Fundamentals of Human Resource Management 5th Edition by Raymond Noe, John Hollenbeck, Barry Gerhart, Patrick Wright

Exercise 19

Why Employees Are Loyal to Bon Secours Health System
Unemployment may persist in other industries, but even through the recent recession, hospitals have struggled to find and keep enough qualified medical professionals on their staffs. The need to provide care 24 hours a day, seven days a week intensifies the problem. Shortages of nurses and other health care workers have been a constant challenge. Therefore, any hospital's approach to talent management has to include ways to reduce employee turnover.
In Virginia, the Bon Secours Health System meets the challenge with flexible scheduling. The organization runs four hospitals, a separate emergency department, a health center, and a college of nursing. To staff all these facilities, Bon Secours is open to a variety of schedules. Employees may choose to work compressed workweeks of four 10-hour shifts or three 12-hour shifts. They have other choices as well: weekends only (at higher pay), four- or eight-hour shifts, and seven-day workweeks followed by seven-day breaks. Employees who want to work part-time may do so and receive full benefits if they work at least 16 hours a week. These part-time workers are especially important when managers are looking for extra help on busy days.
The scheduling options are popular. In a recent analysis, most Bon Secours employees chose one of these flexible work schedules, with one-fourth opting for temporary or part-time work. In addition, 10% of Bon Secours employees are in job-sharing arrangements, and 3% are engaged in telework.
The variety of schedules reflects management's recognition that employees have a variety of needs. Newly hired employees fresh out of college may welcome a fulltime schedule and be willing to rotate shifts. Employees with children want a schedule that is the same each week and corresponds to times when child care is available. The option of part-time status lets employees adjust their total work hours as family or other needs require. Without that option, some employees would likely quit when full-time work becomes too demanding.
Bon Secours tracks measures that show real benefits from flexible work arrangements. Surveys of employee engagement show that it has risen from 3.6 points out of 5 in 2005 to 4.55 in 2010. During the same period, employee turnover fell dramatically. At 10% per year, turnover among first-year employees is far below the median for hospitals (28.3%). The cost of hiring and training a nurse is estimated to be three times the nurse's annual salary. At that rate, reducing turnover has a real impact on a hospital's financial performance.
Another way Bon Secours retains employees is by offering a comprehensive set of benefits. After financial meltdown of 2008, many workers were devastated by the plummeting value of their homes, followed by tight lending standards that shrank the options of people looking for a way out of the mess. Bon Secours responded by offering financial assistance. It set up financial education programs, seminars to help out unemployed family members, an option to receive cash in exchange for working instead of taking time off, and a crisis fund to help out employees experiencing financial difficulties. Other benefits that help Bon Secours employees make ends meet during lean times include college tuition assistance (for employees and family members) and discounts arranged with local businesses.
Employee turnover is not the only area in which job design is linked to the organization's performance. Bon Secours participates in the Hospital Quality Incentive Demonstration Project, run by the federal government's Centers for Medicare and Medicaid Services as part of a drive to slow rising costs of health care and improve health care outcomes. The project has identified best practices associated with superior results, and it pays a financial award to participating institutions that can demonstrate they have followed these best practices.
Participating in the program means that designated employees monitor the care given to groups of patients, to make sure practices follow established guidelines. For example, when patients undergo knee or hip replacement surgery, a program coordinator visits them to verify that each has received a set of treatments to prevent blood clots. The hospital also set up measures to ensure that these patients stop receiving antibiotics within 24 hours after the surgery to prevent resistance to the drugs. Such measures are a change from days when hospitals left it up to doctors to ensure that the proper care was delivered to each patient. The more structured approach is associated with lower rates of complications, readmissions, and deaths.
How does Bon Secours address the mental demands of providing quality patient care?