,

Agency SolutionsHealthcareSource; Woburn, Mass.

MODERATOR Felicia BloomAccount ManagerAmerican Hospital Association; Chicago

what we call the Good Catch program. Every employee wears a special safety pin attached to his or her badge as a daily reminder that safety comes first. We view catches as learn-ing opportunities. If someone makes a good catch, he or she receives a ceramic baseball mitt with a baseball in it. Each month, we select the Catch of the Month and that individ-ual is honored in front of our leadership.


{ workforce planning }

KEY FINDINGS


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MODERATOR: How is your organization engaging in workforce planning and development, and who owns workforce planning?

CARPINO: Our organization has a three-year workforce plan for registered nurses. Now we’re looking at how we implement that at the individual facility level so that it’s meaningful to them and addresses their unique and particular needs, and we’re also looking at other professions that we talked about earlier today, such as medical technologist. But we need to do more planning around understanding how roles will change with population health management and the changes in the reimbursement system that are shift-ing care outside of our facilities. What new roles are going to develop from this? We think we have a good plan on the acute side, but we’re really looking at other shortage occupations and new occupations on the non-acute care side.

1 In light of current and looming workforce shortages, hospital and health system human resources executives continue to

focus on employee engagement to drive patient-centered care.

2 Implementation of talent management strategies, including leadership development and onboarding, leads to

reduced turnover and enhances productivity.

3Hospitals and health systems need to take a holistic view of their employees, understanding their interests and commit-

ments outside of work to provide work-life balance and develop a greater sense of community.

BRAMAN: We’re working on a state of the workforce report that is a collaborative effort among HR, physician services, Lakeland Uni-versity and our director of organizational effec-tiveness. We’re looking at all perspectives: turnover, generational issues, engagement, etc. The hard part, of course, is determining what we should do with the information once we complete the report.

MODERATOR: What are some things the hospital field should do to ensure an ade-quate workforce in the coming years?

PASTORE: First, we need to pay attention to our current staff and always re-recruit them. We lose sight of that sometimes.

CARPINO: I agree. And we have to remember that everyone in our organization serves as a recruiter. Every interaction they have with peo-ple in the community is with a potential future candidate. It’s a never-ending process. ●



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SPONSOR

HealthcareSource® is the only comprehensive talent management suite designed specifically to support the healthcare talent ecosystem. Our software, services, content, and analytics enable more than 3,500 healthcare organizations and staffing agencies to ensure quality patient care by recruiting, retaining, and developing quality talent — both employees and contingent staff. HealthcareSource has been recognized for their award-winning healthcare talent management solutions. For more information visit: www.healthcaresource.com

HealthcareSource’s Recruitment Optimization, Behavioral Assessments, Reference Checking and Performance Management have earned the exclusive endorsement of the American Hospital Association.

executive dialogue - healthcaresource · the new hire, and the monthly check-ins. the managers must...

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