Patient Flow E-Newsletter
Volume 4, Issue 3
July/August 2007
Special Focus Issue-Employee & Patient Satisfaction Affects Patient Flow

Perspectives
Employee Satisfaction: Key to Driving Performance Excellence

In today's health care market, American hospitals are faced with intense competition, declining reimbursements, and workforce shortages. Healthcare consumers choose hospitals where they believe they will receive the very best care and service. Employees also have choices on where to work, and increasingly choose to work in organizations that create an environment where caregivers feel valued for the work they do, have the tools and equipment to do their jobs, and have a positive relationship with their supervisor. Many of our healthcare employees leave us because the barriers to doing their jobs seemed insurmountable and eventually erode their sense of doing purposeful, worthwhile work. Retaining high performing talent in today's healthcare environment is crucial to an organization's ability to effectively compete, provide the highest quality and safest care, gain system efficiencies, and achieve bottom line results.

After serving as a COO of Robert Wood Johnson University Hospital Hamilton (RWJ Hamilton) in central N.J., I experienced first hand the powerful combination of the 3 P's- people, passion and process. Passionate leaders are relentless in their commitment to excellence. High employee retention is key to performance excellence and a continuous focus on process and systems improvement removes barriers to efficiency and effectiveness. By retaining more staff, organizations will reduce overtime and use of temporary staff. With lower turnover, the cost to bring new employees on board is reduced (advertising, physicals, orientation costs). And that's only the beginning- length of stay in the inpatient and emergency department settings will go down because seasoned employees will move a patient through the system more efficiently. A retained staff understands the organization's processes and procedures - thus fewer medical errors and better clinical outcomes will result.

For hospitals trying to improve the delivery and quality of their care, I believe that employee satisfaction is a critical consideration in the quest for excellence. I find that most people who choose to work in healthcare see it as a calling versus a job and are among the most dedicated professionals. This is particularly true for emergency department (ED) staff that deals with both patients with minor illnesses and injuries, to patients with life -threatening emergencies, many of whom judge our hospitals based on their emergency department experience. As process-driven environments, EDs rely heavily on the human capital of veteran employees. If the staff feel the barriers to delivering high quality care are too many they may no longer feel their work is worthwhile.

Some of the best quality improvements that I've seen are generated by teams of employees committed to making a difference in patient service and outcomes. Front line employees have a unique perspective and are able to identify effective solutions to everyday challenges. For example, at RWJ Hamilton a team of ED nurses and physicians worked with Radiology and Laboratory Services to identify system efficiencies and improved patient flow. Front line employees also served as active members of the team who ultimately redesigned a new ED. Clearly, staff and leader involvement in performance improvement are a winning combination.

My experience as a StuderGroup Coach and a Malcolm Baldrige Award Examiner shows that one approach to performance excellence is using a balanced framework such as the Baldrige Criteria that I now use to coach hospitals in their improvement journey. Using the Baldrige Criteria at RWJ Hamilton helped us as leaders to focus, align and accelerate our performance improvement efforts. Our Baldrige journey was one of the most exhilarating experiences I had as a healthcare leader.

Achieving employee satisfaction and retention is not a simple or short-term goal. It takes significant attention and effort from hospital leadership, and a commitment to invest in processes designed to promote employee satisfaction- such as rounding for outcomes, employee recognition, peer- interviewing, and behavioral based hiring. I believe that when the postscript on hospital care in the early 21st century is written, improving the satisfaction of employees will be recognized as the necessary first step toward enjoying clinical success and patient satisfaction. And- sooner or later, each of our hospitals - and each of us, to an extent - will likely be paid in direct proportion to how effectively we provide health care in an evidence-based, consumer-driven marketplace. Ultimately, the systems that recognize employee satisfaction as the cornerstone of their improvement plans will also be the ones that lead the health care pack.

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Debbie Cardello, RN, MSN
Coach
StuderGroup