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Putting People Before Profits Keeps the Team Together
Deborah Saylor
Publish Date: October 10, 2007   |  Tags:   Staffing

Deborah Saylor, MS, RN, ARNP The outpatient surgery unit at Holy Cross Hospital in Fort Lauderdale, Fla., hasn't had a vacancy in more than a year. And we have a waiting list of nurses standing by to join our staff. We've done this, and you can, too, by following these seven practices of successful organizations.

1. Extensive sharing of financial and other information
Only fully informed associates (we call all staffers associates) can help us achieve our targets. We employ such typical methods of sharing information as open forums and staff meetings. But there's more. Our internal communications department produces a daily, facility-wide newsletter, the Associates' Press, that shares patient-satisfaction scores, case volumes and financial performance, and activities and events that increase staff spirit. Several nurses from the outpatient surgery unit also serve on nursing shared-governance councils, another means of gaining insight and information. The members of each of our five governance councils (nursing leadership, nursing practice, quality, nursing research and an executive council) make facility-wide decisions in their respective areas.

2. Decentralization of decision-making, self-managed teams
The best person to solve a problem is the one closest to it, not a manager or administrator who is sitting in an office and is too far removed from the issue to fully understand it. On the outpatient surgery unit, the staff determines workflow and assignments. They create documentation forms and they convene as necessary with other departments to address pertinent issues. Nurses also serve on a hospital-wide council called the Employer of Choice Task Force. This group meets monthly to identify solutions to hospital-wide human resources-related issues and to provide feedback and input on policy revisions and development.

3. Comparatively high compensation, based on organizational performance
If your company is prospering, the staff is responsible for that prosperity - and thus should be rewarded with compensation commensurate to the success. For us, this isn't just about meeting or exceeding financial goals, but about patient satisfaction and quality-improvement efforts as well. Efficiency is a major factor in outpatient surgery, so measures are in place to monitor efficiency and reward it accordingly.

We don't have a profit-sharing system because we're a not-for-profit organization; rather, it's called gain-sharing. Each year, we set budget and patient-satisfaction targets. If we meet or exceed those targets, the hospital pays a gain-sharing bonus; the amount goes up or down, depending on how we do as an organization, so all employees have a vested interest in helping us exceed our targets. Last year, associates earned one week's pay in their gain-sharing checks.

4. Job security
If an employee feels her employer is not committed to sticking it out through tough times, she's less likely to be committed to the organization's long-term success. This is all about layoffs. Probably the single-most destructive act an employer can take during a period of downturn is to lay workers off. The effects of a layoff last for years - and those left behind often find themselves perusing the Sunday classifieds. During tough economic times, we managed to avoid layoffs by getting creative, reassigning staff and offering training and cross-training.

5. Extensive commitment to education and training
Allocating resources for education and training, a difficult employer commitment, breeds the most associate loyalty and commitment to success. No one at Holy Cross has to pay to get contact hours for licensure. We offer free online CEUs, so employees can get their contact hours in their spare time from home. As an extra incentive, our clinical advancement ladder pays up to $6.50 an hour more as you move up from a level 1 to a level 4. Staff who feel that their employer is committed to their personal growth are more likely to remain with the organization.

6. Reducing status differences
We treat everyone equally - staffers have different, but no less or more important jobs. In the nursing division, shared decision-making occurs through the shared governance councils, which grants staff a voice that carries the same weight as management's in important decisions.

7. Selective hiring
An important yet often-overlooked aspect of creating a win-win workplace is hiring the right people in the first place. We conduct routine screening procedures and competency assessments in the pre-hire human resources department, and our managers are all trained in interviewing techniques. We also include peers in the interview process for all positions.

In outpatient surgery, we even include peer interviewing for our per diem positions. Peer interviews serve two primary purposes. First, they let staff determine whether the prospective co-worker is a fit for the team and its dynamics. Second, peers who give an applicant the thumbs-up after a peer interview are more likely to welcome the new employee and actively help to assure the new employee's success.

We also involve peers in the 90-day probationary evaluation of new associates. That way, the new associate gets timely feedback on performance that includes aspects of teamwork critical to the long-term success of an employee.

Of course, now that we have a waiting list of applicants for our outpatient surgery unit, there haven't been many interviews or probationary evaluations for this team.