By Chuck Lauer, Healthcare Policy Expert
Healthcare workers are in crisis today, and it's up to managers in the healthcare industry to come to their rescue. Everyone from the CEO to frontline managers should be getting out of their offices and mixing with employees. Only in this way can you truly grasp the level of morale in your institution and start trying to fix it. Your presence can provide an extra spark of inspiration, which is sorely needed these days.
There is a crisis in morale within healthcare today, according to Joe Tye, the CEO of Values Coach Inc., which provides life and leadership skills for hospital, corporate and association clients. While everyone talks about the external healthcare crisis, which has to do with cost, access and quality, Tye sees an internal healthcare crisis, which involves employee disengagement, bullying and employee-on-employee violence.
Tye was bowled over by the results of a Values Coach survey of more than 6,000 people at 15 different hospitals and healthcare professional associations. Almost 60% could not agree with the statement: "Our people reflect positive attitudes, treat others with respect, and refrain from complaining, gossiping, or pointing fingers."
He calls this "toxic emotional negativity," which is "the emotional and spiritual equivalent of cigarette smoke in the workplace – it is malignant, contagious, and highly destructive."
This corrosive atmosphere can quickly eat into your workforce. In a survey reported by American Nurse Today in 2012, about 60% of new RNs who had been bullied had quit their first job within the next six months, and one in three new graduate nurses considers quitting nursing altogether because of "abusive or humiliating encounters."
How can managers turn the situation around? I'd like you to try "management by wandering around." The concept comes from Bill Hewlett and Dave Packard, the founders of Hewlett-Packard, which they developed when they started the company eight decades ago. They did a lot of wandering past employees' desks – but it was "wandering" with a purpose. As they walked past, they were asking employees about their work and their lives. And then they'd listen – really listen – to what employees had to say. The result? Employees felt they were valued, and Messrs. Hewlett and Packard learned a thing or two about what they needed to do to improve their company.
Getting out of your office and meeting with the troops goes back to Abraham Lincoln in the Civil War. He would leave the White House and trek to the front lines for some impromptu meetings with soldiers. In an old photograph, the presidential visitor sits in the shade of a Union Army tent, with his stovepipe hat next to him, chatting with his chief general at the time.
Fast-forward to today, when millions of people tune into reality television to watch CEOs taking jobs within their own companies. In "Undercover Boss," now in its sixth season, distinguished leaders of the c-suite take jobs in disguise. As ordinary workers, they find out all sorts of things about the work environment. A university president and the mayor of Pittsburgh have been featured, though no healthcare executives so far.
However, many healthcare CEOs not in disguise are "managing by wandering round." One of them is Chris Van Gorder, the CEO of Scripps Health in San Diego. In his new book, "The Front-Line Leader: Building a High-Performance Organization from the Ground Up," he recalls that when he was working as a hospital security guard decades ago, he learned the importance of reaching out to your employees – through a negative example.
Back then, he was in the basement of the hospital late at night, when suddenly the CEO appeared before him. "He walked right by," Van Gorder recalled in an interview with Becker's Hospital Review last year. "I didn't think it was going to be a long conversation, but I thought at least he'd acknowledge me or shake my hand."
Now, when Van Gorder walks the hospital halls, he makes a point of having meaningful conversations. He looks employees straight in the eye and asks questions like, "What do you like?," "What don’t you like?" and "Do you like working at this hospital?"
If you're interested in wandering around your institution – or simply holding planned meetings with employees – I've put together some tips on how you might go about it:
Be personal. Talk to people individually, whether they be physicians, nurses, housekeepers or even patients. Patients can tell you a lot about employee morale and whether the organization is functioning properly. Choose the people you want to speak with, rather than having your people chose them. A Potemkin Village assembled for you isn't going to help you get a true glimpse of the environment in your organization.
Meet in groups, too. In addition to one-on-one meetings, meet with groups of nurses and ask them how they feel about their jobs and their hours and their supervisors. Answer questions as openly an honestly as you can. This will go a long way toward building trust.
Try visiting on off-hours. You might want to occasionally visit your hospital late at night so that you can see firsthand how it functions then. Try to get around to as many different parts of your operations as possible. Don't go back to the same places every time.
Treat people with respect. If you show them you care, they will respond more readily to your questions. A conversation over breakfast and over a cup of coffee is a good way to get confidential. Keep eye contact at all times. Don’t be clever and try to smile your way through the interviews, so that you don’t offend anyone! You won’t learn anything meaningful that way.
Have a real conversation. Ask everyone how they see the mission of the hospital. One question to always ask is whether people feel comfortable about their jobs. Is it getting too difficult? Are the hours getting too long? Do people see how they fit into the big picture?
Look professional. Formal clothing shows respect, even if everyone around you is dressed more casually. Always present yourself as a person willing to listen. Be open and sincere, keep your comments brief and don’t interrupt.
Give your undivided attention. Don’t sit there and take notes, because people will think every word will go into their personnel file. Turn it into a personal discussion about work, and keep an open mind. Remember, listening is the most powerful tool we have. Use it liberally!
Follow up on your conversations. If you couldn’t answer an employee's question, get back to them later. Send everyone you’ve talked to a handwritten note telling them how much you appreciated the time they took to talk to you.
Review what everyone said. Pull your management team together and go over the interviews you had. Tell them everything you learned – the good, the bad and the surprising. Some suggested changes in the organization may seem warranted, while others might not be necessary.
If you do all these things, the morale in your institution will rise and it will move on to greater things. It all starts with taking the time to listen.